Assessing the competence of APPs

Prospective review, concurrent review (proctoring), or retrospective review are examples of the various ways to conduct a focused review or to evaluate privileged practitioners. The medical staff should work with advanced practice professionals (APP) to define specific quality indicators and to collect data on an ongoing basis. Many APP disciplines may be evaluated utilizing the same quality indicators as their physician counterparts (e.g., CRNA and anesthesiologist; CNM and OB/GYN). If it is difficult or impossible to gather patient records showing that the APP participated in patient care, then MSP may reach out to the APP and request a list of patient records in which the APP was involved.

For organizations that are still challenged with attributing care to the APP, it is helpful to both parties if the APP is notified ahead of time of the need to keep a list of activity for ongoing review. Once that list has been provided, a random number of records can be pulled and retrospectively reviewed by a peer or a physician, utilizing the same review forms that are used for physician review. However, it may be more appropriate to develop a review form that is tailored to the APP and the medical care that he or she provides under the supervision of or in collaboration with the sponsoring physician, including the documentation of consultation with the physician as appropriate.

Source: The Medical Staff’s Guide to Overcoming Competence Assessment Challenges