DAFORMFILLABLE.COM | DA FORM 5440-8 Fillable – Army Pubs 5440-8 PDF – DA FORM 5440-8 – Delineation Of Clinical Privileges-Pediatrics is an essential document used within the Department of the Army to specify and authorize the clinical privileges for pediatric healthcare providers. The form, published on February 1, 2004, is vital for ensuring that pediatricians working under the Department of the Army are appropriately credentialed and have the necessary privileges to perform their duties. This article aims to provide a comprehensive overview of DA FORM 5440-8, highlighting its importance, structure, and the key aspects related to its use.
DA FORM 5440-8 – Delineation Of Clinical Privileges-Pediatrics
| Form Number | DA Form 5440-8 |
| Form Title | Delineation Of Clinical Privileges-Pediatrics |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5440-8
Purpose and Importance
The primary purpose of DA FORM 5440-8 is to outline and delineate the clinical privileges granted to pediatric healthcare providers. This delineation ensures that only qualified and credentialed professionals are allowed to provide specific pediatric care, enhancing the quality of care and patient safety.
Key Information
- Pub/Form Number: DA FORM 5440-8
- Pub/Form Date: 02/01/2004
- Pub/Form Title: Delineation Of Clinical Privileges-Pediatrics
- Pub/Form Proponent: TSG (The Surgeon General)
- Pub/Form Status: ACTIVE
- Prescribed Forms/Prescribing Directive: AR 40-68
- Security Classification: UNCLASSIFIED
- Distribution Restriction Code: A (Approved for public release; distribution is unlimited)
- Pub/Form IDN: 990001
- Pub/Form PIN: 066523
Structure and Content of DA FORM 5440-8
Sections of the Form
DA FORM 5440-8 is divided into several sections, each designed to capture specific information about the healthcare provider and their clinical privileges. These sections include:
- Personal Information: This section captures the basic details of the pediatric healthcare provider, including their name, rank, and contact information.
- Professional Qualifications: Details about the provider’s medical education, certifications, and professional experience in pediatrics are recorded here.
- Clinical Privileges: This is the core section of the form, where the specific clinical privileges granted to the provider are listed. It includes various pediatric procedures and treatments that the provider is authorized to perform.
- Approval and Signature: This section is for the approving authority to sign and date the form, officially granting the delineated clinical privileges to the provider.
Compliance and Privacy
DA FORM 5440-8 requires compliance with AR 40-68, which governs the credentialing and privileging of healthcare providers within the Department of the Army. Additionally, the form includes a Privacy Act Statement as mandated by AR 340-21, ensuring the confidentiality and protection of personal information.
How to Use DA FORM 5440-8
Step-by-Step Process
- Completion: The healthcare provider fills out the necessary personal and professional information on the form.
- Verification: The information provided is verified by the credentialing authority to ensure accuracy and completeness.
- Approval: The approving authority reviews the delineated clinical privileges and, if satisfactory, signs and dates the form to grant the privileges.
- Record Keeping: The completed and approved form is kept in the provider’s personnel file for future reference and audits.
Electronic Media and Accessibility
As noted in the footnotes, DA FORM 5440-8 is produced only in electronic media, making it easily accessible and distributable. This aligns with modern practices of maintaining digital records, which are more secure and manageable compared to paper-based systems.
Conclusion
DA FORM 5440-8 – Delineation Of Clinical Privileges-Pediatrics plays a crucial role in ensuring that pediatric healthcare providers within the Department of the Army are properly credentialed and authorized to perform their duties. By clearly outlining the clinical privileges, the form helps maintain high standards of pediatric care and patient safety. Understanding the structure, purpose, and use of this form is essential for both healthcare providers and administrative personnel involved in the credentialing process.
For more information or to access the form, individuals can refer to the official Army publications or the prescribing directive, AR 40-68.
DA FORM 5440-8 Fillable – Army Pubs 5440-8 PDF DOWNLOAD
