1. LifeGuard ® Mid-Atlantic Physician Recruiter Alliance, Inc. Marcia A. Lammando, RN, BSN, MHSA, Program Director October 2-3, 2014 COMPLETE CLINICAL CONFIDENCE

2. Agenda Presentation Goals Recruitment Resource LifeGuard® Case Studies Questions & Answers 2

3. Presentation Goals AWARENESS: LifeGuard® is a clinical competency skills assessment program; providing recommendations for remediation when deficiencies are discovered. CUSTOMIZED: Every case/situation/referral is unique and is handled as such. – There is no one methodology. – Each participant is approached with an individual case management plan. RESOURCE: Pennsylvania Medical Society Corporate Family 3

4. Recruitment Resource Recruiting Physicians – Pathway for retired physicians to return to active practice – Resource for physicians who have no peer references or current experience – Option to address resume concerns or gaps in resume – Third party resource for credentialing committees to address concerns Retaining Physicians – Assist physicians that have clinical related privileging issues – Injured physicians desiring to return to active practice – Aging physician assessments – practice modifications Shadowing/Precepting Physicians – Physicians without jobs participating in shadowing or precepting arrangements to determine if a candidate for employment 4

5. LifeGuard ® Developed to assist physicians: – Who have a known or suspected: clinical deficiency medical deficiency cognitive deficiency – About whom quality concerns have arisen – Who would benefit from refresher/remediation experiences – Who are seeking reentry into the workforce – Who have disciplinary actions on their license and are seeking reinstatement Provide an objective clinical competency skills assessment to referral sources 5

6. Program Pathways Reentry/Reinstatement Aging Physician Self-Referral 6

7. Case Management Approach Case Management – Individualized – Facilitate and schedule assessment components – Ongoing communications Participants Preceptors Referral resource Hospital stakeholders Independent evaluators State Medical Board – Review results – Facilitate remediation as necessary – Report generation 7

8. Case Management Plan Variables affecting the case management plan: – How many years away from active practice – How many years practicing prior to inactivity – Enrollment in a Physicians Health Program or other mandated monitoring program – Specialty – State in which the physician is licensed, wishes to become licensed, or maintains license – Future practice intentions Based on information gathered, program components are selected 8

9. Multi-Stage Program Components Assessment Phase – Fitness for Duty Evaluation/IME – Psychiatric Evaluation – Functional Capacity Examination – Neurocognitive Screen – Professionalism Evaluation – External Peer Review – PLAS Testing – Standardized Patient – Simulation Labs 9

10. Multi-Stage Program Components Clinical Phase – Mentoring – Precepting – Observation Educational Phase – Simulation Laboratory – CME on selected topics – Practical Education based on identified needs 10

11. End Results Data-driven tool Objective results of clinical competency skills assessments and evaluations Recommendations provided based on clinical skills assessments and evaluation, when applicable END USERS ARE ENPOWERED WITH LIFEGUARD® DATA TO MAKE INFORMED DECISIONS 11

12. Case Studies

13. Case Study #1 Retired - Returning to Active Practice Situation – Retired for eight (8) years – General surgeon transitioning to family practice – Placed license in “retired active” category Process – Neurocognitive screen – 60-hour family practice review course (DVD) – PLAS exam module in family practice – Four-week preceptorship – Time with an instructor in a family practice residency End Results – Report issued to the state board of medicine – Unrestricted license reissued 13

14. Case Study #2 General Surgeon Situation – Debilitating neurovascular event – Cleared by neurologist and rehab to return to practice – Lingering concern with cognition as related to the tasks and responsibilities associated with a surgeon Process – Develop a surgical simulation Test functional capacity Evaluate communication skills related to OR situations Determine ability to quickly re-evaluate situations when complications occur – Report on findings End Results – Re-licensed – Working with another general surgeon in the practice (first assist) until the participant feels comfortable in conducting surgery solo 14

15. Case Study #3 Pediatric Physician – Returning to Practice Situation – Pediatric physician left active practice to raise a family – Sought reactivation of license Process – Neurocognitive screen – PLAS exam module in pediatrics – Preceptorship through future employer End Result – Report issued to the state board of medicine – Unrestrictive medical license reissued 15

16. Case Study #4 Aging Physician Assessment Situation – 75 year old physician receives notification from Medical Staff Office – Fitness for Duty assessment required as part of ongoing privileging Process – Fitness for duty evaluation/IME – Neurocognitive assessment – Functional capacity evaluation – Psychiatric evaluation – Clinical skills testing if warranted End Results – Deficits identified through various assessments – Recommendations to modify practice patterns 16

17. Adjunctive Services PMSCO Healthcare Consulting, a subsidiary of the Pennsylvania Medical Society, provides adjunctive services to LifeGuard®: – Coding and documentation reviews – Education CMEs provided for most educational sessions – External Peer Review Chart Audits Through URAC-Accredited Independent Review Organization (IRO) 17

18. Recruitment Resource Recruiting Physicians Retaining Physicians Shadowing/Precepting Physicians 18

19. Questions and Answers Thank you! www.LifeGuardProgram.com mlammando@lifeguardprogram.com (717) 909-2590