Legal Strategies for MSPs & Physician Leaders
Prevent negligent credentialing and protect peer review
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Product Description:
Litigation from credentialing and privileging disputes is on the rise. Recent legal cases have allowed physicians to challenge long-standing policies and decision-making by hospitals. MSPs and physician leaders need to be educated on the legal issues that arise from their everyday tasks and know how to avoid exposure to multi-million dollar lawsuits.
Legal Strategies for MSPs & Physician Leaders: Prevent negligent credentialing and protect peer review will help you to navigate negligent credentialing, malpractice, and peer review and manage your liability.Table of Contents
Introduction
- Legal pitfalls Medical Staff Leaders should avoid
- Negligent Credentialing
- Ensuring Unbiased Peer Review
- Breach of Due Process Rights
About the Author
Commonly used acronyms
Part 1: Prevention - Negligent Credentialing
Chapter 1: Negligent Credentialing Lawsuits - History and Prior Cases
- Credentialing and Privileging Basics
- Civil litigation & tort law
- Hospital liability for patient injuries
- Prior Cases
- Failure to disclose
- Failure to conduct unbiased peer review
- Failure to implement best practice credentialing
- Failure to prove negligent credentialing
Chapter 2: Effective Strategies to limit liability
- Medical Staff Bylaws
- Medical Staff Rules and Regulations
- Medical Staff and Hospital Policies
- Corrective Action & Due Process Policy
- Criminal Background Checks
Chapter 3: Applications, Attestations, Acknowledgements & Release Forms
- Initial and Reappointment Applications
- Attestations
- Acknowledgements
- Release Forms
- Code of Conduct
Chapter 4: Thorough Credentialing Processes
- Best Practice Credentialing Processes
- Privileging based on clinical competence
- Orientation at initial and reappointment
- Ongoing Monitoring
Part 2 - Peer Review
Chapter 5: Ongoing competency monitoring
- Monitoring competency to avoid negligent credentialing claims
- Focused Professional Practice Evaluations
- Ongoing Professional Practice Evaluations
- Individual Practice Evaluations
Chapter 6: Peer Review Committees
- Healthcare Quality Improvement Act
- Committee protection
- Personal liability of individual participants
- Division peer review vs. committee peer review
- Relationship with the Medical Executive Committee
- Impaired Practitioners
Chapter 7: Addressing unprofessional behavior and other rule/policy violations
- Centralization of practitioner data
- Incident reporting system
- Confidentiality vs. anonymity
- Educational event vs. Incident Report
- Division level review vs. escalation to peer review
- Addressing trends
- Collegial intervention
- Corrective Action
Chapter 8: Quality review process
- Origination of reports
- Internal reports - staff, quality monitoring
- Peer to Peer - practice reviews, M&M
- Root Cause Analyses (RCA)
- Patient Complaints & Patient Grievances
- Personal liability for committee members
- Personal liability for individual physician reviewers
Part 3 - Due Process Procedures, Negligent Credentialing Claims & Common Credentialing Pitfalls
Chapter 9: Medical Staff Rights
- What constitutes formal corrective action?
- When is a member entitled the right to due process?
- Who can implement and enforce corrective action?
- Taking corrective action
- Communication of rights
Chapter 10: Defending Against Claims of Negligent Credentialing
- Breach of duty
- Protection of confidential peer review and credentialing files
- Causation defense
- Statutory Immunity
- Statute of Limitations
Chapter 11: Medical malpractice claims
- Malpractice vs. Negligence
- Contributory or comparative negligence - patient’s contribution to harm
- Vicarious Liability - being held liable for the actions of an agent
- Ostensible agents
- Res Ipsa Loquitur "The thing speaks for itself"
- EMTALA
Chapter 12: Common Legal Pitfalls
- Pitfalls during initial credentialing
- Inadequate review of red flags
- Failure to ask the right questions on your application
- Failure to thoroughly review verifications submitted
- Pitfalls during reappointment
- New Technology
- Supervision of residents and mid-level providers
Meet the Author
Anne Roberts, CPMSM, CPCS
Anne Roberts is the Senior Director of Medical Affairs at Children's Medical Center of Dallas. She oversees Medical Staff Quality, Graduate Medical Education, Medical Staff Services, Continuing Medical Education, Research Administration, Surgery Administration and Medical Staff Governance & Communications. Additionally, she has been an independent healthcare consultant for over 10 years and is an award winning author with over 100 articles and several guidebooks related to medical staff leadership, governance, peer review and credentialing/privileging. She is recognized nationally as an expert in the medical staff credentialing and privileging field
Product Types : Departments :
SOURCE CODE: ESFNM10
ISBN: 978-1-60146-917-5
PUBLISHED: 03/13/2012