Updating your bylaws

Your medical staff governance documents may fail to provide clear guidance, be noncompliant with accreditation standards, or create liability for your hospital if they are inadequate for today’s care environment. During the webcast, Medical Staff Governance Documents: The Increasing Importance of Contemporary Bylaws, Todd Sagin, MD, JD, offered best practices for contemporary medical staff bylaws and guidance on how to best address hot-button issues that create liability or controversy for medical staffs. Sagin also took questions from the audience. The following is one of the questions he addressed:

Q: Our system includes a hospital, with clinics across three cities. Should our bylaws, rules, and regulations stretch to include them, rather than have more focus on hospital practices and privileges?

A: Increasingly, there are good best practices out there for bylaws, policies, rules and regulations. If it was as simple as there being one set of bylaws and one set of policies and procedures that were perfect for everyone, I'm sure everyone would buy them and use them. It's not that simple, but there are well thought out, well vetted, widely used policies, policy language, and bylaws language.

[Unfortunately,] what happens at many medical staffs is that leaders recognize an issue and make up an approach to address it. This is not a bad thing, but when people try to create policy language and solve problems without any awareness of how the relevant issues has been tackled or approached in other places, they can't benefit from the lessons learned by their colleagues on other medical staffs.

It really is worth trying to adopt well-vetted policies. If you've got multiple institutions, you'd want to see them adopt the best language and best practices, unless there is some kind of mitigating circumstance which warrants deviation. Sometimes that deviation is just local politics, which doesn't make sense and ought to be resisted. Sometimes it's local culture which actually is supportive of good practice and probably ought to be indulged. Again, there's no right or wrong here.

Click here for more information about the webcast or to order it on-demand.