Enabling medical staff leaders

Dear Medical Staff Leader:

If we expect physician leaders to lead, we must make sure the medical staff is "leadable." A leadable medical staff begins with simple, efficient structures that follow clear, reliable processes. These structures and processes involve the following areas:

• Bylaws: Bylaws establish the rights and responsiblities of medical staff members. Yet most medical staffs confuse governance and this constitutional function with administration. Administration is the activity of carrying out the responsiblities of the organized medical staff. This includes the committees and departments of the medical staff as well as the policies and procedures. To achieve a well-designed and well-functioning medical staff, physician leaders must design how the medical staff will carry out its responsiblities for quality, credentialing, governance, and administration. Once the medical staff has determined how these functions will be carried out, then the bylaws and associated policies and manuals can be written to reflect these decisions.
• Committee and departments: Given the flexibility in regulatory requirements, the medical staff is free to determine the number of departments and committees that will allow it to optimally carry out its responsibilities for quality, credentialing, governance, and administration. Medical staff leaders must determine which departments will carry out which functions, which committees will carry out which functions, and which functions individuals will carry out.
• Credentialing, privileging, quality, and peer review:To determine the optimal number of departments and committees, medical staff leaders must determine how peer review, system performance improvement, and credentialing and privileging will be carried out. Once these functions are redesigned for optimal effectiveness, the rest of the medical staff structure can be designed. The result will be a medical staff that is efficient, effective, and more "leadable."

That's all for this week!

All the best,

Rick Sheff, MD
Chair
The Greeley Company