DAFORMFILLABLE.COM | DA FORM 5441-9 Fillable – Army Pubs 5441-9 PDF – DA FORM 5441-9, titled “Evaluation Of Clinical Privileges-Podiatry,” is a crucial document used within the military medical system to assess the clinical privileges of podiatrists. This form, which was published on February 1, 2004, by the TSG (The Surgeon General), remains active and is utilized under the prescribing directive AR 40-68. The evaluation process facilitated by this form ensures that podiatric professionals are adequately qualified to perform specific clinical tasks within the military healthcare setting.
DA FORM 5441-9 – Evaluation Of Clinical Privileges-Podiatry
| Form Number | DA Form 5441-9 |
| Form Title | Evaluation Of Clinical Privileges-Podiatry |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Purpose and Importance of DA FORM 5441-9
The primary purpose of DA FORM 5441-9 is to evaluate the clinical competencies of podiatrists. This evaluation helps maintain high standards of medical care by ensuring that only those with verified skills and knowledge are granted clinical privileges. The form requires detailed information on the podiatrist’s abilities, ensuring that they meet the necessary standards to provide quality healthcare services to military personnel.
Structure and Key Components of DA FORM 5441-9
Sections of the Form
DA FORM 5441-9 is structured to capture comprehensive information about a podiatrist’s clinical privileges. It includes several key sections:
- Personal Information: This section collects the basic details of the podiatrist, including their name, rank, and contact information.
- Clinical Privileges Requested: Here, the specific clinical procedures and privileges being requested by the podiatrist are listed.
- Evaluation of Competencies: This crucial section is where the podiatrist’s competencies in various clinical procedures are evaluated. It involves detailed assessments and may include feedback from supervisors or other medical professionals.
- Recommendations and Approvals: The final section includes recommendations from evaluators and the approval status from the appropriate authority within the military medical system.
Privacy and Security Considerations
One of the footnotes associated with DA FORM 5441-9 indicates that it requires a Privacy Act Statement (AR 340-21). This means that all personal and evaluative information collected on this form is protected under the Privacy Act, ensuring that sensitive data is handled with the utmost confidentiality. Additionally, the form is produced only in electronic media, aligning with modern data management practices.
Utilizing DA FORM 5441-9 in Professional Practice
Submission and Approval Process
The process of submitting and getting approval for DA FORM 5441-9 involves several steps:
- Completion by Podiatrist: The podiatrist requesting clinical privileges must accurately fill out the form, providing all required information about their competencies and the specific privileges they seek.
- Evaluation: The completed form is then reviewed by a supervising medical officer or a committee who evaluates the podiatrist’s skills and qualifications.
- Recommendations: Based on the evaluation, recommendations are made regarding the granting of clinical privileges. These recommendations are documented on the form.
- Final Approval: The form, along with the recommendations, is sent to the appropriate authority for final approval. This ensures that only qualified podiatrists receive the privileges they request.
Importance for Quality Assurance
Using DA FORM 5441-9 for evaluating clinical privileges is essential for maintaining quality assurance within the military healthcare system. By systematically assessing each podiatrist’s competencies, the military ensures that all healthcare providers meet the necessary standards to deliver safe and effective care to service members.
Conclusion
DA FORM 5441-9 – Evaluation Of Clinical Privileges-Podiatry plays a vital role in the military medical system. By ensuring that podiatrists are thoroughly evaluated before being granted clinical privileges, this form helps maintain high standards of medical care. The structured evaluation process, combined with strict privacy and security measures, underscores the form’s importance in safeguarding the quality of healthcare provided to military personnel. For those involved in the military medical field, understanding and correctly utilizing DA FORM 5441-9 is crucial for both professional practice and patient safety.
DA FORM 5441-9 Fillable – Army Pubs 5441-9 PDF DOWNLOAD
