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OPPE and FPPE are mainstays in the privileging process, but they're anything but cut and dry. In today's evolving healthcare industry, medical staff leaders and MSPs often encounter scenarios that don't fit squarely into evaluation frameworks, such as telehealth providers, low-volume practitioners, and the growing ranks of advanced practice professionals. With a myriad of factors at play, it can be difficult to take the proper steps to ensure effective peer review. The Complete Guide to OPPE and FPPE is your comprehensive guide to navigating today's OPPE and FPPE landscape, and a handy companion to The OPPE Toolbox and The FPPE Toolbox. Authors Juli Maxworthy, DNP, MSN, MBA, RN, CNL, CPHQ, CPPS, CHSE, and Evalynn Buczkowski, RN, BSN, MS, shed light on the industry's most pressing questions about hard-to-evaluate practitioners, data aggregation, effective reporting strategies, and more. Plus, customizable forms make for a seamless transition from education to application. With a healthy blend of practical guidance on core OPPE and FPPE concepts and targeted strategy on specific pain points, The Complete Guide is a must-have for medical staff veterans and newcomers alike. This book will help you: - Evaluate and strengthen existing OPPE/FPPE approaches - Integrate, evaluate, and share meaningful performance data - Understand confusing OPPE/FPPE scenarios - Prepare for the future of OPPE/FPPE
The Complete Guide to OPPE: Strategies for Medical Staff Professionals, Physician Leaders, and Quality Directors Evalynn Buczkowski, RN, BSN, MS; Wendy R. Crimp, BSN, MBA, CPHQ; Valerie Handunge, MA The Complete Guide to OPPE provides medical staff leaders, medical staff professionals, and the quality team with the tools and strategies they need to effectively carry out OPPE. Authors Evalynn Buczkowski and Valerie Handunge, and contributing author Wendy R. Crimp deliver practical guidance to build and implement an OPPE process in your institution. They provide how-to approaches to help you: Create and implement a comprehensive and compliant OPPE policy Select meaningful indicators and gather appropriate data Establish thresholds to identify opportunities for performance improvement Assess performance and help evaluators and practitioners interpret OPPE reports Intervene on practitioners with improvement opportunities and performance concerns Targeted for Joint Commission--accredited organizations, The Complete Guide to OPPE offers best practices for all hospitals, regardless of their accreditation provider. It walks you through the steps to develop, implement, and maintain a strong OPPE program, including: Developing a framework for OPPE and defining the scope of the program Creating a communication plan for implementing the program Evaluating potential indicators for fairness and feasibility of collection Determining who should share perceptions of practitioners and how their perception data should be interpreted Selecting thresholds based on indicator types and using thresholds to interpret variation Solving data integrity issues and minimizing data collection errors, such as attribution Structuring and staffing the OPPE review Preparing for and carrying out critical practitioner conversations about performance improvement Table of ContentsSection 1: Developing a Strategy for OPPE The Impetus for Practitioner Performance Improvement Building a Successful OPPE Program Developing an OPPE Communication Plan Section 2: Selecting Data for the OPPE Program Understanding Performance Indicators Using Perception Data as a Source for OPPE Evaluations Establishing Thresholds and Benchmarks to Interpret Performance Solving the Attribution Problem Developing Protocols for Low-Volume Practitioners and Advanced Practice Practitioners Section 3: Compiling OPPE Reports and Implementing the OPPE Program Designing Practitioner-Friendly OPPE Reports Delivering OPPE Reports to Practitioners Evaluating Performance and Engaging Practitioners in Performance Improvement Conversations When OPPE Leads to FPPE Who should read OPPE? The Complete Guide to OPPE is the perfect companion for medical staff professionals, physician leaders, quality directors, medical executive committee members, credentials committee members, vice presidents of medical affairs, chief medical officers, and risk managers.
Peer review continues to rate as a top problematic issue in healthcare organizations. Even if they are meeting regulatory standards, most organizations struggle to develop a peer review program that is meaningful to physicians, causing them to become resistant to this performance measurement tool. This new edition explains the connection between peer review, OPPE, and FPPE. It also contains updated information on OPPE and FPPE as related to The Joint Commission's standards. This book also incorporates three previous books: Effective Peer Review, Peer Review Best Practices, and Measuring Physician Competency. Now readers have one, all-encompassing resource to answer their peer review and physician performance questions. This completely updated book will help you: * Engage physicians in the peer review process * Create tools to recognize and celebrate excellence * Design OPPE profiles and create a plan for distributing the information to physicians * Eliminate bias and improve case reviewer efficiency * Determine if your peer review policies comply with regulatory standards
Effective Peer Review The Complete Guide to Physician Performance Improvement, Third Edition Robert J. Marder, MD Peer review continues to rate as a top problematic issue in healthcare organizations. Even if they are meeting regulatory standards, most organizations struggle to develop a peer review program that is meaningful to physicians, causing them to become resistant to this performance measurement tool. This new edition explains the connection between peer review, OPPE, and FPPE. It also contains updated information on OPPE and FPPE as related to The Joint Commission''s standards. This book also incorporates three previous books: Effective Peer Review, Peer Review Best Practices, and Measuring Physician Competency. Now readers have one, all-encompassing resource to answer their peer review and physician performance questions. This completely updated book will help you: Engage physicians in the peer review process Create tools to recognize and celebrate excellence Design OPPE profiles and create a plan for distributing the information to physicians Eliminate bias and improve case reviewer efficiency Determine if your peer review policies comply with regulatory standards Take a look at the Table of Contents: Chapter 1: Peer Review: Why Do We Need to Measure Physician Competence? What Peer Review Is What Peer Review Is Not Who Is a Peer? Impartiality and Conflicts of interest Sham Peer Reviews The Duty to Perform Effective Peer Review Should Physicians Be Paid to Perform Peer Reviews? Chapter 2: From Punitive to Positive: Creating a Performance Improvement Culture for Peer Review How Can Culture Change? Values of a Performance Improvement-Focused Peer Review Culture Peer Review and the Just Culture Chapter 3: Legal Considerations: Impact of Regulations and Liability on Peer Review Redefining Peer Review: OPPE, FPPE, and the Core Competencies How the Standards Apply Peer Review Protection Laws Affirmative Duty to Keep Information Confidential Fair Hearings The National Practitioner Data Bank Negligent Peer Review Chapter 4: Peer Review Structures: The Impact of Multi-Specialty Peer Review Peer Review Structures: Three Primary Functions Goals for Peer Review Redesign Basic Peer Review Models Who Should Oversee Peer Review? Selecting the Right Model Physician Behavior: Who Should Handle It? Chapter 5: Measuring Physician Performance: What to Measure and How to Do It Fairly? What Is a Physician Performance Indicator? Indicator Validity: Selecting Physician-Driven Measures What Are You Required to Measure? What to Measure: Structure, Process, and Outcome How to Measure Physicians Fairly: Review, Rate, and Rule Indicators Understanding and Improving Risk- Adjusted Data Using Perception Data to Evaluate Physician Performance Case Study Indicator Selection Chapter 6: Case Review: Reducing Bias and Improving Reviewer Efficiency and Effectiveness Standardizing the Case Review Process Case Identification and Screening Physician Reviewer Assignment Physician Review and Initial Case Rating Initial Committee Review and Physician Input Committee Decision and Improvement Opportunity Identification Communication of Findings and Follow-Up Accountability Case Rating Systems Case Review and the Electronic Age Chapter 7: Selecting Physician-Driven Measures for OPPE: Understanding and Applying the Six Core Competencies ACGME, ABMS, and The Joint Commission: Where Did the Core Competencies Come From and How Are They Used? Alternative Frameworks to the Core Competencies Using the Competency Statement and Expectations to Drive Physician Performance Measures Applying the Core Competencies to OPPE Chapter 8: Physician Data Attribution: Making OPPE Data Meaningful to Individual Physicians Using Imprecise Data for OPPE Attribution and Case Review Improving Attribution for Process Measures Outcome Measure Attribution in a Multiple-Provider World Attribution and Patient Satisfaction Data Chapter 9: Evaluating OPPE Data: Using Benchmarks and Targets for FPPE and the Pursuit of Excellence Understanding Normative Data Interpreting OPPE Data for a Time Interval How to Set Indicator Targets Targets for Indicator Types Interpreting OPPE Data for Trends Chapter 10: From OPPE to FPPE: Creating Accountability for Physician Performance Improvement Accountability for FPPE Initiation, Monitoring, and Follow-Up Designing an Effective FPPE Plan Getting Physician Buy-In for Improvement Opportunities and FPPE What Happens If FPPE Fails? Chapter 11: OPPE Profiles and Physician Performance Feedback: Practical Principles for Competency Report Design and Distribution OPPE Profile and Physician Performance Feedback Report: What Is the Difference? Designing the Report Define the Principles: 10 Questions to Guide Your Design Create a Format That Reflects the Design Principles Preparing and Distributing Competency Data Reports Develop the Infrastructure and Support Materials Pilot-Test Your Design Create a Policy for Physician Competency Reports Chapter 12: External Peer Review in a Physician Improvement Culture EPR Uses The EPR Policy What Circumstances Typically Require EPR? Who Determines When EPR Is Needed? Who Will Select the Reviewer? How Will the Cases Be Selected? Who Will Review the EPR Report Findings? How Will the Results Be Used? Beyond Case-Based EPR: Physician Assessment Programs Chapter 13: Reporting Peer Review: What Does the Board Need to Know? Contemporary Board Accountabilities for Hospital Quality What Keeps the Board Awake at Night? Filling In the Knowledge Gap: Helping Boards Understand Physician Competency Measurement What Data Should the Board Get? Chapter 14: Running an Effective Peer Review Committee Meeting Elements of an Effective Meeting Role of the Committee Chair Responsibilities of Committee Members in Meeting Preparation and Management Practical Tips for Managing Committee Discussion to Avoid Wasting Physician Time Chapter 15: Beyond the Hospital Walls: Peer Review in Ambulatory Care and ACOs Why Would You Want to Do Peer Review in a Nonhospital Setting? Can You Do Peer Review in the Nonhospital Setting? What Data Can You Obtain From the Hospital and What Are You Willing to Share? Peer Review Outside the Hospital: How Should You Organize It? Peer Review Outside the Hospital: What Can You Measure? Chapter 16: Creating Effective Peer Review Policies and Procedures What Do Your Policies and Procedures Need to Cover? Redesigning Your Peer Review Program: A Step-by-Step Guide Should You Do This Yourself or Get Some Help?
Nurse Practitioner’s Business Practice and Legal Guide, Sixth Edition is a must-have resource for every new or current nurse practitioner (NP) that explains and analyzes the legal issues relevant to nurse practitioners. Completely updated and revised, it includes a new chapter on answering frequently asked questions from NPs. In addition, it provides the latest state-by-state laws, including regulatory developments and prosecutions of nurse practitioners, and new case analysis and lessons learned from those cases. The Sixth Edition also provides new discussions of NP competencies, how the Doctor of Nursing Practice (DNP) degree relates to NPs, the differences in primary care and acute care NPs, definitions of medical bio-ethics terminology, additional malpractice cases and the lessons to learn from them, emerging issues in health policy, guidelines around prescribing opioids and controlled drugs, clinical performance measures, electronic health records, and new opportunities for NPs u
Simulation can be a valuable tool in academic or clinical settings, but technology changes quickly, and faculty, students, and clinicians need to know how to respond. Understanding simulation scenarios and environments is essential when designing and implementing effective programs for interdisciplinary learners. In this fully revised second edition of Mastering Simulation, nationally known experts Janice Palaganas, Beth Ulrich, and Beth Mancini guide students and practitioners in developing clinical competencies and provide a solid foundation for improving patient outcomes. Coverage includes: · Creating simulation scenarios and improving learner performance · Designing program evaluations and managing risk and quality improvement · Developing interprofessional programs and designing research using simulation
The FPPE Toolbox: Field-Tested Documents for Credentialing, Competency, and Compliance Carol S. Cairns, CPMSM, CPCS; Sally J. Pelletier, CPMSM, CPCS; Donna K. Goestenkors, CPMSM Not sure how to collect, organize, and present your FPPE data? Just open your toolbox By now you know the importance of focused professional practice evaluation (FPPE). Due to revisions to Joint Commission standards in both 2007 and 2008, hospitals must establish and track practitioner competency using measurable performance data. What is the bottom line for your MSO? The bottom line is, to be compliant with the regulatory changes, your MSO must adopt a standard framework defining the dimensions of privileged practitioners performance, applying The Joint Commission s requirements for competency. In addition, failing to gather and organize FPPE data in a standardized way presents risks including failing to gather sufficient data, redundancy, inconsistency across specialties, and failing to articulate to practitioners their role in FPPE. Do you have the tools for FPPE compliance? "The FPPE Toolbox: Field-Tested Documents for Credentialing, Competency, and Compliance"provides exactly that a comprehensive toolbox full of the forms and tools you need to conduct FPPE and OPPE. It offers: Forms Policies Letters Scorecards Reports Save time by tailoring your existing materials to meet the latest requirements In addition to providing new forms and tools you can customize for your facility, this guide also shows you how to repurpose existing materials to achieve compliance. Eliminate the headache of developing an organizational system on your own Use the tools in this book to manage the tremendous amount of quality data you must gather through FPPE. Organizing your FPPE data now means you will save time applying it to credentialing and privileging decisions in the future. Don t reinvent the wheel get the tools you need to get the job done Take advantage of the expert knowledge and practical resources in this toolbox you can put its contents to use immediately at your facility, without wading through lengthy background information. Use sample policies and forms to create a cohesive competency documentation process This book and CD-ROM set includes field-tested FPPE policies from your peers around the country. This toolbox is useful for facilities of all types and sizes, and it includes sample tools you can use right away: Case studies showing how your peers implemented FPPE FPPE policy documents FPPE language excerpted from peers bylaws documents or policies and procedures A practice evaluation form based on the six general competencies Department-specific proctoring forms Inpatient and outpatient proctoring (nonprocedural) forms A proctoring summary report of a provisional staff member Notification to a practitioner successful conclusion of provisional staff status and advancement of staff category A letter to a physician requesting his/her service as proctor A summary report to the board Physician competency data scorecards Guide to drafting a focused professional practice evaluation policy Retrospective, concurrent, and prospective proctoring guidelines Performance feedback process for mid-level practitioners Earn continuing education credits This program has been approved by the National Association Medical Staff Services for 5 continuing education units. Accreditation of this educational program in no way implies endorsement or sponsorship by NAMSS. Who will benefit? Medical staff coordinators/directors Managers of medical staff services Credentialing coordinators/managers Quality managers/directors Chief medical officers VPMAs Medical executive committee members
Nurse Practitioner’s Business Practice and Legal Guide, Seventh Edition is a must-have resource for every new or current nurse practitioner (NP). It explains and analyzes the legal issues relevant to nurse practitioners. The Seventh Edition was updated to include additional information on documentation requirements for avoiding malpractice and new case studies related to risk management. In addition, it provides the latest state-by-state laws, including regulatory developments and prosecutions of nurse practitioners, and new case analyses and lessons learned from those cases. The Seventh Edition also offers discussions of NP competencies, how the Doctor of Nursing Practice (DNP) degree relates to NPs, the differences in primary care and acute care NPs, definitions of medical bio-ethics terminology, malpractice cases and the lessons to learn from them, emerging issues in health policy, guidelines around prescribing opioids and controlled drugs, clinical performance measures, and more.
Credentialing A to Z is an on-the-go reference packed with easy- to-digest information, Q&As, quizzes, notes, and downloadable forms that will help MSPs gain knowledge about their tasks and the value of their work, enhance team-building, and combat burnout and stress. Author Mary Long, CPMSM, brings in-depth insights, a light touch, and a sense of humor that fellow MSPs will appreciate. This valuable reference guide addresses, defines, and explains your toughest topics in alphabetical order, including: A: Applications-where all credentialing processes start, and possibly end. APPs-are advanced practice professionals processed through the medical staff services department or human resources? B: Bylaws, policies, and rules and regulations-do you know where your medical staff information is? C: Credentialing-the right information to verify, and the correct way to do it. G: Governance-an organized medical staff requires governance in order to function. But what does that have to do with credentialing? M: Meetings-medical staff management in "minutes." P: Peer evaluations, FPPE, and OPPE-who's a peer? Who's a good peer? Privileging-the whens and hows of core privileges, disaster privileges, emergency privileges, and temporary privileges of all stripes. R: Reappointment-building and sticking to a cycle. Red flags-spotting them, stopping them, and getting answers. V: Verification-the querying process, the organizations, and the information they provide. X, Y, and Z: Xenon, yag lasers, and zero data (mastering medical terminology-no, CABG isn't "cabbage") Credentialing A to Z provides new MSPs and credentialing coordinators on-the-job spot training that will build and test their knowledge in a fun way before they're put to the test with less-fun credentialing challenges (such as surveys). All quizzes, Q&As, and other forms are downloadable and customizable, allowing MSPs to tailor them to their programs.