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The importance of "The Five P's"

Credentialing Resource Center Connection, June 19, 2008

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Anne Roberts, CPMSM, CPCS, is the director of medical affairs at Children’s Medical Center in Dallas, where she oversees the medical administration, graduate medical education, and medical staff services departments.

Dear credentialing colleague:

Throughout my career and through my affiliation with The Greeley Company, either as a consultant, an author, or a client, I have heard and adopted the credentialing principle of following the five P’s: Our Policy is to follow our Policy. In the absence of a Policy, our Policy is to create a Policy.

Regulatory agencies such as The Joint Commission (formerly JCAHO) require organizations to follow their policies and may require them to show documentation that they have done so. The Joint Commission can cite organizations or give them a Recommendation for Improvement (RFI) if they fail to follow their own policies. For example, if your policy requires that all licensed independent practitioners (LIPs) be certified in advanced trauma life support (ATLS) before they can participate on the trauma team, yet the organization is unable to provide documentation that all members of the trauma team are currently ATLS certified, it can lead to an RFI.

Failure to follow your organizations policies can also potentially lead to legal ramifications. The legal counsel in my organization recently informed me about an appellate court in Minnesota which ruled that a hospital’s failure to follow its own policies constituted malice. In this case, the hospital did not follow their policies related to disruptive/abusive behavior and due process. As the court found that the hospital acted willingly in violating their own peer review process and that the hospital repeatedly disregarded their own policies, they were held liable for malice (intentional doing of a wrongful act without legal justification).To read more about these courts findings, please click on the following link: http://www.mncourts.gov/opinions/coa/current/opa070813-0603.pdf

In summary, regardless of whether you are processing a credentialing application, granting privileges, or conducting a hearing, it is important for you and your organization to consistently follow its policies. If your organization’s practice differs from its policy, then the policy supersedes until it is revised.

Remember, clear, effective communication is the key to success!

That’s all for this week.

All the best,

Anne Roberts, CPMSM, CPCS

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