Due diligence for all healthcare professionals
The story of Michael Swango, the physician currently serving a life prison sentence for poisoning his patients and colleagues, motivated numerous medical executive committees to conduct background investigations on all medical staff applicants. Such practices allow medical staffs to identify individuals who are not qualified for medical staff membership and clinical privileges.
Medical staff leaders may now want to meet with the hospital's human resource staff to learn how that department gathers information about other healthcare professionals practicing at the facility. Consider a New Jersey nurse's admission that he murdered more than 40 patients during the last 16 years. The nurse, Charles Cullen of Bethlehem, Pennsylvania, also admitted to murdering patients in Indiana, Kentucky, Ohio, and Texas—approximately 100 patients in total.
As a medical staff leader, you are continually challenged to implement patient safety systems, which include stringent credentialing programs, medication error prevention systems, and surgical site marking protocols. Most leaders have met this challenge and successfully addressed patient safety. However, could better human resources practices have prevented Cullen from securing a position as a staff nurse? According to The Chicago Tribune, "Information about [Cullen's] performance and the (past) dismissals was never forwarded to his successive employers, a circumstance that enabled him to move from one hospital to another with an ease that evidently concealed a pattern of problems."
Such situations will sound familiar to those of you who remember a time when disciplined physician could easily move from one facility or state to another without revealing his or her past. However, credentials committees have since adopted rigorous reference and background checks that put an end to this pattern. You should now challenge your human resources department to adopt similar procedures to obtain complete information concerning a practitioner's past employment. If comprehensive information about the applicant can not be gathered, your organization must reconsider hiring the prospective employee. In addition, challenge the argument that past employers will provide nothing more than the dates of the provider's employment. If medical staffs can insist on the full disclosure, the hospital should insist on nothing less for potential employees.
The patients killed by these "potentially discoverable" aberrations were admitted and cared for by physicians just like those on your staff. As a medical staff leader, you owe it to them to do all you can to ensure a safe health care environment.