The First Line of Defense: Why Medical Staff Office Professionals are Essential for Patient Safety

The unfortunate truth is that medical errors can and often do happen. Recent studies show that 6 out of 10 patients who experience medical errors say that it occurred due to an incorrect diagnosis, late diagnosis, or a problem that wasn’t diagnosed at all. 

Imagine being a patient or family member affected by a preventable medical error. You may have believed that the doctor or nurse caring for you or your loved one was competent to do so. However, once the error occurs, you discover that the healthcare organization (HCO) did not have their employees undergo stringent credentialing and privileging. 

At these life-changing moments, it becomes clear that dedicated insight and research into the qualifications and backgrounds of healthcare providers are essential to ensure patient safety. And the critical role of medical staff office professionals becomes more apparent. 

In this article, we will explore the expanding responsibilities of medical staff office professionals as gatekeepers for healthcare quality and patient safety. 

Putting Patients First: The NEW Face of Healthcare!

The healthcare industry is moving toward a new era of standardization, centralization, and consolidation, with a growing emphasis on care coordination, driven by growth in multi-state licensing and a boost in healthcare technology. With the move from volume-based to value-based medicine, practitioners are now paid based on the outcomes they deliver. 

With these changes, there is a need for universal, standardized processes to achieve safety and outcome-based goals. Hospital management has recognized the need for strong administrative and recruiting efforts to ensure that HCOs employ qualified professionals for patient care. 

Over the last 40 years, the role of medical service professionals (MSPs) has evolved through professional certifications, formal education, and college degree programs. They are now vital to any healthcare environment, providing valuable personnel assessments to support patient safety, quality care, and excellence in healthcare delivery.

Qualified, credentialed, and privileged: A recipe for healthcare excellence!

Laws that focus on patient safety and healthcare quality, like the Health Care Quality Improvement Act and the accreditation requirements of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), require that healthcare organizations perform due diligence before appointing doctors, nurses, or any provider to deliver care. 

Through credentialing, medical staff office professionals verify and validate a provider's education, training, and licensing to ensure that only qualified practitioners are involved in patient care, holding all providers to the same standard. 

They also undertake privileging processes which determine whether a doctor or a nurse is eligible to perform specific medical procedures or treatments based on their qualifications, training, and experience. This ensures that only qualified professionals deliver quality care with the unique skill sets they bring to the workplace. 

However, the process doesn’t end there. Medical staff office professionals also set up remediation, revocation, and appeals processes to clear loopholes or potential lapses while ensuring that providers are treated fairly. 

Healthcare recruitment becomes even more challenging during staff shortages or an unexpected healthcare system overload. HCOs must then have provisions for privileging temporary workers in emergencies to ensure their patients receive the care they need on time. 

With a strong, trained, and skilled team of medical service professionals, an HCO can ensure they have the support they need to deliver quality healthcare services while ensuring patient safety and reducing liabilities. 

Behind the Scenes: Medical Staff Office Professionals Boost Efficiency in HCOs 

In addition to routine credentialing and privileging, medical safety office professionals also: 

• Ensure that all medical staff business is adequately documented and approved by the Executive Committee of the Medical Staff (ECMS) and the hospital governing board. 

• Implement approved initiatives and guide hospital leaders in making informed decisions.

• Track expiring credentials for all medical staff and allied health professionals.

• Facilitate adherence to medical staff bylaws, rules, and regulations from The Joint Commission (TJC), the National Committee for Quality Assurance (NCQA), and the Centers for Medicare and Medicaid Services (CMS).

Managing the Demands of Credentialing and Privileging in Modern Healthcare Environments 

The demands on medical staff services have become more complex as the healthcare industry evolves. For example, mergers between large HCO groups have resulted in multisite healthcare systems and hospitals, adding to the workload. Hence, medical staff services departments must now vet a single provider for privileges across multiple facilities. 

Moreover, medical staff officers must keep track of system-specific policies and state and local regulations and track negative credentialing to avoid liability issues. 

Telemedicine has also posed challenges, as the organization's remote providers must be credentialed. Failure to maintain updated practitioner lists could also jeopardize hospital accreditation. 

Better healthcare starts with the right people: Why qualified Medical Staff Office professional’s matter!

In today's healthcare landscape, medical credentialing and privileging are more critical than ever before. However, these processes can be time-consuming and complex, and many organizations struggle with finding and retaining medical staff office professionals. After all, they are the first line of defense in reviewing a physician's credentials and confirming that no red flags are associated with their licensing, medical malpractice history, or sanctions.

Fortunately, contractors are available to manage these detailed processes, which can help alleviate some of the burden. HCOs should ensure they have the right people on board for these positions. It’s time to transform care delivery and invest in patient safety, one qualified medical staff office professional at a time!