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Responding to privileging requests involving new procedures

Medical Staff Leader Connection, January 6, 2003

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Dear Medical Staff Leader,

Constant advances in medical research, technology, education, and consumer demand for health care organizations to offer new and innovative procedures have increased dramatically in the past several years-a trend that isn't likely to end anytime soon! As a result, the medical executive committee must determine how to respond to practitioners' requests to perform procedures and treatments that the institution has not previously offered. These organizations do not have internal outcome data or other performance measures to help them determine which practitioners are qualified to perform the new procedure or treatment.

The fist step is to determine the value of the new procedure or treatment. If you decide that the procedure has merit and is suitable for your patient population, you must then process the privilege request with great care. You must resist the temptation to grant temporary privileges.

In addition, it is wise to insist that the practitioner requesting the new privileges first perform the procedure in the presence of a practitioner from another organization who is experienced in performing the procedure.

Keep in mind the following steps the next time your institution receives a request from a physician for privileges in a new procedure or treatment:

1. Conduct research to determine whether the procedure should be permitted at your organization. Ask whether the procedure is more efficient or as efficient as traditional treatment.

2. If you decide to allow practitioners to perform the procedure, conduct research to determine what education and training is necessary to perform the procedure effectively.

3. Evaluate patient safety issues to determine what steps to take to ensure a safe, comfortable experience for patients who opt for the procedure-and for the physician performing the new procedure.

4. Draft an institutional policy concerning the new procedure and present it to the MEC for approval.

The challenge is yours. Remember, as medical staff leaders you have the ability to resolve this dilemma before it becomes even more complex and confusing.

That's all for this week.

All the best,

Hugh Greeley

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