Wednesday, August 23, 2017

4 Questions Departmentalized Medical Staffs Should Ask to Keep Negligent Credentialing Claims at Bay


This article was originally published on Health Leaders Media, August 14, 2017.

Most medical staffs today are departmentalized in nature. Where departmentalization exists, a medical staff must take care to involve each department properly in the practitioner vetting process to avoid negligent credentialing landmines. For example, if a medical staff is departmentalized, the department chair (or designee) plays an important role in credentialing. This role may be spelled out in accreditation requirements or applicable regulations and typically makes the department chair one of the first clinical professionals to review a credentials application.

Despite this weighty expectation, department chairs are often given little guidance as to what their review should entail. In all cases, the chair (or possibly a designee) should assess the appropriateness of the applicant’s privilege requests and provide his or her opinion to the credentials committee or medical executive committee (MEC). But there are many other tasks that, depending on the facility, a chair could be asked to undertake when he or she receives an application.

Considerations include the following:

  1. Is the department chair expected to review the file for completeness, or can he or she assume that the medical staff office did this?
  2. Is the department chair expected to know whether the application is consistent with any medical staff development plan or exclusive contracts adopted by the hospital?
  3. Is the department chair supposed to make direct contact with the applicant or with his or her references?
  4. Is it the department chair’s responsibility to obtain more information whenever anyone identifies red flags in an applicant’s file, or should this be done at the direction of the credentials committee?
Medical staffs may answer these questions differently, but regardless of the selected approach, it’s critical to be clear about the extent of the department chair’s role. This is particularly true for medical staffs where the department chair serves a limited term and turns over regularly. It is especially damaging in negligent credentialing lawsuits when a chair states that he or she did not understand the role or thought someone else was doing a task that the credentials committee or MEC believed was the chair’s responsibility.

The duties of the department chair are typically spelled out in the medical staff bylaws or in credentialing policies and procedures. As with all medical staff leaders, adequate training and orientation for department chairs is an investment well worth any cost incurred. The effort can save an institution from large payouts if it loses a negligent credentialing claim because a chair or another medical staff leader did not understand how to do his or her job properly or appreciate the importance of diligence in this work.

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