Tip of the week: When credentialing APPs and CAs, don't answer "who" until you've answered "what" and "how"

As organizations consider redesigning their processes and allow advanced practice professionals (APPs) and clinical assistants (CAs) to provide new services, the question on the tip of everyone’s tongue is “Who will be responsible for credentialing the nonprivileged CAs?” Historically, the prevalent attitude in organizations with an medical staff services department (MSSD) is that if the individual is related to the medical staff, then the MSSD is responsible.

Once the need to create a different credentialing mechanism and route is identified, the MSSD is usually thrilled by the possibility of being relieved of some responsibilities, while the human resources department resists the prospect of acquiring additional responsibilities.

Experience tells us that as an organization designs a new process for the credentialing and granting of a scope of care to CAs, the last decision should be which individual or department will do it. Although this may be the first question all parties ask, it should be the last one answered.

The organization cannot decide the “who” until the “what” and “how” have been determined. The following are examples of the questions that must be answered:

• What CA disciplines will be included in the new process?
• What are the Joint Commission requirements for credentialing these care providers?
• What elements of background will be verified and what source will be used?
• What method of competence assessment will be used?
• Which individuals or departments will perform the competence assessment?
• Which individuals or departments will have the authority to approve credentialing and granting of a scope of care to CAs?

Until these issues (and others) are resolved, it is inappropriate to decide who will perform the function. Draft the policy with blanks when addressing who will perform these actions.

This week’s tip is adapted from Solving the AHP Conundrum, by Carol S. Cairns, CPMSM, CPCS, now at a discounted price!!