Kepatuhan Fasilitas Kesehatan 13 butir
Medical Staff Credentialing & Privileging Audit
Daftar periksa ini dalam bahasa Inggris.
Audit of the medical staff credentialing and privileging process covering primary source verification, privilege delineation, peer review, and ongoing professional practice evaluation.
CMS 42 CFR 482.12(a) / 482.22TJC Medical Staff (MS)NCQA Credentialing
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Application & Primary Source Verification
- Is a complete application obtained including education, training, licensure, and work history? *
- Is licensure, board certification, and training verified through primary sources? *
- Is the National Practitioner Data Bank (NPDB) queried at appointment and reappointment? *
- Are current DEA registration and malpractice history/coverage verified? *
Privilege Delineation
- Are clinical privileges granted specific to each practitioner based on documented competence? *
- Are criteria for privileges based on education, training, experience, and demonstrated competence? *
- Is the governing body responsible for the final appointment and privileging decision? *
Reappointment & Ongoing Evaluation
- Is reappointment/reprivileging conducted at least every 24 months? *
- Is Ongoing Professional Practice Evaluation (OPPE) data collected and reviewed continuously? *
- Is Focused Professional Practice Evaluation (FPPE) performed for new privileges and for-cause concerns? *
Peer Review & Corrective Action
- Is there a peer review process to evaluate the quality and appropriateness of practitioner care? *
- Are there fair hearing and appeal procedures for adverse privileging actions in the bylaws? *
- Are professional review actions reported to the NPDB and state board as required? *
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