Tip of the week: Create gradations in your delineations of privileges for low-volume providers

Traditionally, physicians received either full privileges or none at all. With the growing diversity of practitioners, which includes physicians, dentists, podiatrists, and advanced practice providers, such as nurse practitioners, certified registered nurse anesthetists, midwives, and physician assistants, it is becoming increasingly necessary to think of privileges in a more nuanced way through gradations of independence. Consider the key questions in developing different categories of privileges:

• Does the practitioner hold a license to practice independently in the state?
• Does the institution authorize the practitioner to practice independently within the institution?
• Does the organization generate adequate quality data to determine practitioner competency?
• Is it likely the organization will generate adequate quality data to determine practitioner competency in the near future?
• Does the organization have access to quality data generated in other institutions where the provider practices and/or have references adequate to determine practitioner competency?
• Does the practitioner have adequate recent practice volume to determine competency?
   

For example, an active surgeon on your medical staff who is licensed to practice independently and has adequate data to demonstrate competence would be granted independent privileges. However, an OB/GYN who has taken five years off from practice to raise children may need to be granted comanagement privileges until he or she can generate enough performance data to demonstrate current competence.

This week’s tip is fromEngage and Align the Medical Staff and Hospital Management: Expert Strategies and Field Tested Tools by Jonathan H. Burroughs, MD, MBA, FACPE, CMSL; Robert J. Marder, MD, CMSL; and Mary J. Hoppa, MD, MBA, CMSL, published by HCPro.