Performing credentialing process audits is similar to conducting patient record audits in that it is usually more productive to audit specific aspects of the process to answer specific questions. This is as opposed to attempting to audit an entire credentials file to address every possible...
One of the key challenges that low- and no-volume providers present is how to assess their competence when you have little or no data on their performance in your organization. Most medical staff leaders say it is difficult to get any information of real value from references today.
When addressing disruptive physician behavior, organizations must understand an often confusing phrase: zero tolerance. Many medical staffs are adopting a zero-tolerance policy with regard to disruptive behavior, but some hospitals are confused about what exactly zero tolerance entails. This...
Credentialing Resource Center Journal - Volume 35, Issue 1
Recently, the Superior Court of Pennsylvania partly granted and partly denied a couple’s request for the discovery of documents related to injuries sustained during the birth of their child.
The primary question a physician reviewer is trying to answer is whether a physician’s actions and decisions were appropriate independent of the care outcome. One of the main components of reviewing performance is identifying the key issues of the case. Physicians reviewers should ask themselves...
When physicians are given feedback data regarding outcomes, a common response is “My outcomes are worse because my patients are sicker.” This concern is legitimate and should be addressed by...
