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What's in a name?

Credentialing Resource Center Connection, December 13, 2007

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Sally J. Pelletier, CPMSM, CPCS, is a consultant with The Greeley Company, a division of HCPro, Inc., specializing in the areas of credentialing and privileging.

Dear credentialing colleague:

One of the really cool benefits I have as a result of being a part of the credentialing and privileging practice at The Greeley Company is the chance to brainstorm and create best practices with experienced and knowledgeable co-workers. One of the topics that we discussed early in 2007 was whether there was a need, based on what we were observing in the field, to create new terminology for allied health professionals (AHP) that would have a more consistent meaning.

As consultants who work with a wide number of hospitals nationwide, we have discovered that the use of the term AHP has a variety of meanings across organizations. AHPs may or may not be defined in an organization's medical staff bylaws, or policies and procedures, or it may be defined culturally by the geographic region of the country, or by groups of peers who network together. We concluded that it is time to "float the balloon" so to speak, to see how the field reacts to the following new definitions. In the future, The Greeley Company will shift from the universal terminology (because it is without a universal definition) of "allied health professional" and utilize two new designations: advanced practice professionals (APPs) and clinical assistants (CAs).

This first group of individuals known as, "Advanced Practice Professionals" will be those practitioners other than licensed physicians (and possibly dentists, podiatrists, and psychologists[1]) who practice and provide care and treatment to patients without direct supervision and who (according to The Joint Commission) must be privileged though the medical staff process or an equivalent process, to include physician assistants (PAs), and advanced practice registered nurses (APRNs), and other individuals deemed by the institution to provide care at a level of complexity that warrants privileging-essentially, these are privileged-AHPs. 

The second set of practitioners we are identifying are "Clinical Assistants", and are those individuals who are employed or sponsored by members of the medical staff organization) to provide patient care services via authorization mechanisms administered by the human resources department.  Included in this group would be physician employed nurses, surgical scrub technicians, dental assistants, etc.  Essentially, Clinical Assistants are non-privileged AHPs.

Should you begin to use this terminology for your own organization, you'd need to make sure your existing documents-including medical staff bylaws, rules and regulations, policies and procedures-were revised accordingly. Your organization should ensure it has policies in place that address each of these groups and at a minimum include:

• The definition of who is in each group
• Supervision requirements
• Methodology for processing applications and requests for privileges (applicable to APPs)
• Qualification requirements
• Grievance procedures
• Methods to evaluate competence

What do you think of these new terms? Please send your comments about whether you like these new definitions and believe they could be effective in eliminating the current confusion surrounding the term allied health professional to Associate Editor Emily Berry at eberry@hcpro.com. She will then forward the responses to me.

Remember, credentialing has no other master than the patient.

That's all for this week.

All the best,

Sally J. Pelletier, CPMSM, CPCS
http://www.greeley.com/consulting.cfm

[1] Note:Your organization may define dentists, podiatrists, clinical psychologists, and others as part of your medical staff - thus they would not be considered an APP.

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