The Credentialing FunctionResources

• Discussion and Participation Scoring Guide.

 

Credentialing of clinicians is a specific area that requires integration of quality improvement with risk management functions.

Credentialing is an official process that all health care organizations must complete. The National Practitioner Data Base (NPDB) is a specific source that organizations should use for assuring that licensed providers have no records of fraud, lawsuits, et cetera. In addition, state licensing boards must also be consulted to ensure that the clinician indeed has a license and may be employed by your organization.

You are the risk manager in charge of credentialing of a large, teaching hospital. All health care providers must be credentialed prior to working with patients. Consider one of the following:

• foreign-trained medical students.
• on-call registered nursing from a staffing agency.
• a physician with three pending lawsuits from patients injured by the physician.

What type of credentialing needs to be considered for your choice? What databases should be checked? What type of background should be collected? Create a 250- to 300-word response.

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