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DOES YOUR CREDENTIALS COMMITTEE LACK FOCUS?

July 27, 2020

Planning for Provider Credentialing Committee Meetings Saves Time and Serves the True Purpose of Assuring a Competent Provider Staff

The following post reviews ways in which credentials committees can suffer from the lack of effective leadership. Hugh Greeley’s example describes committee meetings being held without sufficient preparation of materials and disorganization that can lead to inefficacious or even dangerous approvals. The time spent reviewing the skills and background of providers applying for appointment and reappointment makes the difference to the hospital’s reputation, the quality of care provided, and patient safety.

Something as simple as a chair failing to review files prior to a meeting can create ineffective use of meeting time, confusion among committee members, and ill-considered authorization of applications. A few poorly run meetings resulting in questionable appointments will negatively affect the institution for years, and possibly cause a cascading effect of quality providers who leave for an opportunity to practice medicine in a place that carefully vets and monitors its physician staff.

After pointing out a handful of credential committee meeting transgressions, Hugh goes on to offer insightful corrective solutions and best practices for productive and advantageous committee meeting management.

The following provided by Hugh Greeley, author of Hugh’s Credentialing Digest

Recently, while watching a credentials committee in action, I was struck by the lack of organization and committee management evident in the room.

A FEW OBSERVATIONS:

  • The chair arrived late and immediately began a conversation with another committee member about a patient.
  • Of the eight appointed members, only four were present.
  • The 67 files in need of review [nine appointments, four locums, eleven advanced practice registered nurses (APRNs) or physician assistants (PAs), and 43 reappointments] had not been pre-reviewed by the chair, who proceeded simply to hand them out to the committee members expecting on-the-spot reviews.
  • Members searched for items to review and, astoundingly, asked the most basic questions, such as, “Where is the license or certification?” and “Have we conducted an NPDB check yet?” The most interesting comment came from a member who arrived late: “We should just lose this application—I know this guy!”
  • When reviewing the application of an APRN, one member mused about how a particular staff member could only supervise so many APRNs or PAs.
  • The chair, upon noticing the time, called for recommendations and, within a matter of seconds, all files were approved for forwarding to the medical executive committee (MEC).
  • Exactly 47 minutes after the meeting began, the chair simply said, “Meeting over. Thanks, everyone.” and left.
  • The medical staff professional (MSP) was left to collect all the files, rearrange them, and otherwise restore them to some semblance of organization.
  • One member hung around for a few minutes and asked the MSP if the hospital really needed this many locum tenens physicians.
  • Most lunches were hardly touched.

WHAT SHOULD HAVE HAPPENED?

  1. The chair should have reviewed the agenda in advance, should have worked with the MSP to categorize all files into one of three groups: no brainers; needs careful review and discussion; and needs more work prior to committee review. This would have resulted in the need for review of only one file, that of a physician up for reappointment who had not had any clinical activity for the past three years. (He was recommended for reappointment along with the other 43 reappointments, without discussion).
  2. The chair should have arrived in advance and greeted and thanked members, thus demonstrating the importance of the committee’s work.
  3. Any file in need of review should have had such review in advance, with the reviewer leading the discussion regarding action.
  4. Questions about the “need for more practitioners” should have been resolved in advance, through a planning process. Credential review is not the time to debate whether a physician or specialty is needed.
  5. All members should have been educated about the process so they fully understood that files not containing basic material would not be presented. (This begs the question, “What is a credentials committee’s function?” See my corresponding article addressing 4 Steps to Becoming an Effective Credentials Chair).
  6. Lunch should not have been served.

REVIEW THE CREDENTIALS COMMITTEE PROCESS REGULARLY FOR OPPORTUNITIES FOR IMPROVEMENT

The above does not represent a typical credentials committee, but it does suggest that, at least in some cases, the process continues to demand greater attention and also that committee members must be well-oriented and managed by a well-trained and experienced chair and medical staff credentials assistant/manager.

Be sure to look for next week’s blog titled: How Many Does it Take to Appoint a Good Physician? for more suggestions on improving the effectiveness of your credentialing process.

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POSTSCRIPT: START WITH DATA AND ONLY PRESENT VIABLE APPLICANTS TO THE COMMITTEE

As a first step to demonstrate respect for the credentialing committee’s time and the process, pre-screening all applicants for license status and exclusion from Medicaid or Medicare participation and other critical data points will assure that only viable applicants are brought to the committee for initial review.

With Verisys’ choices for pre-screening, real-time results are available on the day of committee meetings and can reduce the time and energy of reviewing applications that should not be considered in the first place.

Here are a couple of examples of Verisys data services and products that can save time and effort for everyone from HR, to the MSP team, the credentials chair, credentials committee, C-suite, legal, and the board. Including reasons a physician would be withdrawn from the credentialing or re-credentialing process in the bylaws, rules, regulations and when required, articles of incorporation, relieves the burden of disputes and long legal battles.

Verisys Connect® is Verisys’ self-service data search portal that provides real-time data solutions to check current and historical national license status, history of disciplinary actions, exclusions, debarments, sanctions, and other critical primary source data such as criminal and abuse records. The data sources include FACIS®, Verisys’ proprietary data set of more than 8 million records, current and historical, tapping more than 3,500 primary sources. Additional primary source publishers include national abuse and sex offender registries, OFAC, and Social Security-Death Master File.

CheckMedic® is the enterprise-wide, turn-key solution to screening, credentials verification, and continuous monitoring against more than 3,500 primary sources including FACIS®. CheckMedic® issues a MedPass® to each provider and employee as a comprehensive digital credentialing profile for all data, credentials, peer reviews, board certifications, license status and history, and other relevant data. The MedPass® is a secure, portable digital credentials profile and has custom alerts for expirations, CEU requirements, and actionable adverse actions.

Data Insights for Health Care Best Practice is a downloadable whitepaper outlining data sources and how including a larger net of data insights can help protect a health care organization from reputational damage.

Also, the e-book, “Closing the Five Critical Gaps in Health Care Screening, Verification and Monitoring for Credentialing” reveals the data solutions that close the data gaps so often missed and that contribute to organizational risk.

Hugh Greeley Written by Hugh Greeley
Credentialing and Healthcare Industry Expert
HG Healthcare Consultant
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