Ill. Admin. Code tit. 77, pt. 640, app K
Level III Review
* Appendix A
* Resource Checklist for Level III
* Evaluation letter from Administrative Perinatal Center
* Vita for co-directors
* Credentials for Obstetric (OB)/Family Practice (FP) physicians, Advance Practice Nurses (APN), Neonatology & Anesthesia
* Copy of OB/Peds Departmental Rules
* Maternal-Fetal Medicine (MFM), Neonatology Consultation/referral tool/QA reports for 3 months
* Mortality and Morbidity (M&M) statistics and description of the process/participation
* Transport statistics, both into and out of hospital
* Listing of educational classes
* Description of educational classes
* Description of CQI
* 3 months of call schedules for OB, Maternal-Fetal Medicine and Neonatology (current and last 2 actual or 3 proposed schedules)
Level II with Extended Neonatal Capabilities Review
* Appendix A
* Resource Checklist for Level II with Extended Neonatal Capabilities
* Evaluation letter from Administrative Perinatal Center
* Vita for Director of Neonatology, Maternal-Fetal Medicine (MFM), if appropriate
* Credentials for Obstetricians/Family Practice physicians, Advanced Practice Nurses (APN), Neonatology & Anesthesia
* Copy of OB/Peds Departmental Rules
* Consultation/referral tool/QA reports for 3 months
* Mortality and Morbidity (M&M) statistics and description of process/participation
* Transport statistics, both into and out of hospital
* Listing of educational classes
* Description of CQI
* 3 months of call schedules for OB, MFM and Neonatology as appropriate
Level II Review
* Appendix A
* Resource Checklist for Level II
* Evaluation letter from Administrative Perinatal Center
* Credentials for Obstetrics (OB)/Family Practice (FP) physicians, Advance Practice Nurses (APN), Neonatology & Anesthesia
* Copy of OB/Peds Departmental Rules
* Consultation/referral tool/QA reports for 3 months
* Mortality and Morbidity (M&M) statistics and description of process/participation
* Transport statistics - out of hospital
* Listing of educational classes
* Description of CQI
Level I Review
* Appendix A
* Resource Checklist for Level I
* Evaluation letter from Administrative Perinatal Center
* Credentials for Obstetrics (OB)/Family Practice (FP) physicians, Advance Practice Nurses (APNs), Neonatology & Anesthesia
* Mortality and Morbidity (M&M) statistics and description of process/participation
* Transport statistics - out of hospital
* Listing of educational classes
* Description of CQI
Administrative Perinatal Center
* Network description
* Educational programs
* Network projects
* Discussion with representatives from Regional Network Hospitals
* Network participation
* Network evaluation
* Network challenges
* Network M&M statistics
* University integration
Ill. Admin. Code tit. 77, pt. 640, app K