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Policy #: 06.LS.001

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MODELS FORM IDEAS – FREE MODELS FORM FOR INSPIRATION – bmc medical prior auth form | bmc medical prior auth form

Purpose: To accommodate safe and amenable use of analytic lasers at Boston Medical Center (BMC) and abbreviate the accident of laser acknowledgment to patients and providers.

Policy Statement: The analytic use of lasers at BMC requires that the BMC Licensed Independent Practitioner (LIP) has laser privileges accustomed by the Trustees of BMC and an allotment to use a laser from the Radiation Assurance Committee. Laser privileges are belted to the specific laser type(s) and action for which approval has been granted.

Fellows, residents, physician administration and abettor practitioners are not acceptable to use lasers unless they are anon supervised by a advantaged laser user AND accept completed the able training as abundant below.

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MODELS FORM IDEAS – FREE MODELS FORM FOR INSPIRATION – bmc medical prior auth form | bmc medical prior auth form

Many lasers crave a “dedicated laser assistant” to accomplish the ascendancy console of a medical laser for the advantaged “laser user.” Laser administration are Registered Nurses, Licensed Practical Nurses, Physician Assistants, Surgical Technicians, Medical Assistants, or added individuals accounted able by the Deputy Laser Assurance Officer Analytic Lasers (DLSOC).

Laser User: Licensed Independent Practitioner (LIP) accustomed and advantaged to accomplish specific laser procedures and who assumes albatross for the use of the laser and account of the procedure.

Dedicated Laser Assistant: Person assigned to set up the laser and accomplish the ascendancy console for the laser user, and adviser the laser analysis controlled breadth for assurance during the procedure. From the time the laser key about-face is activated, to the time it is angry off, the laser abettor shall accept no added duties except for absolute operation of the laser ascendancy console and ecology the allowance for acquiescence with assurance behavior and procedures.

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MODELS FORM IDEAS – FREE MODELS FORM FOR INSPIRATION – bmc medical prior auth form | bmc medical prior auth form

Deputy Laser Assurance Officer Analytic Lasers (DLSOC): Individual who oversees circadian laser assurance operations in analytic settings who works carefully with the Laser Assurance Officer (LSO), Division of Medical Physics and Radiation Assurance (DMPRS) and Analytic Engineering to ensure safe operations of analytic lasers at BMC. Individual is advised a abstruse able who oversees training, accessories maintenance, inventory, and accession of new analytic lasers.

The LIP requesting laser privileges will access an Appliance for Laser Use at Boston Medical Center anatomy and a Delineation of Privileges anatomy from the Medical Staff Office ([email protected] The Delineation of Privileges anatomy will be specific to the Division in which the appellant is requesting privileges and may be allotment of a appeal for antecedent arrangement to the Medical-Dental Staff. The physician will complete both forms, accouterment the all-important documentation, and abide this actual to the Medical Staff Office. Also to be completed is the online “Physician Laser Safety” tutorial with a casual quiz brand of 80% (tutorial is assigned through HealthStream by the Medical Staff Office). The abstracts will be advised by the Radiation Assurance Committee and accustomed allotment will be submitted to the Credentials Committee above-mentioned to the advocacy of laser advantage by the Trustees of BMC.

LIPs who are “active” accustomed laser users with advantage for the analytic use of lasers must

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MODELS FORM IDEAS – FREE MODELS FORM FOR INSPIRATION – bmc medical prior auth form | bmc medical prior auth form

The reapplication for laser privileges will action accompanying with the LIP’s appliance for reappointment to the Medical-Dental Staff and charge accommodate achievement of the online “Physician Laser Safety” tutorial with a casual quiz brand of 80% (tutorial is assigned through HealthStream by the Medical Staff Office). Failure to renew the laser training will automatically change their cachet to an “inactive” laser user. Inactive users are not acceptable to accomplish laser accessories or renew laser privileges.

All advisers and association from departments/services that use lasers charge annually complete the online “Physician Laser Safety” tutorial during the three months (April, May, and June) above-mentioned the alpha of anniversary new bookish year (July 1) with a casual quiz brand of 80%.

Incoming Residents: Complete the online tutorial as allotment of their BMC onboarding process.

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MODELS FORM IDEAS – FREE MODELS FORM FOR INSPIRATION – bmc medical prior auth form | bmc medical prior auth form

Dedicated Laser Administration (nurses, technicians, etc.) who accept been accustomed to accomplish the ascendancy console of the analytic laser accessories for a advantaged laser user during surgical procedures shall be appropriately accomplished in laser assurance and operation of the specific laser units. Laser administration will complete laser assurance training anniversary and laser specific training as needed. All laser trainings and in-services charge be accustomed by the DLSOC or LSO. Anniversary administration complex in the use of lasers shall accept accordant cadre training in the afterward areas:

The Radiation Assurance Committee and/or the Laser Assurance Subcommittee will adviser acquiescence of this action through analysis of affidavit provided by applicative departments. Noncompliance will accept the afterward repercussions:

Application for Analytic Laser Use at Boston Medical Center (located in Medical Staff Office)

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MODELS FORM IDEAS – FREE MODELS FORM FOR INSPIRATION – bmc medical prior auth form | bmc medical prior auth form

Policy and Action for Obtaining Analytic Laser Privileges at Boston Medical CenterLaser Assurance in the Operating Allowance (#15_02_040)

Policy No.: 06.LS.001Title: Analytic Use of LaserInitiated by: Radiation Assurance Committee and the Credentials CommitteeContributing Departments:

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