Obtaining peer review data on APPs
The following is an excerpt from the webinar, Privileging APPs: Issues and Solutions.
Q: We struggle to obtain sufficient peer review data on advanced practice professionals (APP) who bill under their collaborating or supervising physician and do not keep personal logs. What can we do to assess their competence?
Carol Cairns: Let me share an anecdote that helps illustrate a possible solution. Years ago, I worked at Presence St. Joseph Medical Center in Joliet, Illinois, which had a full active inpatient and outpatient psychiatric facility. At reappointment time, I always struggled to gather enough data on our psychologists and neuropsychologists. The primary issue was that our health information management department (then known as the medical records office) was not coding the services provided by those individuals. One day, I called up the department’s director and asked, “How can we fix this?” She replied, “I’m happy to code the psychologists, but I don’t have the staff to do so. If you get the CEO’s approval, then I can get a budget variance, and we can begin to code the activities of these clinicians.” Instead, I proposed that the director and I approach the CEO together with a request for an additional FTE to complete the necessary coding and to provide support for other medical records and medical staff services functions. We jointly filed the request and eventually received approval.
I share that simple story to emphasize the constant need for additional resources that cost money. Organizations don’t want to spend anything right now, so you really have to make a strong case. When it comes to APPs, I would emphasize the dramatic and rapid growth in the field. These clinicians aren’t going away anytime soon, and so we need a sustainable approach for monitoring their competence and care quality.
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