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No one works without supervision

Credentialing Resource Center Connection, June 17, 2005

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Dear credentialing colleague:

Recently, a hospital CEO confided in me that his facility has virtually no control or supervision of the many clinical personnel practicing there. When pushed, he acknowledged that most of these individuals are employees of physician members of his medical staff, and that he feels powerless to bring order to this chaotic situation. At his major metropolitan medical center, many of these individuals provide clinical services without permission. They are simply sent to the unit by their busy employer, often a surgeon.

Most of these practitioners lack either documented direct or indirect supervision, and some clearly practice beyond the scope of their licenses or state-issued protocol. "Of course it worries me. Fortunately we have not had a catastrophe, but I am afraid it is coming," the CEO admitted.

Credentials committees should insist on three simple measures that will go a long way toward eliminating this very real threat to patient care.

1. The hospital should maintain a searchable online database containing the names of all individuals authorized to provide any type of care. Any representative of the institution could simply type in the name of a person on the unit and confirm that permission had or had not been granted, as well as obtain a general overview of the individual's privileges or scope of practice.

2. Photo ID badges should be mandatory for every person who works in patient care areas. Hospitals should rigorously enforce this simple and effective rule.

3. All physicians should know that they will be expected to provide an annual competency evaluation for every individual they employ or contract with who performs any clinical service within the hospital.

Implement the above three steps in a friendly and business like manner and you will be on your way to creating a safer and more effective hospital environment.

That's it for this week.

All the best,
Hugh Greeley
http://www.greeley.com/seminars/

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