20-9-1303. Definitions.

20-9-1303. Definitions. As used in this subchapter: (1) “Adversely affect”, when used in reference to clinical privileges or medical staff membership, means deny, reduce, restrict, suspend, revoke, or fail to renew; (2) “Conflict of interest” means a personal or financial interest that would lead an objective person to conclude that it would be difficult for the person in those circumstances to make a fair and impartial decision in a professional review activity with regard to a particular physician; (3) “Hospital” means a healthcare facility licensed as a hospital by the Division of Health Facilities Services under § 20-9-213; (4)(A) “Investigation” means a process conducted by a professional review body to: (i) Obtain and make a detailed examination of the facts related to an identified concern about a specific physician; and (ii) Determine whether a professional review action should be requested or recommended. (B) “Investigation” does not include the following: (i) A preliminary review to obtain basic information related to a concern or complaint about a physician in order to determine whether an investigation should commence; (ii) Routine quality assurance, case review, utilization review, and performance improvement activities that take place within a hospital; or (iii) Collegial interventions, ongoing physician practice evaluations and focused physician practice evaluations, and other peer-to-peer performance improvement interventions that are not intended to, and do not, impact a physician's clinical privileges or hospital medical staff membership; (5) “Medical staff” means the physicians who are approved and given privileges to provide health care to patients in the hospital; (6) “Professional review action” means an action or recommendation of a professional review body that is taken or made in the conduct of professional review activity and that: (A) Is based on an individual physician's competence or professional conduct that adversely affects or could adversely affect the health or welfare of a patient or patients; and (B) Adversely affects or may adversely affect the medical staff membership or clinical privileges of the physician; (7)(A) “Professional review activity” means an activity with respect to an individual physician: (i) To determine whether the physician may have clinical privileges at a hospital or membership on the hospital's medical staff; (ii) To determine the scope or conditions of clinical privileges or medical staff membership; or (iii) To change or modify such clinical privileges or medical staff membership. (B) “Professional review activity” includes an investigation, as defined in this section; and (8) “Professional review body” means a hospital, its governing body, or its medical staff when any of these bodies are conducting a professional review activity.