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
- Interview approach
- Determine whether any forms are current and/or adequate
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.
