Granting AHPs permission to provide clinical services

Dear Medical Staff Leader:

As a result of changes to the JCAHO standards governing the credentialing of allied health practitioners (AHPs), many hospitals are developing or revising their policies that address granting these practitioners permission to provide clinical services. For facilities that don't have a current policy, the best place to begin is to evaluate the current scope of practitioners allowed to practice within the organization. If the hospital wants to expand the services offered, it should evaluate the additional disciplines that the leaders may wish to consider adding and include these disciplines in a policy.

From there, creation of a policy should be a board-level activity. This may require the creation of a task force with representation from the governing board, hospital administration, medical staff, and community leaders, as appropriate. The board-level task force should carefully consider the following questions:

• What is the current policy regarding individuals authorized to provide care? Should it change?
• If the policy changes, what impact will the addition of this discipline have on the disciplines already included?
• What statues are applicable to the addition of services from the healthcare provider (licensure, registration, supervision, collaborative agreements, etc.)?
• What types of services would the addition of this practitioner allow the organization to provide?
• Does the hospital or the public want or need these services?
• What changes in staffing or education of current staff will be required if the organization accepts the new service/practitioner?
• How does the contemplated service/practitioner enhance the mission and vision of the organization?
• Is there a community and institutional need for this service?
• Should the practitioners providing the service be employed?
• What will the required minimum qualifications be of practitioners who will be providing the service?
• What applicable regulatory standards apply to the authorization to practice for this category?

Once the governing body task force has considered these and other questions, it should forward its recommendations to the governing board for action. If the recommendation is to add the service, then the task force may also wish to submit a proposed policy or policy revision outlining the conclusion of the task force.

This process should always include medical staff input-an important factor in the decision-making process. Representatives of the medical staff should serve on the task force. These representatives may be chosen from the medical staff leadership (officers and department or committee chairs) or interested individuals or practitioners with particular clinical knowledge regarding the proposed scope of services. However, to avoid potential antitrust charge, the organization should not consult the organized medical staff structure for official input.

That's all for this week!

All the best,

Carol Cairns, CPMSM, CPCS
http://www.greeley.com/seminars/