Make credentialing and privileging a priority at ambulatory facilities
Credentialing and privileging lapses in the ambulatory arena have a familiar calling card: too few staff wearing too many hats.
Compared to the average hospital, ambulatory facilities have much shorter rosters of affiliated practitioners, meaning a lone employee may constitute the entire credentialing workforce. Sometimes, practitioner vetting isn’t even that employee’s primary focus or area of expertise.
“I have been to ambulatory surgical centers where the secretary to the chief nursing officer … is the person who’s dong the credentialing,” says Kathy Matzka, CPMSM, CPCS, FMSP, an independent medical staff consultant in Lebanon, Illinois. “That person usually wears a lot of hats, and this is only one piece of what they do.” Other staff who may take up credentialing as a secondary—or tertiary—duty include the facility’s administrator, director, infection preventionist, or quality assessment and performance improvement committee, says Montgomery.
Given these team members’ heavy and varied workloads, credentialing often becomes an afterthought. “It’s just one of those things that always gets pushed to the back burner,” says Montgomery. “It’s not a priority for many centers because they’re trying to take care of patients or take care of their providers, and all of this paperwork is sometimes overwhelming.”
Although vetting lapses may not disrupt an ambulatory facility’s day-to-day operations, they can have long-term effects on an organization’s legal standing and quality of care, says Montgomery, recalling a recent consulting gig with a facility whose recredentialing process was so backed up that several providers were practicing with expired privileges.
Such shortcomings can “result in providers who are performing services or procedures for which they need additional qualifications, more experience, and/or performance improvement,” the AAAHC roadmap states. “These can be immediate threats to patient safety and risk of liability.”
Given these significant implications, facilities must recast the credentialing and privileging process as a priority.
“Within the practice, it has to be viewed as … a critical element,” says Marshall Baker, FACMPE, president and CEO of Physician Advisory Services, Inc., a consulting firm for physician practices in Boise, Idaho, and an AAAHC surveyor for ambulatory facilities. “That means they need to devote some resources to being sure it is that high priority.”
Source: News & Analysis