Taking the Fear and Confusion Out of Core...

WHITE PAPER

Taking the Fear and Confusion Out of

Core Privileges: What Do The Joint

Commission and CMS Really Require?

Understanding what laundry lists and core privileges really are (and are not)

Taking the Fear and Confusion Out of Core Privileges

A laundry list can never be

complete but can only serve as a

representative sample of what

physicians do in practice.

Why do TJC and CMS have concerns with core privileging?

The combination of the no-brainer

nature of most items on laundry lists

and the need for more careful

attention to the truly complex and

higher-risk privileges became the

underlying logic for core privileges.

Will implementation of core privileges

allow your hospital to pass your next

TJC survey without RFIs regarding

privileging? The answer is an

unequivocal YES! In fact, TJC took the

fear out of doing core privileges (as

long as you do core privileges right)

when it published its FAQ of

November 24, 2008.

What does it mean to do core privileges right?

In creating the verbal description of

the core, the ultimate goal is to make

sure the core reflects what the

majority of practitioners within that

particular specialty are currently

performing at your facility.

Unfortunately, increasing

specialization and the desire of

many physicians to get out of

Emergency Department (ED)

coverage through dropping some

privileges in their specialty is

creating a toxic mix that is

contributing to the crisis regarding

ED coverage across the country.

TJC’s OPPE and FPPE create greater focus on the medical staff’s responsibility to

determine current competence

How can medical staffs meet the OPPE and FPPE

requirements using laundry lists?

Hospitals that still utilize laundry lists

struggle to perform meaningful

OPPE and FPPE to determine

current competence for each

specific privilege on the

delineation of privileges form for

any given specialty.

Any attempt to label a

physician as incompetent

and to threaten him or her

with nonrenewal of a particular

privilege based on one or

a few cases faces great

resistance, including being

vulnerable to charges of

bias and antitrust.

How can medical staffs meet the OPPE and

FPPE requirements using core privileges?

Privileging with laundry lists makes it

very difficult for a medical staff to

meet OPPE and FPPE requirements in

a manner that meaningfully raises

the bar on assessing physician

competency and linking this

assessment to privileges granted

through an “objective and evidence

based process.”

Current challenges persist for matching demonstrated competence to

privileges granted

A call to action

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