DAFORMFILLABLE.COM | DA FORM 5441-13 Fillable – Army Pubs 5441-13 PDF – DA FORM 5441-13, also known as the Evaluation Of Clinical Privileges – General Surgery, is a crucial document used within the medical field of the United States Army. This form is designed to assess and document the clinical privileges of healthcare professionals specializing in general surgery.
DA FORM 5441-13 – Evaluation Of Clinical Privileges – General Surgery
| Form Number | DA Form 5441-13 |
| Form Title | Evaluation Of Clinical Privileges – General Surgery |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5441-13
DA FORM 5441-13 was published on February 1, 2004, and it remains in active status. The form is authorized by the TSG (The Surgeon General) and is prescribed under the directive AR 40-68. It requires a Privacy Act Statement as stipulated by AR 340-21. The form is unclassified and approved for public release, with no distribution restrictions, making it widely accessible for relevant personnel.
Purpose of DA FORM 5441-13
The primary purpose of DA FORM 5441-13 is to evaluate the clinical privileges of general surgeons within the Army. This form helps ensure that only qualified and competent surgeons are granted the necessary privileges to perform surgical procedures. By meticulously documenting the skills and competencies of the surgeons, the Army maintains high standards of medical care and patient safety.
Structure and Components of the Form
DA FORM 5441-13 is a detailed form that covers various aspects of a general surgeon’s qualifications. Key components include:
- Personal Information: Basic details about the surgeon, such as name, rank, and identification number.
- Professional Qualifications: Information on the surgeon’s education, training, and board certifications.
- Clinical Competencies: Assessment of specific surgical skills and procedures that the surgeon is authorized to perform.
- Evaluation and Recommendations: Feedback from supervising physicians and recommendations regarding the surgeon’s clinical privileges.
Importance of Accurate and Complete Information
Filling out DA FORM 5441-13 accurately and completely is vital. This ensures that the evaluation is fair and comprehensive, reflecting the true capabilities of the general surgeon. Any discrepancies or omissions could lead to incorrect assessments, potentially compromising patient care and safety.
Electronic Media and Privacy Considerations
DA FORM 5441-13 is produced solely in electronic media, making it easily accessible and manageable. However, it is crucial to handle the form with care due to the sensitive personal and professional information it contains. The inclusion of a Privacy Act Statement ensures that the data is protected and used appropriately, in compliance with privacy regulations.
Distribution and Accessibility
The form is approved for public release with unlimited distribution, signified by the distribution restriction code A. This open accessibility ensures that all authorized personnel can obtain and utilize the form as needed, supporting the overarching goal of maintaining high medical standards within the Army.
Conclusion
In summary, DA FORM 5441-13 – Evaluation Of Clinical Privileges – General Surgery is an essential tool in the Army’s medical evaluation process. By providing a structured and thorough assessment of general surgeons’ qualifications and competencies, the form helps ensure that only capable and skilled surgeons are granted clinical privileges. This commitment to excellence in medical care is a cornerstone of the Army’s healthcare system, safeguarding the well-being of its personnel and maintaining the highest standards of surgical practice.
Keywords: DA FORM 5441-13, Evaluation Of Clinical Privileges, General Surgery, Army, Medical Evaluation, Clinical Competencies, Patient Safety, TSG, AR 40-68, Privacy Act Statement.
DA FORM 5441-13 Fillable – Army Pubs 5441-13 PDF DOWNLOAD
