Recent Articles
Call for submissions: Privileging forms, policies, and procedures
Want to help out your fellow MSPs and learn how other MSPs tackle their credentialing challenges?
Credentialing Resource Center is looking for member-submitted privileging forms, policies, and procedures to share with our subscribers. While we make every effort to keep our Clinical Privilege White Papers up-to-date, sometimes there are new procedures and technologies that we have not been able to address yet. Your forms could aid other organizations in solving their privileging dilemmas, and vice versa!
Whether it’s credentialing criteria for RNFAs or sample bylaws language for delineating medical staff categories, we want to see the forms that have helped your organization address credentialing issues. Examples of these member-submitted forms can be found when you log in at www.credentialingresourcecenter.com.
To share your privileging forms, please email documents, along with a brief explanation of the contents, to Katrina Gravel (kgravel@hcpro.com). Thank you!
Best regards,
Katrina Gravel
Credentialing Resource Center Blog
Don’t ignore cultural fit
Despite popular belief, compensation isn’t everything to today’s physicians. As more physicians move from private practice to an employed model, health care organizations will be challenged to integrate new physicians with different expectations related to cultural attributes such as accountability, autonomy, work environment and communication styles.
How important do you think culture is to the physicians in your organization? Do you think there are any gaps in how you and your physicians view the culture in your organization? Do you believe it is necessary to invest in assessing and developing cultural fit?
You might be surprised by what we learned in our recent survey conducted in partnership with Physician Wellness Services. The survey examined the influence of 14 cultural attributes on physicians’ overall satisfaction, and their perceptions about their organization’s performance related to those cultural attributes.
We discovered gaps between physician satisfaction and their organization’s performance. Many of the attributes that physicians ranked as most important to their overall satisfaction (rated 8 or above on a scale of 1 to 10) were ranked relatively low in terms of organizational performance with the attribute; the most substantial gaps occur with:
- Transparent communication
- Collaborative leadership style
- Organizational adaptation to change
We were particularly concerned to learn that administrators underestimate the frequency with which physician respondents said that lack of cultural fit has prompted them to leave or decline a position. Since the cost of turnover and prolonged vacancy can cost a practice as much as $100,000 per month, it is vital to understand the influence of organizational culture and its impact on a physician’s decision to join – and stay – with your practice. This is especially critical in the first three years of joining a practice, when recruits are highly vulnerable to turnover.
Physicians want to know that their organization is progressive, particularly in today’s evolving health care landscape. The survey makes it clear that a significant number of physicians are not satisfied with their organization’s ability to communicate effectively and transparently, provide collaborative leadership, and adapt to changes.
Organizations can help fill these gaps by more objectively assessing cultural fit of physician candidates with these simple steps:
- Define the attributes that make physicians successful in your organization.
- Screen effectively for those traits and beware of red flags that might indicate a poor fit with your culture.
- Conduct behavioral interviewing to evaluate teamwork and team leadership qualities.
- Onboard effectively to educate new recruits on your organization’s day-to-day culture.
- Assign a mentor and create a formalized program.
- Offer flexibility and work/life balance.
- Identify your organization’s physician leaders to champion transformation and promote positive cultural changes.
For more information on workplace culture and its influence on physician recruitment and retention – or to request a full copy of the survey report – click here or contact Emily Velders at (800) 296-2698 ext. 64508 or evelders@cejkasearch.com.
The Joint Commission releases R3 report
The Joint Commission has released an R3 Report to provide the rationale and references employed in the development of new requirements; the most recent R3 report relates to patient flow through the emergency department. The Joint commission has revised standards LD.04.03.11 and PC.01.01.01 with an increased focus on the importance of patient flow in hospitals. Most of the revised elements of performance (EP) went into effect on January 1, 2013, though two EPs–LD.04.03.11 EP 6 and EP 9 –will not go into effect until January 1, 2014.
Standard LD.04.03.11 requires an organization to manage the flow of patients throughout the hospital. The EPs for this standard mentioned in the R3 report focus on measuring and setting goals for the components of a the patient flow process and the boarding of patients who come through the emergency department, determining whether goals are achieved, and involving leadership actions to improve patient flow processes when goals are not achieved.
Standard PC.01.01.01 requires the hospital to accept the patient for care, treatment, and services based on its ability to meet the patient’s needs. EP 4 requires hospitals that do not provide psychiatric or substance abuse services primarily to have a written plan for defining the care, treatment, and services or referral process for those patients. EP 24 requires hospitals to provide a safe and monitored location and to conduct assessments and reassessments for patients waiting for care for emotional illness or substance abuse, as well as providing orientation and training for staff in these situations.
New Session announced for Greeley Seminars in CA January 24-26, 2013
Additional Complimentary Session Open for January 2013 Seminar Attendees
TOPIC: Catastrophe Preparedness- Learn critical liability mitigation skills first hand from the firm assisting Hurricane Sandy victim hospitals in New York and New Jersey
Have you already registered for, or are you planning to attend the Greeley Credentialing/Privileging and Medical Staff Leadership seminars in Indian Wells, Calif., January 24-26, 2013? For registered attendees of these live seminars, HCPro and The Greeley Company are pleased to offer a complimentary session titled, “How prepared is your hospital/health system for a catastrophic disaster?” on January 25, 2013.
Russell Phillips & Associates, a team of fire, code compliance, and emergency management experts, recently assisted hospitals in New York and New Jersey in the wake of Hurricane Sandy and will lead this session. You will learn:
- What are hospitals’ key vulnerabilities today?
- How prepared is your leadership team for catastrophe?
- If your infrastructure failed, have you properly pre-planned evacuation?
- What training should clinical leadership, clinicians, and ancillary/support services undergo to minimize the impact of evacuation?
- If another regional hospital fails, is yours prepared to handle an influx of patients?
Please note that all brochures are on one convenient download, with pricing and program descriptions. Click here to download your brochures and register today! Time is running out.
- Medical Executive Committee Institute, January 24-26, 2013
- The Credentialing Solution, January 24-26, 2013
- Peer Review Boot Camp, January 24-25, 2013
- Physician Hospital Integration and Alignment, January 24-26, 2013
It’s easy to register; just call 888-242-2642, or email pohara@hcpro.com or scalabro@hcpro.com.
Thinking about going paperless?
Over the years here at Children’s Medical Center in Dallas, we have worked to streamline our credentialing processes as much as possible. Most of this is done through utilizing technology. We have implemented online physician orientation modules at initial and reappointment. WE have electronic OPPE data profiles that the division chiefs can log in and review electronically as well as drill down on quality indicators to get more specific data. FPPE is also electronic; it is linked to our electronic medical record system so proctors are notified electronically that there are cases for them to review and they can they complete the chart audit electronically. Through the use of laptops, we’ve had paperless medical staff meetings for many years.
We recently started the transition from using our old laptops in all of our medical staff meetings to incorporating iPad ©tablets. I asked our director of medical staff services, Kenneth Enad to give me a quick summary from his perspective on this new initiative. His words are worth sharing with others debating whether to go paperless:
“Preparing the packet for the credentials committee meeting has come a long way over the past few years. The entire team used to spend more than a full day gathering material for the packets and literally running around making copies to the point where it was an approved sneaker day. The environment would be such high stress, and I can’t even begin to count the number of times the copy machine would break!
I would say our transition from killing so many trees depended on two major steps. First, we developed an organized process to collect the material for the packet. We structured our shared network drive with a folder created for each major category (new applicants, additional privileges, reappointments, etc). Firm deadlines for each coordinator for getting the information into the folders gave the parameters necessary to allow all five MSPs to contribute to the packet without creating chaos. Secondly, using the Adobe © software and laptops, we found a viable technological solution to gather, merge, bookmark, and display the electronic packets. The committees found these very easy to navigate.
We’re now transitioning to the use of iPads for our meetings. We have found that these are far more cost effective than laptops, and a lot faster to “boot up” before a meeting. So far, the committee members have been very receptive to them. If they’ve never used an iPad © or the iBooks © app before, I give them a 30-second tutorial, and soon enough I see a smile on their face as they impressively tap, pinch, and swipe through the pages of the packet!”
Happy National Medical Staff Services Awareness Week!
Did you know that in 1992, President George H.W. Bush declared the first week of November as National Medical Staff Services Awareness Week? In his proclamation, Bush wrote that the week honors MSPs for playing “an important role in our nation’s healthcare system.” The National Association Medical Staff Services (NAMSS) developed a press release for medical facilities to use in promoting this special week and explaining the role of the MSP. Let’s face it: many healthcare consumers are unaware of the medical staff services department. I will admit, I was one of those healthcare consumers who did know what the word credentialing meant before I started working at HCPro. Here is an excerpt from the NAMSS press release:
“MSPs are experts in provider credentialing and privileging, medical staff organization, accreditation and regulatory compliance, and provider relations in the diverse healthcare industry. They credential and monitor ongoing competence of the physicians and other practitioners who provide patient care services in hospitals, managed care organizations, and other healthcare settings.
“MSPs are a vital part of the community’s healthcare team. They are dedicated to making certain that all patients receive care from practitioners who are properly educated, licensed, and trained in their specialty.”
I think we can all agree that the role of MSP has expanded far beyond what can be summarized in a one-page press release. What I find amazing is how passionate MSPs remain about their work, even as their workload increases and they face greater resistance from physicians to complete all of these credentialing and competency checks. When I told two of my personal physicians what I do for work, they each responded with similar comments: “I hate that credentialing stuff. It takes up so much time and I have to fill out the same papers over and over.” I have to admit, I was kind of surprised to hear this. I guess I had hoped that physician resistance to credentialing was a myth. What I did not get a chance to ask either of my physicians about was their relationship with the MSPs at their hospitals. I will keep my hope alive that this answer would have been a lot more positive.
In honor of all that MSPs do, HCPro is offering you and your colleagues a 20% discount on all of our medical staff and credentialing products from Nov. 5-9. Visit the HCMarketplace and enter EB202434 during check out to receive your discount.
On behalf of HCPro, and as a patient who has always received great care from exceptional physicians, thanks for all of your hard work!
Who should pay for medical education?
It’s no surprise that debt is one of the largest issues facing medical school students after graduation. It’s even less surprising that with an average debt of $162,000, these grads seek some sort of loan repayment program as part of their recruitment package.
World-renowned Princeton University economics professor Uwe Reinhart evaluates the subject in a recent post with the New York Times Economix blog and references a Cejka Search survey. In Dr. Reinhart’s article, he discusses the range of physician compensation and whether or not medical education should be government subsidized as a public good.
According to our annual Resident and Fellow Survey, recent graduates are looking for loan repayment in their starting compensation packages. In fact, 48% of respondents ranked educational loan repayment as important or very important when deciding upon a practice opportunity.
According to the 2011 Cejka Search and AMGA Physician Retention Survey, about 60% of medical groups offer loan repayment, a majority of who believe this incentive acts as a differentiator.
But size matters. For many medical groups, this is not a practical incentive to offer. Midsize groups were much more likely to offer this incentive as a part of their compensation package. Half of respondents from both small groups and large groups reported that loan payment isn’t applicable within their organization.
This mirrors the trends our search consultants are seeing in the field. We’ve found that small group clients often don’t have the resources to offer loan repayment. Large groups, on the other hand, don’t have to offer loan repayment because they are either in a desirable location or they are the primary employer in the area, so their job openings aren’t as difficult to fill.
Medical education debt load can thus be seen as a contributing factor to the demise of the small, independent medical practice. It’s apparent that the cost of medical education deters students and exacerbates the growing physician shortage.
Part of the current debate in the medical community revolves around the size of the role the government should play in subsidizing medical education. This debate will surely continue as the industry and government formulate solutions to offset the high cost of medical care.
Should America continue to let the private sector address the high cost of medical education in this way or follow the lead of other countries that make medical education affordable or free? In essence, who should pay for medical training?
CRC Survey: What is your average application TAT?
Credentialing Resource Center wants to know what your organization’s average turnaround time is for medical staff applications. How long does it take for your medical staff services department or credentialing verification organization to process the application? How long does it take for the application to be reviewed by appropriate medical staff leaders and committees?
Please help us by taking this short survey. Results will be published on the blog and in other HCPro publications.
Templates for detailed peer review documentation
In the November issue of Medical Staff Briefing, we discuss peer review documentation and the importance of creating comprehensive records for peer review files. This includes documenting informal or collegial meetings with physicians, according to Joanne P. Hopkins, JD, a health law attorney based in Austin, Texas. Records of these interactions serve the purpose of establishing trends in physician performance and behavior, and may also be required as evidence in the event of a peer review hearing.
Hopkins, who presented on the importance of documentation in peer review and hearing preparation at the 2012 NAMSS conference in San Francisco last month, provided several examples of correspondence between the practitioner and the peer review committee following a meeting. These letters should include specific details about the meeting and any follow-up actions. See the attached document for Hopkins’ examples.
Keys to improving physician competency and professional development
These days, everyone is talking about how helpful reducing stress, having a positive mental attitude, and being mindful can be for people with health challenges. But when was the last time you heard anyone say that reducing stress, having a positive mental attitude, and being mindful of personal actions can actually increase a physician’s effectiveness while promoting health, healing and well being? It can and it does.
I don’t have to tell you that physicians and all medical professionals working in hospitals or other medical settings are under a great deal of job-related stress. What you might not be aware of is that left unchecked, negative stress is a workplace contaminant that can have a deleterious effect on your health, well-being and effectiveness. Imagine that you are being assisted by a person who is agitated, stressed out, preoccupied or in a bad mood. Now imagine that that person is you. How do you think your attitude and mood will impede your effectiveness and work experience as well as all you are in contact with? Remember that when physicians are stressed out, their patients and colleagues are more likely to be stressed out too.
A positive attitude and focused attention set the tone for how you work (and also how you play, which is important for a good work-life balance). This can be accomplished through simple mental exercises. Briefly, the key to transforming negative stress into positive stress is found within one’s “internal connections;” the way one perceives, experiences, and relates to the internal and external stressors of daily life. Instead of unrelenting pressure, you can sense productive excitement. Instead of helplessness and hopelessness, you and your patients can sense practical action and confidence. Instead of fatigue, you, your staff/employees can find mutual satisfaction. Once these mental re-connections are in place and operating automatically, you can feel robustly challenged by stressful situations rather than incapacitated, drained or debilitated by them.
Learning how to de-stress and focus your attention can help you put the zest back into your life and your practice and diminish the destructive impact of negative stress. It is enlightening to realize that reducing stress, having a positive mental attitude and being mindful will improve patient care along with your competency and professional development. And keep in mind, that these same techniques can help your patients take the suffering out of pain.
Michael Ellner, CHT, is a certified medical hypnotist in private practice in New York City. He teaches advanced courses in medical hypnosis at schools throughout North America and South Africa and is a featured instructor of Hypnotic Pain Relief, Effective Medical Communication and Stress Management at the annual PAINWeek conference. Ellner is the lead author of a peer-reviewed paper “Hypnosis in Disability Settings,” IAIABC Journal, Vol. 46 No. 2; the co-author of “HOPE is Realistic – A Guide to Helping Patients Take Suffering Out of Pain,” co-written with Kelley T. Woods; and he is the author of “BEDSIDE MANNERS – The Pain Clinicians’ Guide to Effective Medical Communication” To contact Ellner, visit his website: www.nycanxietyhypnosis.com or email michaelellner@verizon.net.
