The Complete Guide to OPPE


Book Description

The Complete Guide to OPPE: Strategies for Medical Staff Professionals, Physician Leaders, and Quality Directors Evalynn Buczkowski, RN, BSN, MS; Wendy R. Crimp, BSN, MBA, CPHQ; Valerie Handunge, MA The Complete Guide to OPPE provides medical staff leaders, medical staff professionals, and the quality team with the tools and strategies they need to effectively carry out OPPE. Authors Evalynn Buczkowski and Valerie Handunge, and contributing author Wendy R. Crimp deliver practical guidance to build and implement an OPPE process in your institution. They provide how-to approaches to help you: Create and implement a comprehensive and compliant OPPE policy Select meaningful indicators and gather appropriate data Establish thresholds to identify opportunities for performance improvement Assess performance and help evaluators and practitioners interpret OPPE reports Intervene on practitioners with improvement opportunities and performance concerns Targeted for Joint Commission--accredited organizations, The Complete Guide to OPPE offers best practices for all hospitals, regardless of their accreditation provider. It walks you through the steps to develop, implement, and maintain a strong OPPE program, including: Developing a framework for OPPE and defining the scope of the program Creating a communication plan for implementing the program Evaluating potential indicators for fairness and feasibility of collection Determining who should share perceptions of practitioners and how their perception data should be interpreted Selecting thresholds based on indicator types and using thresholds to interpret variation Solving data integrity issues and minimizing data collection errors, such as attribution Structuring and staffing the OPPE review Preparing for and carrying out critical practitioner conversations about performance improvement Table of ContentsSection 1: Developing a Strategy for OPPE The Impetus for Practitioner Performance Improvement Building a Successful OPPE Program Developing an OPPE Communication Plan Section 2: Selecting Data for the OPPE Program Understanding Performance Indicators Using Perception Data as a Source for OPPE Evaluations Establishing Thresholds and Benchmarks to Interpret Performance Solving the Attribution Problem Developing Protocols for Low-Volume Practitioners and Advanced Practice Practitioners Section 3: Compiling OPPE Reports and Implementing the OPPE Program Designing Practitioner-Friendly OPPE Reports Delivering OPPE Reports to Practitioners Evaluating Performance and Engaging Practitioners in Performance Improvement Conversations When OPPE Leads to FPPE Who should read OPPE? The Complete Guide to OPPE is the perfect companion for medical staff professionals, physician leaders, quality directors, medical executive committee members, credentials committee members, vice presidents of medical affairs, chief medical officers, and risk managers.







The Complete Guide to FPPE


Book Description




The Medical Staff Leaders' Practical Guide


Book Description

You are a great clinician. But do you have the tools to become a great leader? Physicians who accept or are assigned leadership positions are too often left on their own to develop leadership skills and educate themselves on their responsibilities as medical staff leaders. These physicians may be great clinicians and enthusiastic about taking a leadership position, but neither of these characteristics automatically makes a great leader. Get practical answers for physicians in leadership. The Medical Staff Leaders' Practical Guide, Sixth Edition provides direction for physician leaders in hospitals--those who remain primarily clinicians, but who also accept positions of leadership in the hospital or medical staff organization. It gives an overview of physician leaders' roles and responsibilities in credentialing, privileging, bylaws development, performance improvement, physician management, and board/physician relations. Completely revamped and updated, this essential resource for medical staff leaders includes: - Tools and information needed to fulfill leadership responsibilities for all medical staff leaders, including directors of medical staff offices, vice presidents of medical affairs, medical staff presidents, credentials committee chairs and members, and committee and department chairs - Expanded analysis and strategies for overcoming current medical staff leadership challenges, including merger issues, medical staff development plans, physician practice evaluations, assessing and improving clinical competence, and more - Guidance and how-to advice on creating a positive medical staff culture, minimizing distrust or conflict, and improving policies - Tips and insights from experienced medical staff leaders currently working in hospitals How do you keep up with evolving roles? As relationships continue to evolve between hospitals and medical staff, it is especially important for physician leaders to be well-educated about credentialing, privileging, conflicts of interest, medical staff organization, the roles of various physician leaders and committees, performance improvement, and more. This practical guide includes in-depth reviews of the top five medical staff leadership responsibilities: - Medical staff structure and governance - Credentialing and privileging - Peer review and performance improvement - Hospital-medical staff collaboration - Medical staff culture Rise to the challenge of leadership! Written by experienced medical staff leaders currently working in hospitals, The Medical Staff Leaders' Practical Guide, Sixth Edition, gives physicians the tools they need to meet the challenges of a leadership role. The tools and advice in this guide will help you: - Overcome physician apathy, poor meeting attendance, lack of volunteers for leadership positions, and turf battles - Improve peer review, evaluation of physician competency, and physician/hospital relations - Deal with disruptive and impaired physicians, conflicts of interest, exclusive contract problems, accreditation challenges, and emergency department coverage challenges - Create a positive working environment - Gain a better understanding of the credentialing and privileging process Take a look at the table of contents: Introduction: Today's Effective Medical Staff Section I: Medical Staff Structure and Governance - Physician apathy - Poor meeting attendance - Poor medical staff communication - Unprepared leaders - Lack of volunteers for leadership positions - Conflict over member rights and responsibilities Section II: Credentialing and Privileging - Cumbersome and lengthy process - Turf battles - New technology privileges - AHP credentialing and supervision - Information and decision errors - Lack of reappointment data - Unnecessary, lengthy, or costly fair hearings - Lack of criteria for privileges Section III: Peer Review and Performance Improvement - Ineffective peer review - Disruptive conduct - Impaired physicians - Assessing and improving clinical competence - Excessive utilization - Medical records completion - Inappropriate physician practice evaluation Section IV: Hospital-Medical Staff Collaboration - Strained physician-hospital relations - EMTALA and ED coverage - Hospital-physician competition - Economic credentialing - Strained physician-nurse relationships - Costs exceeding reimbursement - Medical errors and patient safety - Ineffective medical staff influence with board and administration - Liability risk - Conflicts of interest - Exclusive contract problems - Corporate compliance challenges - Accreditation challenges - Merger challenges - Lack of effective medical staff development plan Who will benefit from this book? Directors of medical staff offices, vice presidents of medical affairs, medical staff presidents, credentials committee chairs and members, committee and department chairs




The Complete Guide to OPPE and FPPE


Book Description

OPPE and FPPE are mainstays in the privileging process, but they're anything but cut and dry. In today's evolving healthcare industry, medical staff leaders and MSPs often encounter scenarios that don't fit squarely into evaluation frameworks, such as telehealth providers, low-volume practitioners, and the growing ranks of advanced practice professionals. With a myriad of factors at play, it can be difficult to take the proper steps to ensure effective peer review. The Complete Guide to OPPE and FPPE is your comprehensive guide to navigating today's OPPE and FPPE landscape, and a handy companion to The OPPE Toolbox and The FPPE Toolbox. Authors Juli Maxworthy, DNP, MSN, MBA, RN, CNL, CPHQ, CPPS, CHSE, and Evalynn Buczkowski, RN, BSN, MS, shed light on the industry's most pressing questions about hard-to-evaluate practitioners, data aggregation, effective reporting strategies, and more. Plus, customizable forms make for a seamless transition from education to application. With a healthy blend of practical guidance on core OPPE and FPPE concepts and targeted strategy on specific pain points, The Complete Guide is a must-have for medical staff veterans and newcomers alike. This book will help you: - Evaluate and strengthen existing OPPE/FPPE approaches - Integrate, evaluate, and share meaningful performance data - Understand confusing OPPE/FPPE scenarios - Prepare for the future of OPPE/FPPE




The Medical Staff Leader's Survival Guide


Book Description

The Medical Staff Leader''s Survival Guide William K. Cors, MD, MMM, FACPE An affordable, time-sensitive solution to medical staff leadership training. Physicians who accept or are assigned leadership positions are often left on their own to develop leadership skills and educate themselves about their responsibilities as medical staff leaders. Just because a physician is a great clinician does not mean he or she is a great leader. The challenges of being a successful medical staff leader are twofold: You must be well-versed in your role and responsibilities (i.e., peer review, credentialing, medical staff bylaws), and you must inspire other medical staff members to follow the rules while continuing to deliver excellent patient care. A well-trained medical staff leader is vital to the culture of a hospital''s medical staff and can save a hospital from the expense of lawsuits affiliated with negligent credentialing/peer review. This book aims to teach physicians how to become great medical staff leaders and how to motivate other medical staff members on topics such as: AHP credentialing and supervision Reappointment challenges Physician-hospital competition Liability risks Medical staff disharmony and distrust Table of Contents Chapter 1: Where to Begin? Principles of Governance Chapter 2: Meetings: The Cost of Holding a Meeting Chapter 3: Meetings: How to Run an Effective Meeting Chapter 4: Overcoming Physician Apathy Chapter 5: Job Descriptions: Medical Staff Leaders Chapter 6: The VPMA/CMO: Where This Fits Chapter 7: Credentialing and Privileging: Requirements, Guidelines and Tips Chapter 8: New Technology Privileges Chapter 9: Privileging Disputes and How to Resolve Them Chapter 10: Advanced Practice Professionals Chapter 11: Low-Volume, No-Volume Practitioners Chapter 12: The Aging Physician Chapter 13: Proctoring (FPPE) Chapter 14: Peer Review (OPPE): Some Best Practices Chapter 15: Dealing with the Physician with Problems Chapter 16: Corrective Action: The Good, the Bad and the Ugly Chapter 17: Physicians and Hospital Administration: They''re Just Different Chapter 18: EMTALA and Emergency Department Coverage Chapter 19: Conflicts of Interest Chapter 20: Economic Credentialing Chapter 21: Physician-Nursing Relationships Chapter 22: Health Care Finance: A Primer Chapter 23: Medical Errors Disclosure Chapter 24: Employed Practitioners Chapter 25: Contracted Practitioners Chapter 26: Confidentiality Chapter 27: Accreditation and Regulation Chapter 28: Bylaws and Related Documents Chapter 29: Medical Staff Governance: Myths and Misconceptions Chapter 30: Personal Characteristics of Great Leaders Who will benefit from this book? Directors of medical staff offices, vice presidents of medical affairs, medical staff presidents, credentials committee chairs and members, committee and department chairs




Assessing the Competency of Low-Volume Practitioners


Book Description

The Joint Commission requires that hospitals verify physician competence using performance data. Yet organizations often have little or no data related to the competency of low- and no-volume physicians. Medical staff leaders are therefore challenged to develop a strategy that guides the hospital's relationship with low- and no-volume providers, and medical staff services departments are challenged to establish systems to verify physician competence. This fully updated book offers the necessary tools and strategies for medical staff leaders and professionals to manage the increasing number of




The Greeley Guide to New Medical Staff Models


Book Description

The Greeley Guide to New Medical Staff Models: Solutions for Changing Physician-Hospital Relations William Cors, MD, MMM, FACPE; Richard A. Sheff, MD Has your medical staff model evolved to address ever-changing healthcare challenges? The self-governed medical staff is and will remain a requirement of CMS and The Joint Commission for the foreseeable future, yet it is not up to the task of tackling today's patient safety, cost-effectiveness, ED call, and physician-hospital competition challenges. How can you restructure your medical staff to effectively tackle these evolving issues? The Greeley Guide to New Medical Staff Models: Solutions for Changing Physician-Hospital Relations provides a road map for hospital and medical staff leaders to develop new medical staff models that better meet today's challenges than medical staffs of the past. This book and CD-ROM set identifies and explains the multiple evolving medical staff models confronting physicians and hospitals today and helps you determine the models that are best for your organization. Get practical approaches to deal with your medical staff challenges. Written by two of the top leaders in the field, this resource includes strategies, tools, and step-by-step action plans to help you: Deal with physician-hospital and physician-physician competition to build a collaborative culture Understand the mixed model medical staff Choose the medical staff models that are best for your organization Create a physician-hospital relations action plan for your hospital Develop a comprehensive, board-driven physician relations, recruitment, and retention strategy Manage multiple medical staff models within a single institution Improve physician-hospital relations Define the roles of the board, management, and medical staff in achieving hospital and physician success Renegotiate the physician-hospital compact Bring your medical staff models up-to-date with this practical guide. Take a look at the table of contents: Chapter 1: Do we need a new medical staff model? Chapter 2: From self-governed medical staff to a broken social contract: How did we get here? Chapter 3: Physician-hospital competition and collaboration Chapter 4: Candidates for the new medical staff model Chapter 5: Which medical staff model is right for you? Chapter 6: The "Seven Rs" of medical staff development planning Chapter 7: Physician apathy: Is the medical staff still relevant to physicians? Chapter 8: A step-by-step roadmap to improve physician-hospital relations Who will benefit? Chief medical officer, medical director, vice president medical affairs, quality director/manager, director physician relations, chief executive officer, chief operations officer, director of physician recruitment, medical staff director Get the latest medical staff models you can adapt for your own organization-order this essential guide today.




The Medical Staff Professional's Handbook


Book Description

The Medical Staff Professional''s Handbook The essential medical staff professional''s job manual Let your experienced peers provide you with the guidance and training you need to tackle your toughest challenges.The Medical Staff Professional''s Handbook is a comprehensive job manual developed by medical staff professionals (MSPs) Anne Roberts, CPMSM, CPCS, and Maggie Palmer, MSA, CPMSM, CPCS. While providing much-needed education for new MSPs, this book and downloadable toolkit also offer veterans new ideas, tips, sample policies, customizable forms, and advice for improving medical staff and credentialing processes. After reading this book, you will be able to: Define the roles, tasks, and expectations for MSPs to clearly identify their priorities Manage FPPE and OPPE processes to effectively assess physician competency Streamline and improve credentialing and privileging processes with dozens of customizable forms and sample tools Comply with accreditation and regulatory standards by understanding the MSP''s role in accreditation and the consequences of noncompliance Discover important tips to save time and increase efficiency on daily medical staff office tasks Support the medical staff and communicate with leadership Table of ContentsAbout the Authors Introduction Acronyms and Abbreviations Section I: The Successful Medical Staff Professional Chapter 1: Roles and Responsibilities of Medical Staff Professionals The Responsibilities of MSPs Who MSPs Support in the Organization Chapter 2: Managing External and Internal Relationships Navigating External Relationships Navigating Internal Relationships Chapter 3: Review of Credentialing, Privileging, and Medical Staff Standards History of Regulatory Agencies How the Standards Apply to MSPs Joint Commission Requirements What MSPs Should Expect During Accreditation Surveys Chapter 4: Legal and Regulatory Considerations for Medical Staff Professionals Managing Bylaws Rules and Regulations Corrective Action and Due Process Policies and Procedures HCQIA of 1986 NPDB Healthcare Integrity and Protection Data Bank Sharing Information Credentialing Interrogatories Attestation, Acknowledgments, and Release Forms Criminal Background Checks Disruptive and Impaired Practitioners Section II : Effective Credentialing and Privileging Chapter 5: The Credentialing Process Credentialing Basics Rules to Guide Your Credentialing Process Roles and Responsibilities During the Credentialing Process The Application Process Collecting and Verifying Information Review and Approval Process Chapter 6: Credentialing Responsibilities After the Initial Application Orientation for Patient Care Organizations Credentials Expiration Tracking and Ongoing Monitoring Tips for Avoiding Claims of Negligent Credentialing Chapter 7: The Privileging Process Implementing a Privileging Process Developing Clinical Privilege Delineations Granting Clinical Privileges Based on Competency Final Recommendations for Privileges Chapter 8: Reappointment Initiating the Reappointment Process Accepting the Application Performing Primary Source Verification Creating the Reappointment Profile Quality Review, Ongoing Evaluation, and Monitoring Review and Approval Chapter 9: Credentialing and Privileging Hurdles Low- and No-Volume Practitioners Allied Health Practitioners Telemedicine Practitioner Data and Document Confidentiality Leaves of Absence Paperless/Paper-Light Credentialing System Transition New Technology Privileging Chapter 10: Temporary, Emergency, and Disaster Privileges and Expedited Board Approval Temporary Privileges Emergency Privileges Disaster Privileges Fast-Track or Expedited Credentialing Section III : Measuring Practitioner Competency Chapter 11: Focused Professional Practice Evaluations Requirements for an FPPE Policy and Process Developing FPPE Criteria FPPE at Initial Granting of Privileges Tracking Completion of FPPE FPPE for Additional Privileges FPPE for Cause (Ongoing Professional Practice Evaluation, Peer Review, Leave of Absence Reinstatement) Chapter 12: Ongoing Professional Practice Evaluations Developing a Systematic Approach to OPPE Developing Quality Indicators Periodic Performance Feedback Reports Section IV : Sample Forms and Policies Credentialing Sample Forms Privileging Sample Forms Reappointment Sample Forms Competency Sample Form Continuing Education This book has been approved by the National Association Medical Staff Services for 5 continuing education units. Accreditation of this educational program in no way implies endorsement or sponsorship by NAMSS.




Medical Executive Committee


Book Description

Get the knowledge needed to serve as an effective Medical Executive Committee Member and fulfill the role well. The MEC Essentials Handbook breaks down the medical executive committee role to facilitate understanding of the responsibilities and strategies for being an exemplary committee member. Oftentimes physicians end up in a leadership position without really knowing what the job entails and what they are meant to accomplish. This handbook can be used as a comprehensive guide for physician leaders throughout their appointment, providing them with the necessary skills and knowledge they may not have received as part of their medical school training and residency. Plus, to make staff training easy, this handbook includes a customizable PowerPoint(R) presentation highlighting key takeaways covered in the handbook. Benefits of The MEC Essentials Handbook: Earn CE and certification credits Assess, document, and comply with The Joint Commission's core competencies Verify the competence of advance practice professionals and allied health professionals Understand the role of physician leaders in focused professional practice evaluation (FPPE), ongoing professional practice evaluation (OPPE), and peer review Overcome challenges presented by low- and no-volume providers and legal issues such as negligent credentialing Avoid costly, time-consuming fair hearings Oversee professional conduct and confront disruptive behavior What's inside: Compare and contrast the roles and responsibilities of the medical staff, management, and board Describe the dimensions of physician performance Explain the role of MEC as oversight for the credentialing and privileging committee Explain the role of MEC as oversight for the peer review, quality, and patient safety committees Describe the MEC's role in overseeing disruptive physician behavior, according to the law and Joint Commission standards Identify the seven factors of successful medical staff development planning Derive strategies to streamline MEC meetings Table of Contents Chapter 1: Roles and responsibilities of the medical staff, management, and board Chapter 2: The Power of the Pyramid: How to achieve great physician performance Chapter 3: The MEC's role in credentialing and privileging Chapter 4: The MEC's role in peer review, quality, and patient safety Chapter 5: The MEC's role in managing professional conduct Chapter 6: The MEC's role in strategic collaboration with the hospital Chapter 7: Effective MEC meetings