Best FPPE practices to avoid negligent credentialing claims

Most accreditation bodies now require medical staffs to subject applicants with newly granted privileges to some type of FPPE. Some accrediting organizations see this as an important capstone to the process of initial appointment, and knowledgeable plaintiff attorneys often seek documentation of its performance. While most medical staffs do a reasonable job at collecting evidence of competence in the exercise of newly granted privileges, some perform this task sloppily. One common fault is failing to have a medical staff leader actually assess the collated FPPE data. It is important to not only collect performance data after initial appointment, but also to designate a leader or committee to evaluate the FPPE data and attest that it adequately demonstrates the requisite competence.

Key concepts in action

When a hospital fails to call on a medical staff leader’s expertise in evaluating FPPE data, the plaintiff attorney may allege that, despite an otherwise satisfactory appointment process, the new practitioner was not actually competent in the granted privileges, a shortcoming that ultimately resulted in harm to the patient (his or her client). The attorney will claim that a completed FPPE process would have uncovered this fact, and that the hospital could subsequently have taken action to restrict the granted privileges. Had it done so, the hospital could have prevented the injury to the patient.

Legal Insight

The following is a sampling of lapses at initial appointment that can lead to negligent credentialing claims:

• Failure to gather and, when appropriate, verify all required information for an initial application
• Failure to obtain a satisfactory explanation for all gaps in the chronological professional history of the applicant
• Failure to go through all the steps in the formal credentialing process when an applicant seeks rapid appointment
• Failure to contact references who submit incomplete reference forms
• Failure to complete and document FPPE related to all initially granted privileges