Commission on Quality and Scope of Practice, July 1999
Ambulatory Credentialing/Privileging Committee Prototype
Purpose
To establish a model through which private practices may demonstrate to third-party reviewers the quality of their care provided in the outpatient setting, especially when they do not have hospital privileges.
Composition
The committee should include physicians from the practice who have current credentials/privileges in the procedures for which privileges are being requested.
Others who may be considered for the committee are the office manager or someone who is familiar with front office operations and a non-physician provider (nurse, assistant, etc.) familiar with the integration of office services, procedures, patient flow and outcomes. One person should be designated as responsible for collecting, disseminating and reporting the information obtained by the committee.
Others who may be considered for the committee are the office manager or someone who is familiar with front office operations and a non-physician provider (nurse, assistant, etc.) familiar with the integration of office services, procedures, patient flow and outcomes. One person should be designated as responsible for collecting, disseminating and reporting the information obtained by the committee.
Function
The committee is responsible for reviewing applications and recommending approval or denial of the requested ambulatory privileges for all new practitioners and for periodic recredentialing and renewal of privileges. The committee should maintain appropriate documentation of the process.
Process
- Obtain verification of physician background.
- Current licensure
- Relevant training and/or experience
- Current competence
- Ability to perform the privileges requested
- Administer the group’s credentialing/privileging instrument.
- Committee discussion and decision-making on privileges.
- Establish or apply the group’s proctoring tool, if appropriate.
- Communicate the status of the application with the applicant and the practice.
- Application pending
- Application approved pending proctoring
- Approved for independent activity.
- Supply information to appropriate third parties when necessary to assist the reviewers to verify physician competency.
Evaluation
The ambulatory credentialing/privileging committee should establish a timeline by which it will periodically review its process. This will ensure that it is relevant in meeting the needs of the practice in establishing its providers as competent to provide and perform the services and procedures represented.
