Axuall Key Terms

Axuall Key Terms

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Privileging

Credentialing Impact

Patient Safety

Primary Source Verification (PSV)

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Course Objectives After this course you will be able to:

• Define key terms
• Recognize the difference between Credentialing and Privileging
• Apply the impact of credentialing on Patient safety

Defined

Patient safety, as defined by the World Health Organization, is the prevention of errors and adverse effects to patients that are associated with health care. Safety is what patients, families, staff, and the public expect from Joint Commission–accredited organizations. While patient safety events may not be completely eliminated, harm to patients can be reduced, and the goal is always zero harm.The Joint Commission (TJC) Link

Patient Safety

Patient Safety: Credientaling Impact

Credentialing is the front door to ensure patient safety

• Clinician meets minimum requirements to practice medicine
• For any privilege request, has the clinician performed it recently and well?
• Allow ‘bad’ clinicians to be denied privileges based off of all the information collected
• Avoid passing ‘bad doctors’ on to other states and hospitals.
• Avoid clinician imposters

Types of Information Verified during credentialing include:

Credentialing

• Proof of Identity
• Education and Training
• Military Services
• Professional Licensure
• DEA and State CDS's
• Board Certification
• Affiliation and work history
• Criminal Disclosures
• Sanctions
• Health Status
• NPDB
• Malpractice Insurance
• Professional and Peer Referenes

Credentialing = What

The process of obtaining, verifying and assessing the qualifications of a healthcare practitioner to provide patient care services in or for a healthcare entity.The collection, verification, and assessment of information regarding three critical parameters, current licensure, education and relevant training and experience, ability and current competence to perform the requested privilege(s)

Privileging = Where

The authority granted to a [clinician] by a hospital governing board to provide patient care in the hospital. Clinical privileges are limited to the individual’s license, experience, and competence.Any individual permitted by law and by the organization to provide care, treatment, and services, without direction or supervision within the scope of his or license, and in accordance with individually granted clinical privileges.

Credentialing vs. Privileging

Defined

The process by which a health plan or hospital checks an individual provider’s reported credentials and qualifications. This crucial step not only protects the provider but also the hospital, health plan and – more importantly – the patient.Council for Affordable Quality Healthcare (CAQH)

Priamary Source Verification (PSV)

'TRUST BUT VERIFY'

This crucial step not only protects the clinician but also the hospital, health plan and – more importantly – THE PATIENT

Priamary Source Verification (PSV)

Key Terms Review

Primary Source Verification is the process by which a health plan or hospital checks an individual provider’s reported credentials and qualifications. This crucial step not only protects the provider but also the hospital, health plan and – more importantly – the patient.

Question 1/5

True

False

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correctanswer

Credentialing or Privileging? The process of obtaining, verifying and assessing the qualifications of a healthcare practitioner to provide patient care services in or for a healthcare entity.

Question 2/5

Key Terms Review

Credentialing

Privileging

Way to go!

correctanswer

Credentialing or Privileging? Any individual permitted by law and by the organization to provide care, treatment, and services, without direction or supervision within the scope of his or license, and in accordance with individually granted clinical privileges.

Question 3/5

Key Terms Review

Credentialing

Privileging

Way to go!

correctanswer

Credentialing

Patient Safety

Primary Source Verification

________ as defined by the World Health Organization, is the prevention of errors and adverse effects to patients that are associated with health care.

Question 4/5

Key Terms Review

Privileging

Way to go!

correctanswer

Avoid clinician imposters

For any privilege request, has the clinician performed it recently and well?

Allow ‘bad’ clinicians to be denied privileges based off of all the information collected

Credentialing is the front door to ensure patient safety

Question 5/5

Key terms review

Clinician meets minimum requirements to practice medicine

All the above

Avoid passing ‘bad doctors’ on to other states and hospitals.

Way to go! You sure know the impact of credentialing on patient safety!

correctanswer

congratulations!

You have answered everything correctly

What knowledgehave you acquired?

• Define key terms
• Recgonize the difference between Credientialing and Privilaging
• Apply the impact of credentialing on Patient safety

Key terms review

Resources

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