• E-mail
• Print
• RSS

Thorough background checks needed for all health care professionals

Credentialing Resource Center Connection, December 17, 2003

Want to receive articles like this one in your inbox? Subscribe to Credentialing Resource Center Connection!

Dear Credentialing Colleague:

The infamous case of Michael Swango, the physician now serving a life prison sentence after being accused of poisoning his patients and colleagues, motivated many medical executive committees (MECs) to strengthen their credentials background investigations on all medical staff applicants. Hospital leaders recognized the need to acquire complete information about applicants' past employment and any criminal history. Such improvements have helped medical staffs to identify individuals not qualified for appointment and privileges. (James Stewart chronicled the Swango case in his best-selling book "Blind Eye.")

Today, I recommend that medical staff leaders request a full briefing to learn how their hospital's human resource staff gather information about all health care professionals employed by the organization.

This advice follows on the heels of this week's news of yet another situation in which a nurse, 43-year-old Charles Cullen, has claimed he killed up to 40 patients over 16 years. (See the "in the news" link below for more details.) He has been charged with one count each of murder and attempted murder, but more charges could follow. (You'll remember similar charges, admissions, and convictions in Indiana, Kentucky, Ohio, and Texas over the past few years that cumulatively add up to more than 100 patients. Go to http://www.kaiserpapers.org/caregiver.html for more information about instances where caregivers have injured or killed patients.)

Hospital leaders are continually challenged to implement patient safety systems, including credentialing programs, medications error prevention systems, and surgical site marking protocols. Most have stepped up to the plate and addressed the issue of patient safety. Leaders might legitimately wonder if better human resource practices might have prevented Charles Cullen of Bethlehem, PA from securing a position as a staff registered nurse at a New Jersey hospital.

According to the "Chicago Tribune," "Information about his performance and the (past) dismissals was never forwarded to his successive employers, a circumstance that enabled him to move from one hospital to another with an ease that evidently concealed a pattern of problems."

If this sounds familiar, it is exactly the situation occurring years ago when a disciplined physician could easily move from one facility or state to another without revealing his or her past. However, the rigorous reference and background checks that credentials committees and their assistants apply to all prospective medical staff members has largely eliminated this situation.

Hospital leaders should now challenge their human resource departments to adopt procedures more similar to those used by medical staffs. Credentials committees should offer to provide human resource department staff with advice and consultation concerning the mechanisms they use to check the backgrounds of physicians and attempt to make sure the systems for physicians and nurses are similar in all aspects.

Human resource departments should develop ways to either obtain full information concerning past employment or should refrain from hiring a prospective employee. It is time to challenge the argument that past employers will give nothing but dates of employment. If medical staffs can insist upon "full disclosure of all past relevant information," the hospital should do no less with its employees.

The patients killed by these "potentially discoverable" aberrations were patients admitted and cared for by physicians -- physicians just like those on your staff. You as a hospital leader owe it to them to ensure a safe environment for their patients.

That's all for this week,

All the best,

Hugh Greeley

http://www.greeley.com/seminars/

Want to receive articles like this one in your inbox? Subscribe to Credentialing Resource Center Connection!

• E-mail to a Colleague
• Print
• RSS
• Archive