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FORUM - Vendor Credentialing in Australia. Presented by Standards Australia in association with the Medical Technology Association of Australia (MTAA)

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FORUM - Vendor Credentialing in Australia

Presented by Standards

Australia in association with the Medical Technology

Association of Australia (MTAA)

Thursday, 7 July 2015 Sydney, Australia

Thursday, 7 July 2015 Sydney, Australia

(2)

WELCOME AND OPENING REMARKS

Dr Bronwyn Evans

Chief Executive Officer Standards Australia

(3)

WHY ARE WE HERE? – FORUM OBJECTIVES

Susi Tegen,

Chief Executive

Medical Technology Association of Australia (MTAA)

(4)

Vendor Credentialing:

Why are we here?

(5)

Susi Tegen

(6)

Vendor Credentialing

Vendor credentialing within the health sector can

be defined as

“a compliance and risk management

system used to manage risk in

healthcare facilities (HCFs).”

1

1. Reference: Vendor Credentialing Proposal for Australian Healthcare Facilities on behalf of the Medical Technology Industry 2012, MTAA p: 4

(7)

Vendor Credentialing

• Vendor Credentialing (VC) is the process of establishing

the qualifications of vendors and assessing their background and legitimacy. 2

(8)

Benefits

• The greatest benefit of vendor credentialing is patient

safety, with authorised MCRs entering HCFs being more easily identifiable.

• In addition:

• MCRs are better protected from healthcare risks • HCFs are better able to track inappropriate or

non-compliant behaviour

(9)

Process

• In markets, including Australia:

• credentialing is undertaken by third-party vendor

credentialing (TPVC) providers on behalf of an accredited HCF

• an automated integrated database provides badges

for accredited MCRs daily on-site at the HCF upon login

• There is no cost to the HCF for this service, only to

companies for their staff to be credentialed.

• This process is essentially vendor access management,

(10)

USA experience

• Practice is well established in USA and came about as

a result of 911.

1. TPVC conducts checks (e.g. vaccinations, training

and police safety checks) of each MCR within a company and current liability insurance of the company on behalf of a hospital.

2. TPVC provides identification badges for those that

meet the requirements.

(11)

USA experience

• In September 2007, AdvaMed wrote to The Joint

Commission following a review of existing hospital

health care industry representative (HCIR) credentialing requirements.

• AdvaMed proposed nationally recognised credentialing

standards that drew on existing standards (e.g. Association of periOperative Registered Nurses (AORN)), which reflected credible, purposeful and practical credentialing requirements for industry.

(12)

USA experience

• In June 2009, the Independent Medical Distributors

Association (IMDA) released the Updated Joint Best Practices Recommendation for Clinical Health Care Industry Representative Credentialing. 3

• This document enhanced the recommended

credentialing criteria put forward to The Joint Commission in 2007 by AdvaMed.

4. Reference: Updated Joint Best Practices Recommendation for Clinical Health Care Industry Representative Credentialing, IMDA (June 2009)

(13)

USA: today

• While there are a number of relevant Joint Commission

standards including awareness of visitors entering

accredited healthcare facilities, maintenance of patient rights and infection control precautions, there are no specific standards that address the credentialing of HCIRs entering healthcare organisations.

(14)

USA: today

• There is no cost to the HCF for signing up to service,

only to companies requiring service to access a HCF. 3

• Each HCF has its own level of expectation and different

credentialing requirements.

• Result is a wide range of disparate systems that don’t

necessarily meet the needs of each HCF, which has increased the time and cost burdens on industry.

(15)

USA: cost

• An HCIR who needs to access multiple HCFs may have

to be credentialed with a number of TPVC providers, increasing the cost burden on companies.

• Its estimated to cost up to $3,000 per rep per year to

credential in USA (2010 figures).

• Larger companies have had to employ administration

staff to manage VC requirements of HCIR by TPVC providers due to the large administration burden.

(16)

Canadian experience

• To avoid the multiple vendor credentialing providers that have sprung into existence in overseas markets,

(17)

Canadian experience

• Working with industry and key stakeholders, a national vendor credentialing standard was developed by

Healthcare Supply Chain Network (HSCN) to:

– “minimize the costs to the Canadian healthcare system, simplify the process, avoid unnecessary duplication and protect the privacy rights of

individuals.

– “The Standard makes Vendors responsible to ensure and attest that their employees who call on

healthcare facilities meet the Standard.” 5

(18)

Canadian experience

• “Suppliers who wish to attest to their representatives

meeting the national standard submit their attestation form to be published in the national registry annually at no cost.

• “The National Standard for Vendor Credentialing is an efficient model for transferring accountability to the

supplier for potential risks associated with supplier representatives having access to

non-public areas of the hospital.” 6

(19)

Canadian experience

• “The goal of the HSCN national standard and centralized registry is to streamline the credentialing process, so that healthcare providers and their suppliers can address all their credentialing needs in one place and eliminate the need for hospitals and SSO’s to manage the credentialing process individually.” 6

(20)

Canadian experience

• “In January 2013, HSCN unveiled the national standard and accompanying registry to the healthcare supply

chain industry.

• The national standard and registry were developed in response to the request of HSCN members to develop a collaborative approach to vendor credentialing that would avoid the legal risks, inefficiencies and

tremendous costs seen the US.” 6

(21)

Canadian experience

• “The development of the national standard was based on meeting the needs of patients, healthcare providers, but ensuring the process and requirements met legal and ethical standards around human rights, labour rights, and personal privacy laws.

• Under the HSCN model, personally sensitive

information is maintained by the representative’s

employer and is not transferred to HSCN or stored on 3rd party databases.” 6

(22)

Vendor credentialing for Australia

• Vendor credentialing should balance the need for:

– patient safety

– patient and MCR privacy

– high quality care

– immediate access to medical products

– efficient communication of product information and education provided by the MCR

(23)

Australian experience

• Vendor credentialing needs to ensure it:

– addresses patient risk concerns of HCFs

– ensures continued effective interactions between

clinicians and medical companies for the development and delivery of medical products across Australia

– is standards based

– is comprehensive

(24)

INTRODUCTION TO STANDARDS AUSTRALIA

Facilitator: Miss Bronwyn Walker

National Sector Manager Standards Australia

(25)

HOUSE KEEPING Toilets and venue

 Emergency procedures  Mobiles on silent

(26)
(27)
(28)

PROGRAM

10:00 AM - W elcome and opening remarks Bronwyn Evans, CEO,

Standards Australia

10:10 AM - W hy are we here? Susi Tegen, CE, Medical Technology

Association Australia

10:25 AM - Introduction to Standards Australia and the standards

development process Bronwyn Walker National Sector Manager, SA

10:40 AM - An industry perspective Pat Callanan, Country Manager,

(29)

PROGRAM

11:40 AM - Vendor Credentialing: The Mitcham Private Hospital

Experience Samantha Dodd - CEO of Mitcham Private Hospital

12:00 PM - Quality and safe patient care: Important factors to be

considered when working in healthcare facilities Dr Patricia Nicholson, Deakin University, President VPNG and ACORN Board Member

12:20 PM - Q and A panel - (Pat Callanan, Samantha Dodd and Dr

Patricia Nicholson)

12:50 PM - LUNCH

(30)

PROGRAM

2:50 PM - Afternoon break

3:00 PM - Reporting back - summary and evaluation Fiona Shipman -

MTAA/Bronwyn Walker - SA

(31)

WHY DO WE HAVE

STANDARDS?

(32)

STANDARDS BENEFIT THE INDUSTRY

Reduce

costs

Expand

markets

Risk

management

tool

(33)

ARE STANDARDS LAW?

(34)

STANDARDS DEVELOPMENT – OVERVIEW

Our process is built around: • Openness

Transparency Consensus

(35)

PROJECT PROPOSAL PROCESS

For the Standards Resourced Pathway, Project Proposals can be submitted twice a year:

Round 10

Monday 2 February – Wednesday 18 March 2015

Round 11

(36)

Process

Stakeholder engagement/ consultation/ forum Proposal National Sector Manager Net Benefit Assessment Standards Development Committee

(37)

WE MAKE A DIFFERENCE EVERY DAY

AS 3660 Protection of buildings from subterranean termites

AS 2047-1999 Windows in buildings - Selection and installation

ISO 10993-17:2002

Biological evaluation of medical devices -- Part 17: Establishment of allowable limits for

(38)
(39)

AS 3660.1-2014 TERMITE MANAGEMENT FOR NEW BUILDING WORK

Standards Australia has recently published a new Australian Standard for Termite Management for New Building Work known as AS 3660.1-2014

AS 3660.1-2014 is primarily concerned with

- Providing measures to reduce the risks of undetected subterranean termite attack on buildings.

- The Standard sets out requirements for the design and construction of subterranean termite management systems for new buildings and new building work.

- It includes solutions for both physical and chemical termite management systems. - Options are provided so that various approaches may be used either singly, or in

combination, to provided an integrated termite management system.

- Improving design requirements to minimise termite damage is one of several risk reduction measures available.

- The Standard describes measures to deter termite attack arising from concealed entry into a building. The system options available rely on a combination of:

- Partial measures to termite passage

- Perimeter inspection zones (so that when termites attack, evidence of their workings is in the open where it may be detected more readily during regular inspections)

NOTE: The measures contained in the Standard cannot guarantee that a building will never be entered by termites nor will ever suffer some form of termite attack.

(40)
(41)
(42)

FURTHER INFORMATION

• Detailed information on our process is available in our Standardisation Guides available for download on our website.

(43)

PAT CALLANAN

REGIONAL DIRECTOR, AMS, MTAA BOARD DIRECTOR

(44)

Vendor Credentialing: An industry perspective

7 July 2015

(45)

©2012 American Medical Systems, Inc. All rights reserved. 45

Pat Callanan

Regional Director, AMS

MTAA Board Director

(46)

Vendor Credentialing

• Vendor Credentialing (VC) is the process of establishing

the qualifications of vendors and assessing their background and legitimacy. 1

(47)

The role of industry

– Entry to the hospital environment, particularly the perioperative area, is a privilege and not a right for industry

– Industry representatives play a clear role in the efficient training of hospital staff , with provision of products and services to improve patient outcomes

– Industry provide numerous value added benefits in

addition to the products we supply, often at significant cost savings to the institution

(48)

What does VC mean for industry?

– What problem are we trying to solve? – Multiple providers = multiple costs

– Servicing models may be impacted by restricted access – Potential privacy issues with information access

– What mechanisms exist to ensure TPVC providers remain compliant?

– The industry is vibrant with over 500 suppliers ranging from small startups to large multinationals. It is vital that an equitable playing field remains for all, not just those who can pay.

(49)

What are the benefits?

– Most perioperative environments already require sign in – MTAA provides MCR accreditation for ACORN standards – The public can access most areas of the hospital without

accreditation, so how does vendor credentialing improve compliance?

– MCR’s provide services free of charge, which would otherwise be borne by the hospitals

– MCR’s are happy to be credentialed providing it is simple and cost effective

(50)

What are the costs?

– The financial cost for one MCR to be credentialed to enter one healthcare facility, and then have that process

repeated across a number of facilities using a range of TPVC providers could be far reaching.

– Current product pricing restraints means suppliers can not absorb significant credentialing costs without changing

servicing models

– Restricted access may result in ‘cost’ transfer to healthcare providers and result in adverse patient outcomes

– Ensuring one entry, many exits of credentialing data is the best way to minimise the cost burden to companies.

(51)

Burden on Australian industry

– The three immediate issues for Australian medical

companies in relation to vendor credentialing MCRs are:

1. Vendor fees

2. Replication

(52)

Vendor credentialing

– The aim of vendor credentialing should be to balance the need for:

– patient safety

– patient and MCR privacy – high quality care

– immediate access to medical products

– efficient communication of product information and education provided by the MCR

(53)

What is needed?

• It’s essential that the requirements for vendor

credentialing be defined to ensure patient safety and the continued effective interactions between clinicians and medical companies for the development and delivery of medical products across Australia.

• A national standard for vendor credentialing, not access

control, that is accepted by any Australian healthcare facility is required.

• A single, simple process for credentialing that protects

(54)
(55)

ESTABLISHING A UNIFORM POSITION

Samantha Dodd

CEO Mitcham Private Hospital

(56)

Establishing a uniform position Samantha Dodd CEO Mitcham Private Hospital

(57)

Why trial?

Patient factors

Theatre is not a selling space

Who is there and why?

Qualifications

Prosthesis management

Recall

Infection control

(58)

How the trial was run

10 weeks

5 theatres

App technology

Executive buy in

Theatre and Dr buy in

Rep buy in

(59)

The good

No reps could enter without a scheduled visit

Transparent process

Competency had to be completed prior

Particular policy sign off good

Good compliance with policy

Control

(60)

The bad

Financial stand off with some companies, even though

cost was low (during trial period)

Impact on business

Other peoples “dirty work”

Pass on costs

Administration burden

Multiple providers therefore multiple costs to

(61)

Where to now??

Needs to be regulated

Should it be a third party business?

How often to register?

Who credentials the credentiallers?

Impact to companies

(62)
(63)

Dr Patricia Nicholson, Deakin University, President VPNG and ACORN Board Member

QUALITY AND SAFE PATIENT

CARE: IMPORTANT FACTORS TO BE CONSIDERED WHEN WORKING IN

(64)

Quality and safe patient

care: Important factors to be

considered when working in

healthcare facilities

Dr Pat Nicholson

Senior Lecturer, School of Nursing and Midwifery, Deakin University

(65)

Presentation Overview

• Overview of Standards governing Nursing

and Midwifery practice

• Visitors in the healthcare facility (HCF)

• Patient safety

• Visitors to the operating suite

• Education and training of visitors

• Future of credentialing

(66)

Standards in Nursing &

Midwifery

• National competency standards for Nurses

and Midwives

• Code of Ethics and Professional Conduct

(Nursing and Midwifery Board, Australia)

• Australian College of Operating Room

Nurses

Standards of practice for

perioperative nursing (2014 – 2016) &

(67)
(68)

Visitors to HCFs

• Orientation to the HCF

• WH&S requirements

• Professional conduct

• Immunization requirements

• Infection control

(69)

National Safety and Quality Health Service Standards

(70)
(71)
(72)

Hand Hygiene Australia (2012) National data Period 1, 2012. Data available at: http://www.hha.org.au/LatestNationalData.aspx (Accessed 30th May 2012) 69.3% 74.4% 80.7% 83.2% 66.2%

(73)

Patient healthcare rights

• Safe practice

• Respect

• Confidentiality

• Privacy

• Informed consent

(74)
(75)
(76)

76

……..to promote excellence in perioperative nursing care

Australian

College of

Operating

(77)

77

ACORN –

The spirit of perioperative

nursing

S

tandards utilising evidence based practice

P

rofessional growth and development

I

nnovation to achieve best patient care

outcome

R

epresentation of all States and Territories

I

nfluential in health policy

T

eamwork development local, nationally &

internationally

(78)
(79)

ACORN Standards for Perioperative

Nursing

Referenced, reflecting evidence-based practice

– highest standard of patient care

– professional competence

• Provide professional guidelines and specific

recommendations

• Valuable resource for perioperative nurses

involved with the care of patients in the OR

(80)
(81)
(82)
(83)
(84)

Any visitor in the operating suite not

associated in the care that is being

provided has been said to be violating

the patient's right to privacy and

confidentiality. (p. 406)

ACORN 2014-2015

(85)

MCRs shall provide evidence of

education and instruction that ensures

safe conduct and practice within the

perioperative environment. (p: 405)

ACORN 2014-2015

(86)
(87)

Credentialing is everyone’s responsibility

(88)
(89)

OPEN PANEL DISCUSSION: Q&A

Facilitator: Miss Bronwyn Walker National Sector Manager

(90)

Lunch – 30 Minutes

(91)

GROUP DISCUSSION/BREAKOUT GROUPS

(92)

(93)

Standards Australia

Summary and

actions

(94)
(95)

Standards Australia

(96)

FOLLOW US

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