Tailor privileging and competency requirements to office-based practice

When delineating privileges for physicians who will provide basic care in an office setting, simplicity is the way to go. Keep in mind the following considerations:

• Privileging form: The form should feature a concise delineation of expectations for the practitioner, which can be broader than inpatient and/or procedural delineations (e.g., “general pediatric care for ages newborn–16 years”).
• Competency evaluation: Depending on the organization and individual practitioner, certain procedures may be performed in a physician’s office, such as suture closures of small wounds, eye irrigation, and lumbar puncture. Here again, simplicity is the key. Consider results from patient satisfaction surveys, as well as any unsolicited complaints or kudos from patients or families in the competency evaluation.
• Review payment claims to determine what procedures physicians/advanced practice clinicians are most often performing (and charging for). Make those services the focus of whatever peer review you decide to conduct.

Office practices performing few to no invasive procedures can determine what activities are important to track and establish a committee with some physician and administrative/quality members to review those areas, maintaining records of the evaluations and outcomes. The following are potential focuses:

• Patient satisfaction
• Patient complaints
• Adult and pediatric immunizations (e.g., flu, pneumonia, shingles, well-baby shots)
• Counseling for smokers
• Recommendations for routine mammography and Pap smears for appropriate age groups
• Referrals for colonoscopies for appropriate groups
• Random review of patient records for performance on specialty-specific indictors, conducted by a peer in the same specialty as the practitioner under review
• Medication management
• Appropriateness of referrals to other specialists or sub-specialists

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