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Credentialing & Privileging Optimization and Alignment

Why?

Investing in your Medical Staff Services Department pays dividends

The success of your Medical Staff Services Department (MSSD) has a lot riding on it. The work that’s done in the MSSD facilitates the medical staff’s ability to deliver high-quality patient care. Accordingly, the service it provides—to current and candidate staff alike—has a huge impact on the success of the entire organization.

Particularly when it comes to credentialing and privileging, the importance of MSSD optimization and alignment between the department, medical staff, and hospital administration can’t be overemphasized. Unfortunately, all too often we see MSSDs that are anything but optimized and aligned, leading to lost revenue, wasted time, dissatisfied physicians, and ultimately, compromised patient care.

No matter how you think your MSSD is performing, it’s time to take a closer look.

Why now?

Summertime...and the department is busy

Speaking of time, we all know that summer is a very busy time for the MSSD. 

In addition to the ever-changing healthcare space, summertime is notoriously the busiest time of the year for the MSSD since many hospitals have a spike in their credentialing applications. There’s a real need to get residents who are about to graduate appointed to the medical staff and granted clinical privileges.

PTO woes

Layer on the fact that summer is…well, vacation time, and staff are often out on PTO. This exacerbates the pressure on the MSSD. Do more with fewer staff? That’s not an enviable position to be in. One solution: consider interim staffing.

And if application spikes and staff shortages weren’t enough, you can typically expect additional scrutiny to the credentialing and privileging processes by medical staff leadership, applicants, hospital administration, and others.

What?

Get your MSSD house in order

Even though a core responsibility of the MSSD is to perform credentialing and privileging functions, it’s also juggling many other important tasks that facilitate practitioner success. All of the areas listed below need to be optimized and aligned—throughout the entire year. 

When you put time, resources, and attention toward these primary pitfalls, you’re positioning your MSSD and your medical staff for success: 

Medical Staff Bylaws/Policies & Procedures: The MSSD adheres to the processes that are outlined in the medical staff bylaws as well as policies and procedures. So, is the language in the bylaws current, contemporary, and contributing to efficient processes?

Technology: Tech saves time, but not if it’s outdated. Is the MSSD fully utilizing software that effectively manages information and automates processes?

People: It’s about providing excellent service. Medical staff often has high expectations of the MSSD, even (especially!) when the stakes are high. Are you equipping yours with ample knowledge, experience, and resources?

Processes: Are all of the various tasks in MSSD being objectively assessed? Often, many of the essential procedures that the MSSD routinely performs are cumbersome and potentially redundant. If one of the main objectives of the MSSD is to spend their time performing credentialing functions (which should be the main objective), there needs to be an intentional effort to ensure that the processes they are following are as linear as possible—this sets the team up for success.

All of these elements must work together, in harmony, to make your Medical Staff Services Department a well-oiled machine. 

Impact?

Growth and credentialing—a direct correlation

Hospitals continue to look for growth opportunities and ways to effectively expand their services to patients in their communities. And hospital growth is usually directly correlated with additional credentialing volume for the MSSD.

So, when medical staff increases, all the corresponding activities that support them (e.g., Focused Professional Practice Evaluation, Recredentialing, etc.) expand proportionately. There is an important connection between an efficient MSSD and the quality of the medical staff’s work.  

Be proactive, not reactive

When the MSSD is in disarray and working reactively instead of working proactively, you may:

Lose revenue—the longer it takes to credential and privilege practitioners, the longer the lag time before they can bill for their services.

Increase risk—mistakes that happen in the MSSD can mean medical staff don’t get the support they need, possibly putting patients—and your organization—at risk.

Dampen the practitioner experience—current medical staff need relief in the form of fresh team members and potential candidates want quick (yet effective) credentialing. Delays can be detrimental: lost candidates, dissatisfied practitioners, and more.

So, what happens when you’ve provided the MSSD with the tools and support they need? They win. Your medical staff wins. Everybody wins. 

And what does that level of winning look like? The MSSD staff comes to work every day and takes initiative, working efficiently and effectively. Knowing they’re heard, understood, and supported, they’re dedicated to success—of the department, medical staff, and the organization.

Takeaways

Take time for introspection

The demands on your MSSD will only increase as the industry continues to become increasingly complex. In response to current and future pressures on their MSSDs, healthcare leaders need to take the time to examine the four areas we covered above: medical staff bylaws/policies & procedures, technology, people, and processes. 

Have conversations. Ask questions. Assess the current state of your MSSD and map out how to optimize and align it in parallel with broader organizational aims. 

By taking the time for this kind of introspection, you’ll be better positioned to take your MSSD and your entire organization that much further ahead.


© 2022 Chartis Clinical Quality Solutions. All rights reserved. This content draws on the research and experience of Chartis consultants and other sources. It is for general information purposes only and should not be used as a substitute for consultation with professional advisors. It does not constitute legal advice.

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