As healthcare becomes more and more integrated through consolidation, acquisitions, and mergers, one of the most difficult challenges for a system or network to achieve is a highly effective system-wide criteria based privileging methodology. Greeley experts Sally Pelletier, Chief Credentialing Officer and Frances Ponsioen, Advisory Consultant identify strategies for optimizing privileging performance across an integrated delivery system below.

Step 1: Evaluate existing privileges across the system

• Identify and resolve disparate requirements in MS bylaws
• Identify tried and true criteria
• Understand current services / technology -including those under consideration
• Agree on a format
  • Practitioner friendly / Leading practice
  • Electronic or paper
• Have an awareness for current forms that may be “untouchable” due to a sense of ownership

Step 2: Secure support throughout the system

• Utilize social capital
• Understand MSL strategic goals
• Cultivate the shared vision of physician success, hospital success, and good patient care
• Project communique
  • Remember the previous goals and objectives – WIIFM
• Medical staff leaders
  • Physician champions
  • Task Force – Credentials committee
• Administration / Hospital personnel
  • Medical services professionals
  • IT
  • OR director / Clinical managers
  • Quality department
• Governing board

Step 3: Project Planning

• Determine who will oversee project
  • Project steering committee
  • Multiple directors/Managers MSSD
• Develop a project plan that includes tasks, accountabilities, and timelines
• Identify the specialties/subspecialties (physician and advanced practice): Who? What? Where?
• Research exclusive contracts
• Begin to identify representatives

Step 4: Provide education to key stakeholders

• Project steering committee
• Medical staff and MS leadership
  • Specialty representatives
• Administration
• Clinical departments (e.g., operating room)
• Quality department
• MSSD / Credentialing
• Group administrators
• Time commitment
• Roles and responsibilities
• Resources
• Decision points
  • Volumes
  • Grandfathering
  • Cross-specialty disputes
  • Approval process

Step 5: Develop draft privilege forms

• Don’t reinvent the wheel unless you need to
  • Determine whether any forms are current and/or adequate
    • Templates / Software content
    • The Internet is a beautiful thing
  • Initial customization
    • Identify common and site-specific privileges or services
    • Eliminate services that are not offered
  • Conduct specialty specific interviews
    • Engage physician leaders
    • Selecting representatives
      • Department chairs / Section chiefs
      • Specialty “experts”
    • Communicate expectations and time frames
    • Be respectful of practitioners’ time
      • Existing DOPs and criteria
      • Governance documents
    • Conduct specialty-specific interviews
      • Interview approach
        • Largest facility first or is that a mistake?
        • Communicate schedule and agenda
        • Consolidate across the system
          • Avoid he said /she said
          • Avoid having too many opinions at the table
          • Manage politics
        • Advanced practice professionals

Step 6: Approve new/revised privileging criteria and forms

• Establish a strategy for timely review of all forms across all facilities
• Electronic review and approval

Avoid:

• Stonewalling
• 100% department or section approval
• Loss of momentum
• Setting unrealistic time frames

Step 7:  Implement new forms

• Coordinated effort
  • Project steering committee
• Specialty / Departments
• Technology
  • Credentialing/Privileging database

Step 8: Communicate current privileges

• Privileged practitioners
• Hospital staff
• Group administrators

Step 9: Evaluate criteria and forms periodically

• Develop schedule for review
• Avoid referencing dated or archived criteria
• Be proactive about new services / new technology

Step 10: Continuously orient new medical staff leaders to the privileging system

Is your organization ready to start implementing these essential steps towards integration? Contact Greeley to learn how we can help: 888.749.3054 or info@greeley.com.

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