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Credentialing— a process which defines patients safety!


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Credentialing— a process which defines patients safety!

  1. 1. CREDENTIALING— A Process Which Defines Patients Safety!“When bad or imposter physicians slip through the system, patients pay the price!”To most physicians, the word "credentialing" conjures up visions of needless, tediouspaperwork. Professionals in credentialing business view credentialing as the shield ofprotection for their patients and for the healthy society. This article will define the purpose,process and the outcomes of credentialing.Hospitals and health care centers all over the globe are aiming for accreditation and theyare substantially adopting the best credentialing and privileging methods to ensure that thephysicians, doctors or even the nurse in-charge of the patients treatment has adequateeducation, training and experience, to maximize the safety in health care system.Credentialing and privileging are the two important processes which allows a hospital tooptimize the utility of its most crucial assets— the specialists (doctors, physicians, surgeons,nurses etc) and provide efficient and quality patient care to foster a healthy society. Theconcept of credentialing the medical practitioners is gaining momentum with the dawn ofcorporate healthcare and increasing numbers of hospitals choosing different qualitystandards.What is credentialing? How does it stop bad / imposter physicians from reaching patients?Credentialing term is used to describe the process of collecting; verifying; and evaluatingthe education, training, professional experience, work history, and licensure of providers.The process also includes making recommendations regarding category of medical staffmembership and clinical privileges based upon the information received.How the credentialing process works?Credentialing is a process by which the organization (hospital or medical/health carecenters) verifies the authenticity and appropriateness of the qualifications and workexperience of a medical practitioner. On foremost basis the need has to be determined. Thisincludes minimum number of years of experience, quantity and nature of work done,preference to particular type of institute from where the person has graduated.A core committee comprising CEO, medical director and senior medical administrator mustbe on a credentialing bench. Evidence of licensure, registration, certification, and/or otherrelevant credentials, for verification prior to appointment and throughout the employmentprocess should be checked. Experts must stress on a reference check through a known
  2. 2. contact. The credentialing committee passes on its final recommendation/instructionsthrough which the decision has to be made for hiring and privileging.A Step by Step Credentialing Process: • The doctor who applies for association to a hospital fills a credentialing form, giving details of his formal training and work experience. • The head of medical services and the department head try to verify these details with the primary source or University. • A formal reference check is done in communication with a senior professional whom the candidate has trained with or worked under. • Assess the need for that particular skill in the organization. • Meet the candidate. • If found suitable, the candidate is recommended for appointment to the medical staff by the credentialing and privileges committee and the management of the organization. • There would also be a review of any medico-legal cases in which the candidate is currently involved.5 Red Flags When Credentialing the Medical Practitioners:High mobility: A physician who has moved from state to state or from hospital to hospitalevery couple of years, who is licensed in several states, or who is a member of the medicalstaffs of several hospitals in several cities may be attempting to cover up some sort ofprofessional problem.Professional liability suits: While malpractice claims are not necessarily an indication of aproblem, the hospital should be wary of physicians who have been involved in a number ofprofessional liability suits.Professional disciplinary actions: The hospital should be concerned about physicians whohave been disciplined, sanctioned, or suspended, or whose privileges have been restrictedby a licensing board or another hospital.Substance abuse: A practitioner impaired by alcohol or drug abuse may apply for medicalstaff membership and privileges.Time gaps: If an application reveals an unexplained time gap in training or professionalpractice, it should be investigated, (anything over 30 days).Incomplete application: Incomplete sections relate to questions about licensure, hospitaldisciplinary actions, liability claims history, and health status.
  3. 3. Benefits of a Fool-Proof Credentialing Process“Credentialing is like reading between the lines verifying everything claimed with everythingverified”. Credentialing is the process which is saving lives and minimizing the risks ofmedical negligence and medical malpractice. It provides a higher level of trust andguarantee that the medical practitioner is licensed and Board Certified and has not hadlicenses or privileges revoked in any other purpose or state. It can be helpful in determiningthe quality of delivery of health care provided by the medical person.AboutQ2 is based in Singapore and provides informational resources to governments, multinationals andthe background check industry. The team behind Q2 pioneered the background checking industry inAsia when they founded Quest Research in 2000. Quest Research had over 500 employees in 12offices across Asia prior to being sold to a leading listed US background screening company in 2005.The team also established and built IntegraScreen, the largest global reputational due diligencecompany, which was sold to WorldCheck in 2009.The aim of Q2 is to assist the growth and development of background checking internationally byproviding valuable and relevant informational resources.