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Ask the expert: How can I help medical staff leaders prepare for a Joint Commission survey?

Medical Staff Leader Connection, July 1, 2009

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Try a PowerPoint presentation with a little kick, says Dana Crowell, CPMSM, director of medical staff services at Longmont (CO) United Hospital. When a Joint Commission survey is imminent, Crowell gives a presentation that covers medical staff, credentialing, and privileging basics in a question-and-answer format. The following questions are all tied to a Joint Commission standard:

• What type of data is shared with the credentials committee?
• What is the process for granting additional privileges?
• When do you grant temporary privileges?
• How do you address the six general competencies?
• What is the organization’s ongoing professional practice evaluation (OPPE) process?
• What triggers a focused review?
• Do members of the medical staff serve on the board?
• How is the medical staff involved in strategic planning?

The PowerPoint is structured so that the presenter(s) can focus on one of the above questions without providing an answer right away. Instead, presenters encourage leaders to offer their own answers first.

“We try to get them thinking about how they would answer a question if a surveyor was asking them,” Crowell says. The presenter(s) critique their answers, and then provide the approved answers on the next slide. 

Crowell gives each leader with a copy of the presentation to take home and study. “They know this stuff. They do it every day. But a lot of times they get hung up on the language. If they can study this information, it helps them tremendously to feel more prepared,” she says.

This week’s question and answer are from “Prep medical staff leaders for Joint Commission Surveys” in the June issue of Medical Staff Briefing.

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