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HFA To Consult Clinicians On Credentialling In HHS

HFA To Consult Clinicians On Credentialling In HHSs

The Health Funding Authority is consulting medical professionals on a standard framework for credentialling medical practitioners in public hospitals as part of its ongoing quality improvement programme.

Credentialling is a process used within an organisational context to assign specific clinical responsibilities to medical practitioners based on their training, qualifications, experience and current practice.

HFA quality auditor, Gillian Bohm, says the primary purpose of credentialling is to protect the patient. “Credentialling will not eliminate human error, nor will it eliminate those few individuals who deliberately attempt to defraud the system. However, it will identify practitioners who develop a pattern of poor performance and faults within hospital systems that contribute to medical error.

“Credentialling works alongside performance management, but focuses specifically on practitioners’ technical and interpersonal skills. It relies on pracitioners’ ability to actively engage in self- and peer-assessment, and takes a developmental rather than punitive approach,” Ms Bohm says.

Each organisation will develop their own credentialling system based on the national framework, and while there will be some ability to transport information about the credentialled status of practitioners from one organisation to another, each organisation must make its own decision about the status of the practitioners it employs.

“There are two types of credentialling – initial credentialling and ongoing or re-credentialling. Initial credentialling takes place when a practitioner is employed or an organisation introduces credentialling. From then on, senior medical officers regularly review each practitioner’s role (scope of practice) and competence.

“If a practitioner moves from one organisation to another, their role will obviously need to be determined by the new employer as part of its initial credentialling of the practitioner,” Ms Bohm says.

The consultation document has been sent to hospital CEOs, medical and nursing colleges, consumer groups and other stakeholders. Additional copies of the document are available by ringing 0800 ENQUIRE (0800 367 3473) or by visiting the HFA’s website: www.hfa.govt.nz. The final day for submissions is September 29.

[ends – information on credentialling steps follows]
Enquiries: Christine Field ph (04) 495 4335 or Emily Bishop (04) 495 4417

Proposed credentialling steps

Initial credentialling
Step 1: Verification of training, qualifications, experience, and registration status
Includes:
 Health status
 Cultural competence
 Professional disciplinary and criminal record

Step 2: Determination of scope of practice on appointment
Based on:
 Acceptance that verified documentation provided meets requirements detailed in service description
 Further detailed checks as required
 Agreement with practitioner about scope of practice to be undertaken
 Agreement with practitioner about any conditions for a probationary period, if required
 Agreement with practitioner about terms of employment in relation to ongoing credentialling
For practitioners who are employed when credentialling is introduced, it is based on:
 Peer- and self-review of specific skills related to the area of current practice
 Agreement about ongoing scope of practice defined in writing

Ongoing review of credentials and scope of practice
Step 3: Ongoing data collection to monitor professional practice and accumulate information for recredentialling
May include:
 Peer review
 Clinical audit
 Record of clinical activity
 Patient satisfaction in professional interaction and clinical service provision
 Complaints and incident reporting
 Feedback from other health professionals
 Relevant continuing medical education, post-graduate study, teaching and research

Step 4: Formal credentials review
This step is a mechanism to reflect on clinical practice since the last review. It should be held at least every five years. Service reviews should provide a context for individual reviews. Service reviews should include:
 The clinical work the unit is funded to provide
 Adequacy of facilities
 The composition and skill level of the clinical team
 Practitioner workload
 Patient satisfaction and unit’s performance to contract
 Associated clinical activities, such as teaching and research
 Medical quality assurance processes
Individual reviews should include:
 Training and experience gained since last review
 Registration status
 Health status and professional/criminal record
 Clinical activity, including volumes and outcomes
 Other pertinent sources, including complaints, patient satisfaction, accrued leave
 Current and future scope of practice

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