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The unforeseen benefits of tackling your privileging system

Credentialing Resource Center Connection, January 18, 2007

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It is easy to state the known benefits of developing and implementing criteria-based privileging. A criteria-based system:

-        provides a standardized format

-        is evidence-based

-        assists in objective decision making

-        eliminates confusion

-        furthers compliance with regulatory and accreditation standards

-        is easier to use and maintain

-        helps medical staff organizations define and determine competency

As I work with medical staffs across the country in developing and implementing core privileging, I've become particularly aware of the many unforeseen benefits that come to light as a result of going through such a process. While creating a contemporary, criteria-based privileging system cannot solve all problems, it does offer an opportunity to assess and identify other areas that have needed attention all along.  

Here are a few examples of what you may find under the rock when you turn it over:

-          Areas of conflict or discrepancies within existing documents (e.g. bylaws, department rules and regulations, policies and procedures) are brought to the forefront

-          Existing exclusive contracts are identified and appropriate parties informed of same

-          Clarification for board certification requirements for both initial applicants and maintenance of certification by the medical staff

-          Determination whether the credentialing process for allied health professionals (AHPs) is in compliance with The Joint Commission standards

-          Identification of new policies that need to be created, such as a policy that addresses how to manage requests for new technology and procedures

-          Identification of new services and technology already utilized in the hospital

-          discovery of practitioners practicing in the hospital setting that have not been credentialed previously

The process of creating a criteria-based system also provides the opportunity to:

-        review state rules and regulations related to physician assistants and advanced practice nurses

-        address low- and no-volume practitioners

-        define and clarify supervision requirements for privileged AHPs

-        disseminate information to appropriate clinical areas as well-defined privileging content is assimilated into automated privileging software

-        commit to a regular review of the new forms (rather than allow them to become static after significant time and effort has been expended to develop them)

Some of these issues will be addressed through communication and through changes that occur during the transition to criteria-based privileging. Others will need to be put on an action plan for attention at a later date, while others still are reminders of areas needing more frequent attention.

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