Conduct research before bringing APPs on board

As physician shortages accelerate, healthcare institutions should expect to see a rise in the volume of requests for and from advanced practice professionals (APP). Today’s rapidly evolving healthcare industry demands that we extend our reach beyond the well-established APP groups— advanced practice registered nurses, physician assistants, and psychologists—to pharmacists, anesthesiologist assistants, radiology assistants, and others who have not traditionally practiced in a healthcare facility.

Despite the obstacles, many progressive physicians welcome the addition of APPs as an opportunity to expand the clinical team’s expertise and reach. These physicians recognize that, although APP and physician privileges may overlap in some respects, the physician’s scope of practice is wider, and, in collaborative circumstances, he or she has the final say in diagnosis, treatment, and resolution. Additionally, many patients have come to appreciate the care delivered by APPs, and happy patients support successful business for all practitioners in an organization.

When a healthcare institution receives a practice request from an APP in a specialty not currently represented in the facility, the first questions to ask are as follows:

• What are these professionals allowed to do by law?
• Do we need those services?
• If we do need those services, how will they be performed here?

Using these questions as a guide, MSPs should conduct extensive research and translate their findings into a dossier and draft privileging materials to help the medical staff, administration, and governing board decide whether there is a need for that type of professional at the facility.

Where to look

Learn about the profession through internet searches, inquiries to professional associations, and communications to experts in your professional network. Look for information concerning licensure or registration, certification options and boards, professional associations, formal education programs/ curricula, and mechanisms for competency assessment.

Once you have a basic understanding of the profession’s typical scope of training and practice, interview the applicant and, if desired, another individual from the profession. Document why they want to practice at your facility and what they have to offer in terms of treatments, services, or care that differs from your organization’s current portfolio. Ask them to share their education, training, and certification to substantiate what you have already found out about the profession through your research.

What to collect

To cultivate a well-rounded perspective on the given APP discipline, seek out the following information through your chosen research channels: 

• General background information on the APP group. What does the profession do? What tasks, procedures, services, and treatments can they provide, as defined by their training, professional standards, and licensing/registration regulations? How do these parameters compare to what the APP applicant is asking to do in your facility?
• The profession’s state licensure status. Is the profession licensed in your state? If so, obtain the relevant regulations, and have them readily available. Know what qualifications the state requires for licensure (e.g., education, training, certification, examinations). Remember, your minimum practice eligibility criteria should be at least as stringent as your state’s requirements.
• Supervision requirements. Determine the level of independence this profession has under state law and recommendations for the level of independence in your organization.
• Certification options. Identify the organizations that certify the profession (if any), and collect the relevant eligibility requirements. Also, find out how long the certification lasts and whether there is a recertification or maintenance of certification process.
• Competency measures. Determine whether the relevant professional associations have developed competencies for the profession. How do they describe and measure competence in their field? If there aren’t any formal certification options for the profession, reach out to the relevant training programs for insight on alternative measures of qualification. For example, ask program directors to share how they evaluate competency during training.

Source: Overcoming Contemporary Credentialing Challenges: Practical Strategies for MSPs and Medical Staffs