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Three steps for NCQA compliance with standard CR 10

Staff Development Weekly: Insight on Evidence-Based Practice in Education, May 5, 2006

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Take these steps to comply with the National Committee for Quality Assurance's (NCQA) standard CR 10, which requires the ongoing monitoring of practitioner sanctions and complaints.

1. Establish policies and procedures. Here, your organization needs to define "ongoing," how the monitoring is going to be done, who is going to do it, what signifies a quality problem with a practitioner, and how your organization is going to react to evidence indicating a quality problem.

2. Collect the data. During this phase, don't forget documentation. For example, while monitoring the Office of Inspector General's (OIG) sanction list for Medicare and Medicaid, make sure you have a summary log reflecting your ongoing verification of sanctions.

3. Evaluate the data and act upon the outcome, if necessary. If you find that one of your practitioners does appear to have a quality problem, then you need to follow up immediately-not at re-credentialing time.

Editor's note: The above excerpt is from the online course, "Understanding Peer Review." For more information on this and other courses in our library, go to www.hcprofessor.com.

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