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What topics should our AHP-specific policies address?

Medical Staff Leader Connection, June 4, 2003

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Once your organization establishes the overall framework of its general policy on who will be allowed to provide allied health care and on the general AHP credentialing requirements, specific policies may be developed for particular allied health disciplines. Since a broad-spectrum policy cannot outline the specifics for each allied health discipline, discipline-specific policies be developed.

Your organization should agree on a broad template for discipline-specific policies, and the policy for each allied health discipline should include the following :

• Affiliation with medical staff appointee. This segment would outline the relationship that the discipline would have with a member of the medical staff.
• Written orders. This portion would specify whether the individual can leave orders, whether they need to be countersigned, and if so, when.
• Categories of patients who may be treated. This section would generically identify the patients who may be treated (e.g., the AHP can treat only the employing or sponsoring physician's patients).
• Medical record charting responsibilities. The responsibilities of the AHP for clinical charting would be defined in this portion. Information would include which forms would be used and what/when items would need authentication/countersignature (e.g., history and physical, orders, discharge summary, etc.)
• General relationship to other caregivers. The individual's rights and responsibilities would be described as the AHP relates to employees and other caregivers.
• Scope of service. This would be a core statement regarding the scope of care provided. This scope would be expanded upon in a companion document (e.g., a delineation of privileges form or an authorization-to-provide-care form.)
• Qualifications. This section would outline the minimum qualifications that the AHP must meet in order to be considered for this category.
• Location of service. Since the authority to provide care may be the same in all settings (e.g., emergency rooms, intensive care units, ambulatory care clinics, etc.) or quite different from one setting to another, appropriate limitations to the scope of care within a given setting should be outlined.
• Level of supervision. Organizations should clearly define the level of supervisions required of the practitioner.
• Responsible party. The document should identify which party/parties are responsible for supervising the AHP. For example, organizations may wish to share the responsibility between the supervising/sponsoring physician and a hospital-designated individual.
• Initial and subsequent evaluation of competence. The policy should outline the process for initial and subsequent evaluation of competence and the responsible party/parties. The evaluation process should define what will be evaluated and within what time frame and where the documentation will be retained.

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