DAFORMFILLABLE.COM | DA FORM 5441-41 Fillable – Army Pubs 5441-41 PDF – DA FORM 5441-41, titled Evaluation of Clinical Privileges – Physical Medicine and Rehabilitation, plays a crucial role in the medical field, particularly within the Army’s healthcare system. This form is used to assess and document the clinical privileges of medical professionals specializing in Physical Medicine and Rehabilitation (PM&R). Below, we will delve into the specifics of this form, its purpose, and how it is utilized.
DA FORM 5441-41 – Evaluation Of Clinical Privileges – Physical Medicine And Rehabilitation
| Form Number | DA Form 5441-41 |
| Form Title | Evaluation Of Clinical Privileges – Physical Medicine And Rehabilitation |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5441-41
Publication Details
- Pub/Form Number: DA FORM 5441-41
- Pub/Form Date: 02/01/2004
- Pub/Form Title: Evaluation of Clinical Privileges – Physical Medicine and Rehabilitation
- Pub/Form Proponent: TSG (The Surgeon General)
- Pub/Form Status: ACTIVE
- Prescribed Forms/Prescribing Directive: AR 40-68
- Footnotes:
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA
- 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)
- Security Classification: UNCLASSIFIED
- Dist Restriction Code: A (Approved for public release; distribution is unlimited)
- Pub/Form IDN: 990001
- Pub/Form PIN: 081282
Purpose of DA FORM 5441-41
DA FORM 5441-41 is designed to ensure that medical professionals in the field of Physical Medicine and Rehabilitation are properly evaluated for their clinical privileges. This form is essential for maintaining high standards of care and ensuring that only qualified practitioners are granted the necessary privileges to provide medical services in this specialty.
Key Components of the Form
Evaluation Criteria
The evaluation process involves a thorough review of the medical professional’s credentials, experience, and competencies. Key components evaluated include:
- Clinical Skills: Assessment of the practitioner’s ability to perform specific procedures and treatments related to PM&R.
- Professional Experience: Review of the practitioner’s history in the medical field, including past roles and responsibilities.
- Education and Training: Verification of educational background and any specialized training relevant to PM&R.
Privacy and Security
Given the sensitive nature of the information recorded on DA FORM 5441-41, it is produced exclusively in electronic media, ensuring secure handling and storage. Additionally, the form requires a Privacy Act Statement as per AR 340-21, highlighting the importance of protecting personal information.
Utilization in the Military Healthcare System
Process and Workflow
The process for utilizing DA FORM 5441-41 typically involves several steps:
- Submission: The medical professional submits the form along with supporting documents such as diplomas, certificates, and a detailed resume.
- Review: A designated committee or supervisor reviews the submitted materials, assessing the professional’s qualifications and experience.
- Evaluation: The professional’s clinical skills and competencies are evaluated against standardized criteria to determine their suitability for specific privileges.
- Approval/Denial: Based on the evaluation, the professional is either granted or denied the requested clinical privileges.
Importance in Quality Assurance
The meticulous evaluation process associated with DA FORM 5441-41 ensures that only highly qualified and competent practitioners are authorized to deliver medical services in the field of PM&R. This is crucial for maintaining high standards of care and safeguarding patient safety within the military healthcare system.
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Conclusion
In summary, DA FORM 5441-41 – Evaluation of Clinical Privileges – Physical Medicine and Rehabilitation is a critical document in the military healthcare system. It ensures that medical professionals are thoroughly evaluated before being granted clinical privileges, thereby maintaining high standards of care and patient safety. Understanding the purpose, components, and utilization of this form is essential for anyone involved in the field of PM&R within the military.
DA FORM 5441-41 Fillable – Army Pubs 5441-41 PDF DOWNLOAD
