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Advantages of criteria-based core privileging

Credentialing & Verification Update, December 5, 2007

The criteria-based core privileging approach is an efficient and effective approach to privileging. It meets regulatory requirements of The Joint Commission and other accreditors and helps protect the hospital corporation from malpractice suits and charges of antitrust violations. In addition, criteria-based core privileging reflects the thought process a department chair uses when recommending privileges for a practitioner. When looking at a laundry list of privileges for a particular specialty, a department chair recognizes that almost all the listed procedures are appropriate to the specialty area. He or she checks several procedures with little hesitation-an appropriately trained practitioner in that specialty should be competent in performing those procedures. However, a few procedures likely would cause him or her to hesitate and question whether to recommend those privileges for the practitioner. This is the same categorization system that the core privileging system uses.

In addition to reflecting the thought process that department chairs use to decide whether to recommend privileges for a practitioner, the core privileging approach has several other advantages that help make it effective:

• Consistency: All practitioners in a clinical area are asked to meet the same minimum threshold criteria covering education, training, experience, and demonstrated current competence. The same holds true for practitioners from different clinical areas who request privileges to perform the same procedures or treat the same conditions. Consistency is not only a Joint Commission requirement-it also helps to reduce or eliminate medical staff conflict when practitioners from different clinical areas wish to perform the same procedures or treat the same conditions. Consistency is also a significant part of risk management, because consistent criteria help minimize the risk of corporate liability by ensuring that only practitioners with the proper education, training, experience, and demonstrated current competence perform certain procedures and treat specific conditions.
• Flexibility: Another key advantage of the criteria-based core privileging system is its flexibility. When a hospital sets out to develop core criteria for a new clinical area, procedure, or treatment, the format for those criteria is already in place, ready to be followed. The easy-to-use format also increases productivity because nonclinicians can complete much of the initial research.
• Objective prescreening: The criteria-based core privileging system's best advantage is that it clearly defines minimum threshold criteria, providing an objective way to prescreen applicants for clinical privileges. Practitioners who do not meet the predefined criteria for core privileges or special requests are not eligible to apply for those privileges. If they cannot apply, there will be no denials, no fair hearings, and no reports to the state or the NPDB.

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