Finally, adopting credentialing policies and procedures or privileging criteria that do not reflect what a reasonable hospital would do to protect a patient from a foreseeable risk of harm may also be considered a breach of duty. For example, most hospitals verify all past medical staff appointments for all initial applicants. This is not required by Joint Commission accreditation standards. The fact that it is something that most hospitals do, means that it is the standard of care that all hospitals will be held to. It’s essential that your policies meet the requirements of your organization’s accreditation standards as well as state and federal regulations. If there is a difference between accreditation standards and a state and Federal requirements, you always have to follow the strictest requirement. When developing privileging criteria, the organization should take into consideration any guidelines that have been published by
But why should physicians participate in the hospital’s credentialing process or care about the hospital’s credentialing liability? First, the quality of one’s medical staff colleagues bears strongly on their overall experience of treating patients at the hospital. Indeed, most physicians take the process seriously because they want to have an important role in selecting their peers. The quality of their colleagues also reflects well on them as well as the hospital and serves their collective need to have quality peers care for their patients. But they should also share the hospital’s concern for avoiding negligentcredentialing claims because if one physician is accused of negligence the chance of other physicians being drawn into the case either as co-defendants or discovery respondents is substantial. Thus, while the hospital is the only entity that can be sued for negligentcredentialing, all of the physicians on the medical staff are at risk of being caught up in the web of the alleged
The next legal issue of substantial importance to the credentialing and privileging processes is the issue of the confidentiality of the peer review evaluations made in connection with those processes. Particularly, the issue arises as to whether the peer review activity is exempt from discovery in litigation. Discovery, of course, means the right of parties to litigation to obtain relevant documents and testimony from their opposing parties or by subpoena from others not parties to the litigation. Currently, there is no federal-specific protection, or what is known as privilege, for such peer review information. However, throughout the United States, state law provides for such protection with very few exceptions. There is recognition that the most effective peer review can be discouraged if the evaluation activity does not remain confidential, particularly with regard to attempts to discover such information in connection with malpractice or liability actions claiming negligent treatment. The theory of the protection is that plaintiffs in such cases can obtain their own experts and make their own evaluations to present to a judge or jury and do not need to invade the peer review processes that take place within the hospital. “A hospital should obtain counsel from an expert attorney in this
• Another concept to keep in mind is that Appellate Courts have held that information which is normally generated within the hospital or medical staff which is not clearly treated as a “peer review document” cannot be kept confidential by simply submitting it to a Peer Review Committee for review and action. Therefore, the hospital and medical staff should consider
Risk management relates to a theory of "negligentcredentialing" in which an insurer that includes a physician in its network presumably may be liable if that physician is unqualified and the health plan beneficiary suffered as a result. As one way of buttressing their credentialing, insurers may seek verification that a hospital, too, has credentialed that physician and offered privileges. Another reason for an insurer to require hospital privileges, or a plan of care that indicates how a patient can be hospitalized and cared for in a hospital, is for network adequacy of care. In this regard, a 1995 attorney general's opinion differentiated between health
At issue in the credentialing claim was whether the podiatric physician had been “grand- fathered in” – i.e., had obtained hospital staff privileges prior to a change in the prereq- uisites and was not required to satisfy new requirements under the organization’s bylaws due to experience and clinical record. In affirming the Cook County jury verdict, the Illinois appellate court found that the hospital’s medical staff bylaws were silent on the concept of grandfathering. The court also determined that the podiatric physician had failed to meet the standards set out in the medical staff bylaws for Level II surgical privileges upon initial appointment, and so could not have been grandfathered in under any circumstances. The Frigo decision represented the first time that a negligentcredentialing claim was recognized by an Illinois appellate court. Even more important, the decision signified that the state peer review statute does not protect a hospital from these claims, even if the credentialing materials are generated by a peer review committee and therefore consid- ered inadmissible in medical liability litigation.
– The answers to these questions are important because the hospital may want to create a record of compliance with its duty that is not part of an inadmissible peer review file. This effort must be coordinated with internal and/or external legal counsel
This was a cross-sectional, web-based survey that was sent to 160 ACGME-accredited EM residency programs from July 2013 to November 2013. This was the total number of ACGME-accredited EM residency programs in existence during this time frame. A cover letter explain- ing the research study was initially sent to all EM resi- dency program directors who were identified through the SAEM Residency Directory website. If deemed appropri- ate, the residency directors were instructed to share the survey with the US credentialing authority in their emer- gency department to acquire more accurate answers. A reminder email was sent 1 month after the initial survey
In particular, at the tissue and cellular levels, research relating mechanical signals to design has mainly focused on traditional model species and mechanisms that control biomedically relevant traits in biomedically relevant contexts. But it is also evident that studying natural non-traditional systems in a comparative fashion can provide us with insights that laboratory cultures may not. Although a paradigm shift from solely gene-focused thinking to acknowledging the role of mechanical forces as master regulators of organismal traits is evident, we need to be aware of the incredible wealth of genomics and transcriptomics data that are rapidly becoming available for many non- model species (e.g. Misof et al., 2014). Such datasets can allow researchers to bypass the (classically time-consuming) need to obtain relevant and detailed sequence information for genes of interest. Thus, an understanding of the size and weight sensitivity of musculoskeletal design (e.g. at the level of alternative splicing or other gene regulatory control of sarcomere, bone and tendon genes) across phylogenies has become feasible within a reasonable time frame, given appropriate collaborations. Similarly, knowledge about the function of mechanosensitive intracellular pathways is more valuable when combined with data showing how the amino acid coding sequences (and hence, for example, protein kinase activation potential) of the signaling pathway components may evolve. Vice versa, genetic associations with quantitative traits such as body weight and muscle mass mean little without a biochemical, physiological and evolutionary context. Collaborative and integrative studies of how animal designs accommodate body weight variation, across levels of biological organization in different species as well as across evolutionary time scales, will allow us to deepen our understanding of the evolution, plasticity and longevity of animal designs in the face of variable diet, lifespan and environmental stressors. These are important issues that will be relevant to both basic biology and biomedical research.
I n the assessment-driven environment of today’s schools, questions about effectiveness and impact on student learning often focus on the school as a whole. For example, is our school successful in helping all our students meet high standards? Or the focus may be somewhat narrower—how are we doing with math instruction? An often-missed piece is taking a critical look at specific programs and approaches. Program evaluation is a tool that can help do this.
OSU Cooperative Extension Service can apply: management integration knowhow; planning framework knowhow; project building and setup knowhow; defined User interface communications; perform local level and State interagency interface building; applied GIS research/technical development, and produce ready packaged documentation and video tutorials to apply to further development of a Statewide Geographic information System
20. If a client purchases a variable annuity but does not specify how the premium is to be invested, which of the following statement accurately describes how the premium may be invested during the free-look period? A. The premium may be invested only in fixed income investments
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evident in the report, it uses easy-to-read bar charts to indicate fitness levels for each of the completed tests. Comparisons between the past and the current tests allow for some indication of trends over time. Personalized feedback messages that appear in the text blocks help provide individualized feedback to the students. The feedback is processed using internal algorithms in the software that take into account a child’s overall fitness profile. Students with favorable scores on the assessments (i.e., those reaching the HFZ) receive congratulatory messages and remind-ers to maintain their involvement in physical activity. Students with less favorable scores (i.e., those in the “Needs Improvement” zone) receive supportive messages and prescriptive feedback about how to be more active and how to improve their scores.
Type 1 diabetes (insulin dependent) and type 2 (non-insulin dependent) diabetes are a chronic disease that can harm other body organs and cause kidney failure, blindness, heart attacks and strokes, and amputations. According to the U.S. Centers for Disease Control and Prevention (CDC), diabetes is the seventh leading cause of death in the United States. Approximately, 8.3 percent of the U.S. population, or 25.8 million people (all ages), have diabetes. Of these, approximately 7 million people do not know they have diabetes; making them at risk to develop other health complications due to their unmanaged diabetes.
The aging population is increasing worldwide. The decline in cognitive functions, health literacy, visual and hearing limitations add to the challenge of acquiring adequate knowledge. The level of Knowledge has been associated with overall health outcomes. This study aimed to address the Medication Knowledge (MK) in elders. Identify factors associated with knowledge and areas where the knowledge needs to be enhanced. The MK in elders was poor. Illiteracy, Polypharmacy and follow up in multiple clinics compromised knowledge. Knowledge with regards to side effects fared worse. Elders were most knowledgeable on how to store the medications and refills dates. Elders considered knowledge provided by medical staff about their medications as inadequate. The health care providers should be aware that a large gap in MK exists in elders. Multiple factors make MK enhancement in elders very challenging. Knowledge Improvement requires defining evidence based approaches and needs to be individualized. Prospective studies addressing the impact of interventions on improving knowledge and important outcomes like safety, adherence and mortality are needed.
The changes that come with an additional round of investment, however, may also change the incentives of investors to share their resources and know-how with the firm. First, as the venture develops, it accumulates resources of its own, partly by taking advantage of the resources investors may have brought in earlier rounds, such as a defined set of human resources policies, a capable management team, or promising commercialization alliances (Hellmann & Puri, 2002; Hsu, 2006). With more in-house resources, the return to external resources of investors is smaller. In addition, as rounds of investment unfold the investors’ strategy changes. Early-stage investors tend to have narrower portfolios to which they devote much time, while later-stage investors tend to be more diversified and as result devote less attention to each firm. In sum, with more later-stage investors in the syndicate there is likely to be a smaller effect of investors’ resources on firm performance because of a lesser degree of involvement.
In the event a sanction imposes a reprimand or probation, written communication is made to the provider requesting a full explanation, which is then reviewed by the Credentialing/Peer Review Committee. The committee makes a determination as to whether the provider should continue participation or whether termination should be initiated.
• “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