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NRHA Agenda

10-24-2016

Posted: 10/21/2016

NORMAN REGIONAL HOSPITAL AUTHORITY
October 24, 2016
5:30 p.m.
901 N. Porter
2nd Floor Board Room

A G E N D A

I. Call to Order ... Mr. Clote

II. Introduction and Recognition of Outstanding Employee ... Mr. Clote

A. November 2016 Employee of the Month, Robert Lytle, Registration Coordinator, Moore Registration – Darvin Hall, Manager Patient Access

III. Approval of the September 26, 2016 Board Meeting Minutes ... Mr. Clote (Pgs.5-16)

ACTION NEEDED: Approve or Amend Minutes as Circulated

ACTION TAKEN: ___________________________________

IV. Performance Updates ... Dr. Smith (Pgs. 17-30)

ACTION NEEDED: None, Information Item Only

V. Approval of the September 2016, Norman Regional Health System Financial Statements ... Mr. Hopkins (Pgs.31-80)

ACTION NEEDED: Approve or Disapprove September 2016 NRHS Financial Statements

ACTION TAKEN: ____________________________________

VI. Medical Staff ... Dr. Williams

A. Report from the October 12, 2016 Medical Executive Committee

ACTION NEEDED: None, Information Only

B. Recommend Approval of the Revised “Physical and Mental Health Assessment Practitioners Age 70 and Over” Policy ... (Pg. 81)

ACTION NEEDED: Approve or Disapprove the Revised “Physical and Mental Health Assessment Practitioners Age 70 and Over” Policy as Recommended by the Credentials and Medical Executive Committees

ACTION TAKEN: ____________________________________

C. Recommend Approval of the Revised “Endoscopy–Pulmonary Privilege Form (Pg. 82)

ACTION NEEDED: Approve or Disapprove the Revised Endoscopy-Pulmonary Privilege Form as Recommended by the Credentials and Medical Executive Committees

ACTION TAKEN: ____________________________________

D. Recommend Approval of the Revised Sedation/Analgesia for Non-Anesthesiologist Physicians Privilege Form ... (Pgs.83-84)

ACTION NEEDED: Approve or Disapprove the Revised Sedation/Analgesia for Non-Anesthesiologist Physicians Privilege Form as Recommended by the Credentials and Medical Executive Committees

ACTION TAKEN: ____________________________________

E. Recommend Approval of the New NRHS Request for Cardiothoracic Surgery Robotic Privileges ... (Pgs. 85-87)

ACTION NEEDED: Approve or Disapprove the New NRHS Request for Cardiothoracic Surgery Robotic Privileges Form as Recommended by the Credentials and Medical Executive Committees

ACTION TAKEN: ____________________________________

VII. Patient Quality & Safety Committee ... Dr. Anderson

A. Report from the October 3, 2016 Patient Quality & Safety Committee

ACTION NEEDED: None, Information Item Only

VIII. Finance Committee ... Mr. Cubberley

A. Report from the September 19, 2016, Finance Committee

ACTION NEEDED: None, Information Item Only

IX. Old Business ... Mr. Clote & Mr. Splitt

X. New Business ... Mr. Clote & Mr. Splitt

Recommend Approval of the Revised FY2017 Utilization Review Plan ... (Pgs. 88-101)

ACTION NEEDED: Approve or Disapprove the Revised FY2017 Utilization Review Plan as Recommended by the Medical Executive Committee

ACTION TAKEN: _____________________________________

XI. Administrative Report ... Mr. Splitt

ACTION NEEDED: None, Information Item Only

XII. Proposed Executive Session.

A. Proposed Vote to Convene an Executive Session Pursuant to 25 Okla. Stat. § 307.B.4 to Discuss with Legal Counsel Pending Internal Peer Review/Credentialing Investigation Regarding the Medical Staff Members/Applicants Listed Below and Discussion Regarding the CEO Position Pursuant to 25 Okla. Stat. Section 307.B. and Discussion Regarding the CEO Position Pursuant to 25 Okla. Stat. Section 307.B.

ACTION NEEDED: Move to Convene into Executive Session to Discuss with Legal Counsel the Above Referenced Medical Staff Items

ACTION TAKEN: ____________________________________

B. Medical Staff Recommendations Regarding the Medical Staff Members/Applicants as Listed in XIII.B 1-4 Below.

1. Recommend New Provisional Medical Staff Appointments:
a) Cynthia DiMauro, MD, Active Staff – Medicine Department
b) Diana Whiteman, MD, Active Staff – Medicine Department
c) Monica Williams, APRN-CNP, Allied Health Staff – Medicine Dept.

2. Recommend Advancement of Medical Staff from Provisional Status:
a) Justin Fields, MD, Active Staff – Pediatrics Department
b) David Miller, DDS, Active Staff – Surgery Department
c) Cynthia West, DO, Active Staff – Pediatrics Department
d) Shawn Musgrave, APRN-CNP, Allied Health Staff – Emergency Med. Dept.

3. Recommend Medical Staff Reappointments:
a) Mark Camp, MD, Active Staff – Medicine Department
b) Muhammad Ishaq, MD, Active Staff – Behavioral Medicine Department
c) Roy Mullins, III, MD, Active Staff – Medicine Department
d) Leslie Ollar-Shoemake, DO, Active Staff – OB/Gyn Department
e) Mehran Shahsavari, MD, Active Staff – Hospital Medicine Department
f) Tadgy Stacy, MD, Active Staff – Pediatrics Department
g) Kristin Thorp, MD, Active Staff – Medicine Department
h) Amanda Wright, MD, Active-Affiliate Staff – Medicine Department
i) Storm Eagle, APRN-CNP, Allied Health Staff – Medicine Department
j) Laura Velez, APRN-CNS, Allied Health Staff – Cardiovascular Med. Dept.
k) Sanober Malik, MD, Consulting Staff – Medicine Department
l) Charles Mirabile, MD, Consulting Staff – OB/Gyn Department
m) Mohammad Razaq, MD, Consulting Staff – Medicine Department
n) John Stanley, III, MD, Consulting Staff – OB/Gyn Department
o) Lorry Krous, MD, Courtesy Staff – Pediatrics Department

4. Recommend Additional Clinical Privileges Steven Carter, MD is requesting analgesia/sedation privileges. He has successfully completed the education requisites and has met the privileging requirements.

C. Request to Adjourn Out of Any Such Executive Session and Return to Regular Session

ACTION NEEDED: Approve or Disapprove Adjournment of Any Executive Session and Return to Regular Session

ACTION TAKEN: ____________________________________

D. Proposed Vote to Approve or Disapprove the Medical Executive Committee Recommendations Regarding Credentialing of the Referenced Medical Staff Members [As Listed in XII B 1-4]

ACTION NEEDED: Approve or Disapprove the Medical Executive Committee Recommendations Regarding Credentialing of the Referenced Medical Staff Members [As Listed in XII B 1-4]

ACTION TAKEN: _______________________________________

XIII. Board Open Discussion

XIV. Closing Comments

XV. Adjourn

ACTION NEEDED: Motion to Adjourn the Meeting

ACTION TAKEN: _______________________________________.

MISSION: Norman Regional Health System will serve our community as a leader in health and wellness care.

VISION: Norman Regional Health System will be the provider of choice to improve the health and well-being of our regional communities.

2016-2017 Strategy Statement: Norman Regional Health System will provide leadership through the development of action steps to achieve and be recognized as the health system of choice for patients, physicians, and employees; the healthiest regional community; and the health system with the best facilities and quality outcomes.