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Continuously improve credentialing policies and procedures.

Credentialing Resource Center Connection, November 18, 2004

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Medical services professionals must observe basic principles when developing credentialing policies and procedures. One rule to consider is this: Continuously improve your policies and procedures.

Some hospitals are reluctant to upgrade credentialing policies and procedures because existing medical staff members did not have to go through the same rigorous scrutiny to gain appointment to the staff and/or clinical privileges.

However, with the growing influence of managed care organizations (MCOs), improvements in credentialing practices, and a stabilization in the medical, legal and regulatory climate, new credentialing issues are emerging that nearly all hospitals and healthcare facilities must consider.

Hospitals should assume they are beginning the future with a clean slate when it comes time to review their policies and procedures. They must design credentialing policies and procedures that maximize the objectivity and consistency with which they review applicants and increase the likelihood that all patients will be treated by providers who possesses the requisite clinical competence to do so.

To stay competitive in providing the best patient-care possible, hospitals must revisit and revise their credentialing processes and upgrade them when needed. Maintaining the status quo in order to appease every physician will not create a progressive atmosphere at your hospital and will not help to improve patient-care. And this, after all, is the most important goal of your hospital.

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