Medical Director Activity Log
Clinical UNIT:
____________________
MONTH/YEAR:
___________________
th
Due to CMO on 10
of following month- Fax 206/720-3705
Check here (X)
Comments. Describe below other time or duties.
FACILITY OR PROGRAM QUALITY IMPROVEMENT
1. Conduct Quality Improvement and QA/PI per NKC standards/Development and review of action plans
Review Monthly the Clinical Indicators (described in MAT and NKC monthly report)
IF NOT ,PLEASE EXPLAIN WHY:
Hold monthly meetings of QA/PI interdisciplinary team.
Discuss changes to patient outlier Plan of Care with attending nephrologist, as needed
IF NOT, PLEASE EXPLAIN WHY:
2. Review Water Systems
Review all water logs with FSS and Nurse Manager
Review the culture and LAL results; develop action plan and correction steps, as needed
Ensure education of staff and FSS, as indicated
3. Oversees that NKC policy and procedures are followed; provide input to policy/procedures as needed
4. Participate in review and response to Medicare survey requirements and Network projects.
COORDINATION WITH CLINICAL STAFF
5. Regular contacts with facility Nurse Manager and Clinical Director
6. Resource for interdisciplinary team: case manager/nurse educator, social worker, dietician
7. Consultant/resource for facility staff and FSS
EDUCATION OVERSIGHT
8. In-services provided to staff. – Amount of Time (in minutes) of the in-service
-- Topic(s)
INVOLVEMENT WITH NKC ORGANIZATION
9. Attend monthly Medical Director meetings
10. Attend NKC medical staff meetings
11. Represent NKC program to community/public
OTHER
12. Participate in continuing education related to medical dir role
Describe:
13. Transit time back/forth from facility and Medical Directors meetings and other NKC meetings
14. Telephone and Email time spent on Medical Director duties.
PLEASE INDICATE NUMBER OF HOURS
TOTAL HOURS DEVOTED TO MEDICAL DIRECTOR ROLE:
MD Signature / DATE
MD Printed Name
Revised 11/10/2015
ADM-M12067A