DAFORMFILLABLE.COM | DA FORM 5441-49 Fillable – Army Pubs 5441-49 PDF – DA FORM 5441-49 is an essential document used within the military medical system to assess and validate the clinical privileges of plastic surgeons. Published on February 1, 2004, this form serves a critical role in maintaining high standards of care within military medical facilities. The form is actively prescribed under AR 40-68, ensuring it adheres to stringent regulatory requirements.
DA FORM 5441-49 – Evaluation Of Clinical Privileges – Plastic Surgery
| Form Number | DA Form 5441-49 |
| Form Title | Evaluation Of Clinical Privileges – Plastic Surgery |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Purpose of DA FORM 5441-49
The primary purpose of DA FORM 5441-49 is to evaluate the competency and qualifications of plastic surgeons working within the military healthcare system. This evaluation is crucial for ensuring that surgeons possess the necessary skills and knowledge to provide safe and effective care to patients. By systematically reviewing a surgeon’s credentials and performance, the form helps uphold the high standards expected in military medical practices.
Key Features and Sections of DA FORM 5441-49
DA FORM 5441-49 includes several important sections designed to comprehensively evaluate a plastic surgeon’s clinical privileges. These sections typically cover:
Personal and Professional Information
This section gathers basic information about the surgeon, including their name, rank, and contact details. It also includes information about their medical education, training, and board certifications, providing a clear overview of their professional background.
Clinical Privileges Requested
In this section, the surgeon specifies the clinical privileges they are seeking. This can range from general plastic surgery procedures to specialized areas such as reconstructive or cosmetic surgery. Detailed descriptions of each requested privilege ensure that the evaluating authority understands the scope of the surgeon’s practice.
Evaluation of Competency
This critical section assesses the surgeon’s competency in various plastic surgery procedures. Evaluators review the surgeon’s experience, case logs, and outcomes to determine their proficiency. This thorough evaluation process helps ensure that only qualified surgeons are granted clinical privileges.
Peer and Supervisor Reviews
Peer and supervisor reviews are an integral part of the evaluation process. These reviews provide insights into the surgeon’s performance from colleagues and superiors who have directly observed their work. This feedback is invaluable for making informed decisions about granting clinical privileges.
Final Recommendation and Approval
The final section of the form includes the recommendations of the evaluating committee and the final decision on granting clinical privileges. This section must be signed by authorized personnel, signifying that the evaluation has been completed according to regulatory standards.
Regulatory and Privacy Considerations
DA FORM 5441-49 is prescribed under AR 40-68 and requires a Privacy Act Statement in accordance with AR 340-21. This ensures that all personal and professional information provided by the surgeon is protected and handled with confidentiality. The form is classified as UNCLASSIFIED and approved for public release, making it accessible for use within the military healthcare system.
Accessibility and Distribution
The form is produced exclusively in electronic media, indicated by footnote 42. This electronic distribution enhances accessibility, ensuring that medical facilities can easily obtain and utilize the form. Additionally, the distribution restriction code A confirms that the form is approved for public release and can be distributed without limitations.
Importance of Using DA FORM 5441-49
Utilizing DA FORM 5441-49 is vital for maintaining the integrity and quality of plastic surgery services within the military. By rigorously evaluating the clinical privileges of plastic surgeons, the military healthcare system ensures that only highly qualified professionals are allowed to practice. This not only protects patients but also upholds the reputation and standards of military medical care.
Conclusion
DA FORM 5441-49 – Evaluation of Clinical Privileges – Plastic Surgery is a fundamental tool in the military’s efforts to maintain exceptional medical standards. By comprehensively assessing the qualifications and competencies of plastic surgeons, this form plays a crucial role in ensuring that military personnel receive the highest quality of care. Its structured evaluation process, regulatory compliance, and emphasis on privacy and accessibility make it an indispensable resource for military medical facilities.
DA FORM 5441-49 Fillable – Army Pubs 5441-49 PDF DOWNLOAD
