Avoid negligent credentialing claims surrounding privileges for new technology and techniques

This week, CRC Daily covers credentialing. Medical science is advancing with startling speed, and with that evolution comes rapid change in both clinical technology and technique. Patients can benefit vastly from such advances, but only if the practitioner utilizing them is competent. In general, patient safety is at greater risk when a technology or procedure is new than once it is well established. If there is a bad outcome, plaintiff attorneys are often quick to make at least one of the following claims:

• The hospital was negligent and should not have allowed use of the new tools or approaches
• The hospital should have stricter eligibility requirements for the use of the technology/procedure
• The hospital should not have granted the involved practitioner the privileges to use the new technology or procedure
• The hospital was negligent in its FPPE and continuing oversight of the practitioner in his or her use of the new privilege

Consider bolstering medical staff policies with a procedure that addresses privileging for the use of new technology/techniques. It is always a mistake for medical staff and hospital leaders to learn that a physician has deployed a new technology or technique after the fact. Medical staff policies should clearly define the process for evaluating and approving a new technology before a physician uses it in patient care. These policies should also indicate how a practitioner becomes privileged to use a newly approved technology.

Of course, many new techniques and clinical tools are modest extensions of those already in use, and they require little in the way of significant new practitioner knowledge or experience. Others are major breakthroughs that may require additional training and practice before competence can be acquired and demonstrated. When a technology or technique is a significant departure from one where privileging criteria has already been established, the medical staff must decide whether to create a new privilege. The first step is to determine whether the technology or procedure should be utilized or performed at all in the relevant facility. If the answer is yes, then the second step is to establish clear privileging criteria for the new technology or procedure.

From a risk management perspective, it is important to document that a review process was involved in setting the privileging criteria for a new technology. For example, if the hospital relied on the recommendations of professional societies, then MSPs should document that source in meeting minutes. If there will be heavy reliance on technology company training facilities or tools, this usage—and the rationale—should be made explicit in documentation. There is nothing wrong with such reliance if it is done after a thoughtful consideration of its adequacy and the alternatives.

Source: Negligent Credentialing: Strategies for Reducing Hospital Risk