History of PPG
2009 to 2014:
Kara Myers CNM becomes next CIDP representative to Credentials Committee.
Significant developments in the past 5 years include recognizing affiliated staff as peer proctors for the purposes of appointment, developing affiliated staff-specific metrics for biannual ongoing professional practice evaluation (OPPE), and working to increase consistency of practice standards (including proctoring and reappointment criteria), across standardized procedures. In the near future, they will continue this last endeavor by consolidating the standardized procedure format and streamlining the review process, which should also enhance the efficiency of CIDP and Credentials.
Kara Duffy PA becomes next CIDP representative to Credentials Committee
First non-physician member Annette Burns FNP appointed to Credentials Committee with voting ability representing CIDP. Sue Currin RN Director Of Nursing had a large influence in having Credentials take in an NP. SP were being processed too slowly through Credentials largely due to the committee members poor understanding of NP/PA/CNM practice.
SP revised to state names of Formularies. Credentials Committee slow in approving inpatient SP. A template SP developed for inpatient practice.
More NP’s recruited to CIDP to discuss Formulary Restriction. BRN Advanced Practice Consultant advised CIDP that they can cite the name of Formularies that will be used in their practice in the SP.
Template for Standardized Procedures developed for Credentials committee to assist them to pass the SP.
Health Care Reform lawyer hired by CIDP to look at NP/PA/CNM practice.
Recommendations were to keep Standardized Procedures as general as possible because the practice is dynamic and ever changing.
CIDP and NP/PA/CNM battle over Formulary restrictions continues.
Mitch Katz is now Director of Public Health San Francisco Health Plan is being initiated.
NP names will be added to SFHP directory.
Standardized Procedures are the responsibility of the NP/PA/CNM and the clinic where they work to finalize and return to CIDP
CIDP – Discussion to restrict NP/PA/CNM formulary to 20 medications. And restrict NP/PA/CNM practice in the Standardized Procedures.
Administrative Time: Per CHN (Community Health Network) per 1 FTE: 80% clinical, 10% patient follow up, 10% administrative time for meetings. Current language is center-dictated.
Release time for Professional Development Meetings is in contract negotiations. As needed NP positions have been implemented.
October: First Nurse Practitioner Professional Practice Group Conference
HMO’s are beginning to list NP’s and PA’s as primary care providers. Thus, giving legislative leverage for SFCC, and the State Department of Corporations toenable NP’s/PA’s/CNM to become primary care providers.
City wide meeting called for NP, CNM, PA, to discuss Managed Care and NP’s as providers.No release time for meetings yet.
With the support of David Offman MD Primary Care Administrator Gene O’Connell RN MSN Director of Nursing at the time, Sandra Hernandez Director of Public Health, and Lisa Johnson M.D. Director of Community Oriented Primary Care (COPC). An Appointment procedure for privileges as Affiliated Staff was set up through Credentials committeeand their subcommittee CIDP (Committee for Interdisciplinary Practice) for the Nurse Practitioners. CIDP consists of Administrators, Physicians, Nursing Administrator, Clinical Pharmacists and they will add Nurse Practitioners and will be charged with defining scope of practice or NP/PApractice. CIDP will review and approve Standardized Procedures.
Discussion” Different practices among the NP’s. The need to organize and can we use work time for meetings?At present meetings were every 3 month and not on work time.Union was contacted to see if we could get release time at work to go to meetings.Standardized proceduresClinical practice issues – what will our practice be? Productivity expectations, acuity of patients, quality of care.Integration of medical care throughout City and County departments (COPC, SFGH, Laguna Honda)
First city wide meeting in Carr Auditorium 40 NP’s attended. The movers and shakers at this time were Diane Carr, Jackie Wasserman-Gilbert, Helen Martin, Gay Kaplan, Laura Montez-McCarthy, Erica Bisgyer, Roni Robertson.Discussion: why are we not included as primary care providersManaged Care at that time precluded NP’s as providersMedi-Cal beneficiaries were being enrolled in managed care plans.We called ourselves the Nurse Practitioner Practice Group