Healthcare Surgical Partner Policy

Healthcare Surgical Partner Policy

Facility Identification

Policy Effective Date:   Policy Review/Expiration Date:

Purpose and Scope

This Surgical Partner Policy sets forth the expectations, obligations and administrative requirements for all surgical partners who perform operative care within the facility. Surgical partners include attending surgeons, proceduralists, anesthesia providers, surgical assistants, and other licensed providers granted operating privileges. The policy applies to clinical performance, credentialing, infection control, documentation, reporting and compliance with applicable law and facility rules.

Partner Identification and Credentials

Emergency Contact

Insurance and Liability

Credentialing, Privileges and Practice Limitations

The surgical partner affirms that all required credentials, privileging documents and verifications have been submitted to and accepted by the facility credentialing office. The surgical partner agrees to practice within the scope of granted privileges and to comply with the facility's privileging conditions, proctoring requirements, and any temporary or procedural limitations imposed by the Medical Staff.

Operational Requirements and Clinical Protocols

Surgical partners must comply with the facility's pre-operative assessment, time-out procedure, sterile field maintenance, instrument and implant verification, and postoperative handoff practices. The facility retains final authority to deny access to the operating room for noncompliance or safety concerns.

Confirm agreement with the following operational requirements:

I will perform and document the required pre-procedure time-out for every case.

I will adhere to facility sterile technique and infection control policies.

I will verify instrumentation, implants and implants documentation prior to incision.

I will conduct a postoperative handoff to recovery team and document findings.

Documentation and Medical Records

The surgical partner is responsible for timely, accurate and complete documentation of all operative notes, consents, implants, and postoperative orders in the facility's medical record system. Documentation must meet professional and regulatory standards and be available for quality review.

HIPAA, Confidentiality and Data Use

The surgical partner will maintain the confidentiality and security of patient information in compliance with applicable privacy laws and facility privacy policies. Unauthorized access, use, disclosure or reproduction of protected health information is prohibited.

I acknowledge and will comply with HIPAA and facility confidentiality policies.

Quality Assurance, Reporting and Investigations

Surgical partners must promptly report adverse events, sentinel events and any unanticipated patient outcomes to facility leadership. Partners consent to the facility's routine peer review, quality investigations and corrective action processes.

Indemnification and Insurance Requirements

The surgical partner shall maintain professional liability insurance in the amounts stated above and shall indemnify, defend and hold the facility harmless from claims arising out of the partner's acts or omissions, except to the extent the facility's own negligent acts are the proximate cause of such claims. The facility may require a certificate of insurance evidencing required coverage and naming the facility as an additional insured where appropriate.

Term, Amendment and Termination

This agreement is effective as of the Policy Effective Date and continues until terminated by either party with thirty (30) days written notice, or immediately by the facility for cause including but not limited to unprofessional conduct, loss of licensure, or failure to maintain required insurance. The facility reserves the right to amend operational protocols; partners will be notified of substantive amendments and are responsible for compliance.

Certifications and Acknowledgements

By signing below the surgical partner certifies that all information provided in this document is true and correct to the best of their knowledge, that they hold the credentials and privileges represented, and consents to verification of credentials, background checks, peer review and exchange of relevant clinical information for quality and safety purposes.

Authorization Expiration Date (if applicable):

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