Assessing the Competency of Low-Volume Practitioners

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Assessing the Competency of Low-Volume Practitioners

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Assessing the Competency of Low-Volume Practitioners
Tools and Strategies for OPPE & FPPE Compliance, Second Edition

Sally Pelletier, CPMSM, CPCS; Mark Smith    

Fewer physicians are practicing in the hospital, yet The Joint Commission is placing more pressure on hospitals to verify the competency of all physicians.

The Joint Commission requires that hospitals verify physician competence using performance data. Yet organizations often have little or no data related to the competency of low- and no-volume physicians. Medical staff leaders are therefore challenged to develop a strategy that guides the hospital’s relationship with low- and no-volume providers, and medical staff services departments are challenged to establish systems to verify physician competence.

This fully updated book and CD-ROM set offers the necessary tools and strategies for medical staff leaders and professionals to manage the increasing number of low- and no-volume providers and comply with Joint Commission standards.

This resource will help you:

  • Understand the low- and no-volume trend
  • Manage low- and no-volume practitioners
  • Develop a strategy for aligning physician and hospital goals
  • Create medical staff categories to reflect the role of these physicians and encourage participation
  • Effectively appoint and reappoint low-volume practitioners to the medical staff
  • Document and assess performance data for low- and no-volume providers
  • Comply with FPPE and OPPE requirements
  • Effectively credential and privilege low- and no-volume providers
  • Strengthen physician-hospital relations

It provides:

  • Techniques to collect adequate data and verify competence
  • Tools to credential and privilege low and no-volume providers
  • Methods to comply with FPPE and OPPE requirements
  • Case studies to illustrate suggested strategies
  • Customizable tools and forms on CD
  • Strategies to comply with Joint Commission standards
  • Alternatives to having low- and no-volume providers on the active medical staff
  • Ways to align hospital goals with those of low- and no-volume providers

Don’t let the low- and no-volume trend bog down your credentialing and privileging processes. Use this resource to manage low- and no-volume practitioners, effectively appoint and reappoint low-volume practitioners to the medical staff, and document and assess physician competency.

Check out the table of contents:

Chapter 1: The Growing Low-Volume/No-Volume Trend in Hospital Medical Practice

  • How Did We Get Here?
  • Past Meets Present
  • The Challenge This Trend Poses for Your MSPs, Medical Staff Leaders, and Board
  • CMS and Joint Commission Regulations Pose Credentialing Challenges

Chapter 2: Developing a Strategy to Manage Low- and No-Volume Providers

  • Inclusive versus Exclusive Medical Staffs
  • Creating a Medical Staff Development Plan
  • Medical Staff Models
  • Creating Value for Individual Medical Staff Members
  • Designing a Medical Staff Development Plan

Chapter 3: Determining Practitioner Competency

  • Matching Privileges with Competence
  • Remember the Four Basic Credentialing Steps
    • Step 1: Establish Policies and Rules
    • Step 2: Collect, Verify, and Summarize Information
    • Step 3: Evaluate and Recommend
    • Step 4: Review, Grant, or Deny
  • Processing Requests from Low- and No-Volume Providers

Chapter 4: Options for Processing Low- and No-Volume Practitioners’ Applications

Chapter 5: Case Studies

  • Soliciting Physician Input
  • Career Development
  • Creating Options
  • Rural Conundrum
  • Questionable Quality

About the experts who bring you Assessing the Competency of Low-Volume Practitioners:

Mark A. Smith, MD, MBA, CMSL
Director of credentialing and privileging services with The Greeley Company, a division of HCPro, Inc.

Smith serves as the director of credentialing and privileging services and a senior consultant for The Greeley Company. He brings 25 years of clinical practice and hospital management experience to his work with physicians and hospitals across the United States. Smith's clinical practice as a surgeon and multiple roles in senior hospital administration make him uniquely qualified to assist Greeley clients in developing solutions to their complex staffing and managerial problems. Smith has an expertise in peer review, focused professional practice evaluation, and criteria-based privileging.

Sally Pelletier, CPMSM, CPCS
Senior consultant with The Greeley Company

Pelletier brings more than 16 years of credentialing and privileging experience to her work with medical staff leaders and medical service professionals across the nation. She advises in the areas of criteria-based core privileging, medical staff office assessments, and medical staff services management. She is a contributing editor for the monthly newsletter, Briefings on Credentialing, and has coauthored several books, including Core Privileges for AHPs, The FPPE Toolbox, Converting to Core Privileging, and Core Privileges for Physicians, Fourth Edition, also published by HCPro.

Published: March 2009