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Straub Clinic and Hospital STRAUB CLINIC AND HOSPITAL dba: Straub Medical Center 888 South King Street Honolulu, HI 96813 (808) 522-4000 MEDICAL STAFF BYLAWS (Revised 6/10/2021) MEDICAL STAFF BYLAWS TABLE OF CONTENTS PAGE PREAMBLE…………………………………………………………………………………….7 DEFINITIONS…………………………………………………………………………………...8 ARTICLE I: NAME…………………………………………………………………...13 ARTICLE II: PURPOSES AND RESPONSIBILITIES OF THE MEDICAL STAFF…………………………………………………………………...13 ARTICLE III: MEDICAL STAFF MEMBERSHIP…………………………………..14 3.1 NATURE OF MEDICAL STAFF MEMBERSHIP………………………………....14 3.2 BASIC QUALIFICATIONS FOR MEMBERSHIP…………………………………14 3.3 BASIC RESPONSIBILITIES OF MEDICAL STAFF MEMBERSHIP ……………17 3.4 PROHIBITION OF DISCRIMINATION, HARASSMENT, AND BEHAVIOR THAT UNDERMINES A CULTURE OF SAFETY………………………………..20 3.5 DURATION OF APPOINTMENT………………………………………………….22 3.6 PROVISIONAL STATUS…………………………………………………………...22 3.7 LEAVE OF ABSENCE……………………………………………………………...24 3.8 PROVIDER ASSISTANCE…………………………………………………………26 3.9 TEMPORARY MEDICAL STAFF MEMBERSHIP………………………………..26 3.10 RESIGNATION……………………………………………………………………...27 ARTICLE IV: CATEGORIES OF THE MEDICAL STAFF………………………...27 4.1 CATEGORIES……………………………………………………………………….27 4.2 ACTIVE STAFF……………………………………………………………………..27 4.3 REFER AND FOLLOW STAFF…………………………………………………….29 4.4 COURTESY STAFF………………………………………………………………...30 Straub Medical Staff Bylaws rev 06/10//2021 2 4.5 CONSULTANT STAFF……………………………………………………………..31 4.6 TELEMEDICINE STAFF…………………………………………………………...32 4.7 EMERITUS STAFF…………………………………………………………………33 4.8 WAIVER OF PARTICULAR QUALIFICATIONS FOR GOOD CAUSE………...34 ARTICLE V: ALLIED HEALTH PROFESSIONALS (AHPs) ………………………...34 5.1 QUALIFICATIONS…………………………………………………………………34 5.2 PROCEDURES FOR APPOINTING AND GRANTING PRACTICE PREROGATIVES TO AHPs; CORRECTIVE ACTION; AND PROCEDURAL RIGHTS OF AHPs…………………………………………………………………..35 5.3 PREROGATIVES…………………………………………………………………...35 5.4 RESPONSIBILITIES………………………………………………………………..36 ARTICLE VI: APPOINTMENT AND REAPPOINTMENT………………………...36 6.1 GENERAL PROCEDURE…………………………………………………………..36 6.2 APPLICANT’S BURDEN…………………………………………………………..37 6.3 APPLICATION FOR INITIAL APPOINTMENT…………………………………..38 6.4 EFFECT OF APPLICATION………………………………………………………..44 6.5 PROCESSING THE APPLICATION……………………………………………….46 6.6 REAPPOINTMENT…………………………………………………………………50 6.7 REQUESTS FOR MODIFICATION OF APPOINTMENT………………………...53 6.8 REAPPLICATION AFTER ADVERSE RESULT………………………………….53 ARTICLE VII: CLINICAL PRIVILEGES AND PRACTICE PREROGATIVES….54 7.1 EXERCISE OF PRIVILEGES/ PRACTICE PREROGATIVES……………………54 7.2 DELINEATION OF PRIVILEGES/PRACTICE PREROGATIVES IN GENERAL…………………………………………………………………………...55 7.3 SPECIAL CONDITIONS FOR DENTAL AND PODIATRIC PRIVILEGES……..56 7.4 SPECIAL CONDITIONS FOR AHP PRACTICE PREROGATIVES………….......56 7.5 TEMPORARY PRIVILEGES……………………………………………………….56 7.6 EMERGENCY PRIVILEGES……………………………………………………….59 7.7 DISASTER PRIVILEGES…………………………………………………………..59 7.8 TELEMEDICINE SERVICES PRIVILEGES………………………………………61 Straub Medical Staff Bylaws rev 06/10//2021 2 ARTICLE VIII: PERFORMANCE EVALUATION AND MONITORING…………..64 8.1 OVERVIEW OF PERFORMANCE EVALUATION AND MONITORING………64 8.2 PERFORMANCE MONITORING GENERALLY…………………………………64 8.3 ONGOING PROFESSIONAL PRACTICE EVALUATION (OPPE)………………64 8.4 FOCUSED PROFESSIONAL PRACTICE EVALUATION (FPPE) ………………65 ARTICLE IX: PERFORMANCE IMPROVEMENT AND CORRECTIVE ACTION………………………………………………………………...67 9.1 MEDICAL STAFF ROLE IN PERFORMANCE IMPROVEMENT……………….67 9.2 INFORMAL REMEDIAL/CORRECTIVE ACTIVITIES…………………………..68 9.3 CRITERIA FOR INITIATION OF CORRECTIVE ACTION……………………...68 9.4 INVESTIGATION…………………………………………………………………...69 9.5 SUMMARY RESTRICTION OR SUSPENSION OF CLINICAL PRIVILEGES/ PRACTICE PREROGATIVES AND/OR MEDICAL STAFF MEMBERSHIP OR AHP APPOINTMENT…………………………………………………………..72 9.6 AUTOMATIC REVOCATION, SUSPENSION, LIMITATION AND/OR DEEMED RESIGNATION………………………………………………………….73 ARTICLE X: HEARING AND APPELLATE REVIEW PROCEDURES...............78 10.1 GENERAL HEARING AND APPELLATE REVIEW PROVISIONS…………….78 10.2 GROUNDS FOR HEARING………………………………………………………..79 10.3 NOTICE OF PROPOSED ADVERSE PROFESSIONAL REVIEW ACTION……80 10.4 PROVIDER’S REQUEST FOR HEARING OR ACCEPTANCE OF THE ACTION……………………………………………………………………………..81 10.5 MEDIATION………………………………………………………………………...81 10.6 NOTICE OF HEARING……………………………………………………………..82 10.7 HEARING PANEL…………………………………………………………………..83 10.8 HEARING OFFICER………………………………………………………………..83 10.9 RIGHTS OF THE PARTIES………………………………………………………...84 10.10 PRE-HEARING AND HEARING PROCEDURE………………………………….85 10.11 THE HEARING……………………………………………………………………...87 10.12 APPEAL……………………………………………………………………………..90 10.13 EXCEPTIONS TO HEARING RIGHTS……………………………………………94 10.14 VALIDITY OF BYLAWS, RULES & REGULATIONS AND/OR POLICIES ……95 Straub Medical Staff Bylaws rev 06/10//2021 3 10.15 JOINT HEARINGS AND APPEALS…………………………………………….....95 ARTICLE XI: OFFICERS……………………………………………………………...96 11.1 OFFICERS OF THE MEDICAL STAFF ……………………………………………96 11.2 QUALIFICATIONS OF OFFICERS………………………………………………..96 11.3 ELECTION OF OFFICERS…………………………………………………………97 11.4 TERM OF OFFICE……………………………………………………………….....98 11.5 VACANCIES IN OFFICE…………………………………………………………..98 11.6 REMOVAL FROM OFFICE………………………………………………………..98 11.7 RESIGNATION……………………………………………………………………..99 11.8 DUTIES OF OFFICERS…………………………………………………………….99 ARTICLE XII: CLINICAL DEPARTMENTS AND DIVISIONS ………………….101 12.1 MEDICAL STAFF ORGANIZATION CONSISTING OF DEPARTMENTS …...101 12.2 SPECIFIC DEPARTMENTS ……………………………………………………...102 12.3 FORMATION AND ELIMINATION OF DEPARTMENTS AND DIVISIONS…102 12.4 DEPARTMENT FUNCTIONS…………………………………………………….103 12.5 DEPARTMENT CHAIRS………………………………………………………….104 12.6 DIVISION CHAIRS………………………………………………………………..106 12.7 ASSIGNMENT TO DEPARTMENTS ……………………………………………107 ARTICLE XIII: COMMITTEES AND FUNCTIONS………………………………...107 13.1 GENERAL………………………………………………………………………….107 13.2 STANDING COMMITTEES ………………………………………………………109 13.3 SPECIAL OR AD HOC COMMITTEES………………………………………….117 ARTICLE XIV: MEETINGS, ACTION WITHOUT A MEETING………………....117 14.1 MEETINGS OF THE MEDICAL STAFF…………………………………………117 14.2 DEPARTMENT, DIVISION AND COMMITTEE MEETINGS………………….118 14.3 COMBINED OR JOINT MEETINGS……………………………………………..118 14.4 NOTICE OF MEETINGS………………………………………………………….119 14.5 QUORUM …………………………………………………………………………..119 14.6 MANNER OF ACTION……………………………………………………………119 Straub Medical Staff Bylaws rev 06/10//2021 4 14.7 MINUTES …………………………………………………………………………..120 14.8 ATTENDANCE REQUIREMENTS ………………………………………………120 14.9 SPECIAL APPEARANCE REQUIREMENT……………………………………..120 14.10 RULES OF ORDER………………………………………………………………..120 ARTICLE XV: CONFIDENTIALITY, IMMUNITY, AND RELEASES/AUTHORIZATIONS …………………………………121 15.1 SCOPE……………………………………………………………………………...121 15.2 CONFIDENTIALITY OF INFORMATION………………………………………121 15.3 IMMUNITY………………………………………………………………………..122 15.4 RELEASES…………………………………………………………………………123 ARTICLE XVI: RULES & REGULATIONS AND POLICIES……………………...123 16.1 MEC AUTHORITY TO ADOPT AND AMEND RULES & REGULATIONS AND POLICIES ………………………………………………..123 16.2 DEPARTMENT, SERVICE AND ADMINISTRATION INPUT INTO FORMULATION OF RULES & REGULATIONS AND POLICIES…………….124 16.3 NO UNILATERAL AMENDMENT ………………………………………………124 16.4 BYLAWS PREVAIL IN THE EVENT OF A CONFLICT WITH THE RULES & REGULATIONS OR POLICIES……………………………………….124 16.5 DIRECT AMENDMENT BY THE MEDICAL STAFF OF RULES & REGULATIONS……………………………………………………………………124 16.6 METHODOLOGY FOR DIRECT ADOPTION/AMENDMENT OF RULES & REGULATIONS……………………………………………………………………124 16.7 DIRECT MEDICAL STAFF RECOMMENDATION OF POLICIES TO THE BOARD…………………………………………………………………………….125 16.8 METHODOLOGY FOR DIRECT MEDICAL STAFF RECOMMENDATION OF POLICIES TO THE BOARD …………………………………………………..126 16.9 CONFLICT MANAGEMENT……………………………………………………..127 ARTICLE XVII: METHODOLOGY FOR ADOPTION OF MEC-APPROVED BYLAWS AMENDMENTS …………………………………………..127 17.1 MEDICAL STAFF RESPONSIBILITY AND AUTHORITY…………………….127 17.2 METHODOLOGY FOR ADOPTION OF MEC-APPROVED BYLAWS AMENDMENTS…………………………………………………………………...128 Straub Medical Staff Bylaws rev 06/10//2021 5 17.3 METHODOLOGY FOR DIRECT MEDICAL STAFF PROPOSAL OF BYLAWS AMENDMENTS TO THE BOARD…………………………………...128 17.4 EDITORIAL CORRECTIONS…………………………………………………….130 17.5 EXCLUSIVITY…………………………………………………………………….130 ARTICLE XVIII: MISCELLANEOUS PROVISIONS…………………………………130 18.1 CONSTRUCTION OF TERMS AND HEADINGS ………………………………130 18.2 EXCLUSIVE MECHANISMS FOR PROVIDING PROFESSIONAL SERVICES AT THE HOSPITAL………………………………………………….130 18.3 DUES OR ASSESSMENTS AND APPLICATION FEES………………………..131 18.4 FORMS……………………………………………………………………………..131 18.6 TRANSMITTAL OF REPORTS …………………………………………………..131 18.6 NOTICES TO THE MEDICAL STAFF OR ITS OFFICERS……………………..131 18.7 CONSEQUENCES OF ACTION WITHOUT AUTHORITY……………………..131 18.8 DISCLOSURE OF INTERESTS …………………………………………………..131 18.9 NOMINATION OF MEDICAL STAFF REPRESENTATIVES………………….132 18.10 EXCLUSIVE CONTRACTING AND ADDITION OR ELIMINATION OF SERVICES………………………………………………………………………….132 18.11 HISTORY AND PHYSICAL EXAMINATION REQUIREMENTS……………...133 18.12 GRADUATE MEDICAL EDUCATION …………………………………………..133 18.13 MANAGEMENT OF CONFLICTS BETWEEN THE MEDICAL STAFF OR MEC AND THE BOARD OR HOSPITAL ADMINISTRATION……………………………………………………………….134 18.14 BYLAWS/RULES NOT A CONTRACT………………………………………….136 Straub Medical Staff Bylaws rev 06/10//2021 6 STRAUB CLINIC AND HOSPITAL dba STRAUB MEDICAL CENTER MEDICAL STAFF BYLAWS PREAMBLE WHEREAS Straub Clinic & Hospital (also known as Straub Medical Center), a member of Hawai`i Pacific Health, is a nonprofit corporation organized under the laws of the State of Hawai`i; WHEREAS its primary purpose is to serve as a general hospital providing patient
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