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Tip of the week: Clear up misconceptions about criteria-based core privileging

Credentialing Resource Center Connection, July 8, 2011

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MSPs working with department chairs or specialty section representatives to either convert to criteria-based core privileging or to revise their core forms will undoubtedly find that these medical staff leaders do not understand the core privileging process or philosophy as well as MSPs do. The practitioners might be skeptical about the need for a new system. Be prepared to deal with the following misconceptions:

• There is a hidden agenda behind the decision to move to criteria-based core privileging. Clarify that the current activity is designed to simplify the privileging process for the medical staff and the medical staff leadership and to make the issue of privilege delineation more consistent, more objective, and fairer for all involved. Core privileging also has legal benefits and advantages. Point out that the organization’s current privilege delineation system has many holes that a plaintiff’s attorney could exploit in a corporate negligence case. Explain that the organization hopes that this new system will plug these holes by defining objective eligibility criteria and delineating care treatment and services that are currently able to be supported by the healthcare organization.
• The credentials committee or administration is attempting to restrict privileges. Explain that no one is trying to take privileges away from practitioners. A practitioner will continue to maintain his or her current privileges as long as he or she demonstrates current clinical competence and meets the defined criteria for renewal of privileges. This should hold true regardless of the type of privileging system utilized.
• A core system spurs more bureaucracy and paperwork. Clarify that a core privileging system in fact does not produce more bureaucracy and paperwork. The MEC and credentials committee have chosen to develop core privileges because they want to eliminate some of the bureaucracy and complexity associated with granting clinical privileges.
• It is just another Joint Commission change. Educate department chairs and others that, in fact, The Joint Commission has no position on core privileges or any other privilege delineation system. It simply requires that privileges be criteria based and reasonably comprehensive and provide a mechanism for management to ensure that physicians practice within the bounds of demonstrated current competence.

During your discussion, you might wish to refer to the advantages and disadvantages of the various systems for delineating clinical privileges. In addition, you can be prepared to point out situations that have occurred within your organization that clearly show that flaws exist within your current system.


This week’s tip is from Core Privileges for Physicians, 5th Edition.
 

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