Use guidelines to help you develop criteria for new privileges

Due to changing healthcare technologies, increasing specialization, and the growth of individual healthcare institutions, organizations must routinely evaluate new procedures to establish criteria for privileging practitioners in that area. It is often difficult to determine whether a privilege belongs in the basic core or whether the criteria for a particular privilege should include additional education, training, or recent experience.

You can ask yourself the following questions to get a good idea of whether a privilege might be core or noncore:

• Knowledge: Is this procedure based on additional education or training that takes place within a postgraduate training program or via hands-on continuing medical education?
• Skill: Does the procedure require a higher level of skill, or does the procedure require regular practice to maintain proficiency?
• Judgment: Does the procedure require an especially high level of judgment?
• Risk: Are there significant risks associated with the procedure?
• Complications: Would the practitioner require additional, specific training, skills, and/or techniques to manage any potential complications?
• Techniques: Are new or controversial clinical techniques used?
• Equipment: Does the procedure require recently introduced technology or equipment, or does the procedure require additional training, advanced clinical skills, and/or specialized judgment?

Typically, a practitioner with extensive clinical expertise in the specialty under consideration will answer these questions. If the answer to any of these questions is yes, the organization will usually classify the procedure as a special, noncore privilege.