You are the Chairperson of the Department of Surgery and you attend the quality committee meetings. You do not have a vote on the quality committee because you need to carry out the recommendations of that committee. The committee is reviewing several cases of Dr. Monitor, one of the busiest surgeons on staff. These cases have had bad outcomes, and the committee is concerned about Dr. Monitor’s surgical judgment. When each case is reviewed individually, it appears the issues are minor. However, upon the detailed review of many of Dr. Monitor’s cases, a devastating pattern of events has emerged, and the committee feels his practice patterns are not safe for the patients at this hospital. The committee has several choices; all choices are, however, only recommendations to you, the Department Chairperson. The surgeon under scrutiny is not known to be arrogant or malicious and is, in fact, well liked. When you discuss these events with the partners in his practice, you find they are also concerned about Dr. Monitor’s practice patterns. You ask the committee to hold off on a recommendation giving you the opportunity to discuss the situation with the surgeon. After a very open discussion with Dr. Monitor and one of his partners, the Division Chief, you ask Dr. Monitor to voluntarily give up his privileges to perform the procedures that are in question. After being informed that he can only assist one of his partners in the procedures of concern, Dr. Monitor cordially agrees to comply with this recommendation. At the next quality committee meeting, you announce Dr. Monitor has volunteered to reduce his privileges.

Background Statement: What is going on in this case as it relates to the identified major problem? What are (only) the key points the reader needs to know in order to understand how you will “solve” the case? Describe the organization, setting, situation, who is involved, who decides what, etc.