Atch 2a OPPE.docx

ROBERT J. DOLE VA MEDICAL CENTER

ONGOING PROFESSIONAL PRACTICE EVALUATION (OPPE)

OPPE Review Cycle (DATES): From: To:

Physician Confirmation of Receipt of OPPE at Initiation:

Practitioner: Physician Name, MD.

FTEE: Contractor or Employee

Service: Medicine Service

Specialty/Subspecialty:

Nephrology

Location: (Please Check All that Apply) |_| Hospital Inpatient |_| Hospital Outpatient |_| Emergency department

|_| CBOC

|_| CLC

|_| Telemedicine

ATTACH MEDICAL RECORDS REVIEWS/SUMMARY FORM, SUPPORTING DATA, PEER SURVEY/FEEDBACK/REFERENCE, PATIENT SURVEY DATA, VETERANS EXPERIENCE OFFICE REPORT, AND COMMENTS SUPPORTING THE RATING OF EACH COMPETENCY

Performance Activity (6 months):

Encounters: ____ (Benchmark: ____) RVUs: _____ (Benchmark: ____) Attachments:

· Record Review Forms/Summary (# Chart Reviews: _______)

· Additional Data (Service Specific)

SIX GENERAL COMPETENCIES:

1. Patient Care: Practitioners are expected to provide patient care that is compassionate, appropriate, and effective for the promotion of health, prevention of illness, treatment of disease and care at the end of life.

· Adequate documentation of chief complaint

· Adequate documentation of review of systems

· Pertinent personal medical hx, social/psychosocial hx, and/or family medical hx documented

· Evidence of review of allergies/drug sensitivities

· Evidence showing review of VA-prescribed and non-VA prescribed medications, OTC Medications, herbs, and supplements

· Adequate documentation of vitals and physical exam as pertinent to chief complaint and history of present illness

· Results of available diagnostic studies (e.g. labs, radiographs, microbiology, pathology) documented and managed

· Assessment(s)/finding(s)/impression(s) clearly documented

· Assessment addressed chief complaint and history of present illness

Additional Nephrology Specific Competency:

· ACE-I/ARB prescribed to patient with HTN and proteinuria OR documentation of Contraindication

· Epo prescribed for hgb less than 9.0 mg/dl OR contraindication documented

· Documentation of dialysis modalities and/or referral for AVF for GFR less than 20 ml/min

· Labs to include Calcium, Phosphorus, iPTH, and lipid profile obtained at least once for CKD stage 4 and 5

ATTACH MEDICAL RECORDS REVIEWS/SUMMARY FORM, SUPPORTING DATA AND COMMENTS SUPPORTING COMPETENCY:

Competency Rating

Satisfactory Performance Needs Improvement Unsatisfactory Performance

Comments regarding less than satisfactory performance must include feedback provided for improvement and timeframe for next evaluation.

Comments: ______________________________________________________________________________

2. Medical/Clinical Knowledge: Practitioners are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care and the education of others.

· Clinical management is consistent with best practices/guidelines

· Clinical practice is within scope

· Maintain Board Certification

· Maintain CME credits as per medical license requirement

ATTACH MEDICAL RECORDS REVIEW DATA:

Competency Rating

Satisfactory Performance Needs Improvement Unsatisfactory Performance

Comments regarding less than satisfactory performance must include feedback provided for improvement and timeframe for next evaluation.

Comments: ______________________________________________________________________________

3. Practice-Based Learning and Improvement: Practice based learning and improvement requires practitioners to evaluate and learn from their care of patients, appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning.

· Participates in performance improvement teams

· Analyzes his/her own practice to make improvements

· Overall orders (medication changes, consults, test, etc.) consistent with plan of care clearly documented

· Follow-up plan (e.g. disposition, discharge, handoff, return to clinic (RTC) appropriate for the patients’ condition.

· Education/Counseling regarding care provided to patient and/or family

ATTACH MEDICAL RECORDS REVIEW AND SUPPORTING DATA:

Competency Rating

Satisfactory Performance Needs Improvement Unsatisfactory Performance

Comments regarding less than satisfactory performance must include feedback provided for improvement and timeframe for next evaluation.

Comments: ______________________________________________________________________________

4. Interpersonal and Communication Skills: Practitioners are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams. Demonstrates interpersonal and communication skills that result in effective information exchange and collaboration with patients, their families, and health professionals.

· Read and respond appropriately to emails/phone calls

· Responds to Critical Test Results

· Consultations timely/appropriate

· Follows Clinic Cancellation Policy

ATTACH RECORDS REVIEW DATA, PEER SURVEY/FEEDBACK/REFERENCE, PATIENT SURVEY DATA, VETERANS EXPERIENCE OFFICE REPORT.

Competency Rating

Satisfactory Performance Needs Improvement Unsatisfactory Performance

Comments regarding less than satisfactory performance must include feedback provided for improvement and timeframe for next evaluation.

Comments: ______________________________________________________________________________

5. Professionalism: Practitioners are expected to demonstrate behaviors that reflect a commitment to carrying out professional responsibilities, ethical practice, an understanding and sensitivity to diversity, and a responsible attitude toward their patients, their profession, and society.

· Compliances with VHA/Medical Center Policies and Medicine Service Standard Operating Procedures (SOP)

· Accommodates the patient (works with patient who shows up early or arrive late)

· Has zero validated patient complaints

· Participates in teaching activities of Students/Residents

ATTACH RECORDS REVIEW DATA, PEER SURVEY/FEEDBACK/REFERENCE, PATIENT SURVEY DATA, VETERANS EXPERIENCE OFFICE REPORT.

Competency Rating

Satisfactory Performance Needs Improvement Unsatisfactory Performance

Comments regarding less than satisfactory performance must include feedback provided for improvement and timeframe for next evaluation.

Comments: ______________________________________________________________________________

6. Systems-Based Practice: Practitioners are expected to demonstrate an awareness of, and responsiveness to, the larger context and system of healthcare and the ability to call on system resources in the provision of care of optimal value.

· Participates in Medicine Service Performance Improvement Initiatives

· Optimize productivity and quality metrics

· Authenticated date, time, provider signature was within 24 hours of encounter

· Pertinent diagnoses for patient encounter with correct ICD-10 diagnoses

· No unnecessary diagnostic results copied verbatim

ATTACH MEDICAL RECORDS REVIEW DATA:

Competency Rating

Satisfactory Performance Needs Improvement Unsatisfactory Performance

Comments regarding less than satisfactory performance must include feedback provided for improvement and timeframe for next evaluation.

Comments: ______________________________________________________________________________

|_| Practitioner has full privileges and is in good standing. OPPE documentation reveals competence.

|_| Low volume of care provided. Recommend extending observation and/or obtaining OPPE data from primary practice.

Dr. (enter Physician Name) – verbiage as applicable

|_| OPPE identified the concern(s):

Based on my review of the OPPE and supporting data including the Medical Record Reviews, I recommend privileges be:

|_| Continued; |_| Limited; |_| Evaluated again on:______; |_| Formally Reviewed Now

Rater of OPPE Competencies:

OPPE Completed, Discussed with Provider and Copy Provided: