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At least 1,225 records · Page 68Linked to original sources
PubMed2000

The specialist nurse: a classification system.

This paper focuses on the important developments of specialty nursing practice within Australia and reports the results of a recent survey of specialist nurses in Victoria. Debate among the worldwide nursing community reflects confusion and ambiguity about specialist practice. Similarly, variation, duplication and inconsistency characterise the status of specialist nurse education in Australia. This situation contributes to role problems for specialist nurses and may arise from their lack of contribution to the decision making process. Seventy-five nurses undertaking a range of specialist nursing courses offered by three educational providers (a university, major teaching hospital and professional organisation) completed a survey questionnaire to establish the extent to which they agreed with the major recommendations proposed in the National Review of Specialist Nurse Education (Specialist Review) (Russell et al 1997). Despite contention within the profession, specialist nurses in Victoria show support for a unified approach toward definition, title and credentials. The discussion specifically addresses the implications for the future classification of specialist nurses in Australia.

Australia↗
PubMed2005

Who will do general surgery?

Advantages to patients of a single anaesthetic for more than one operation are obvious; attracting generalist surgeons, training them and ensuring they have adequate credentials remain hurdles.

Australia↗
PubMed1990

Privacy Act of 1974; new routine use and system of records name change--HHS. Notification of a new routine use and system of records name change.

The Public Health Service (PHS) is publishing notice of a new routine use, responding to comments, changing the system name, providing the contractor's address, and making editorial clarifications for system of records: 09-15-0054, "Health Care Practitioner Adverse Credentialing Data Bank, HHS/HRSA/BHPr", now titled "National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners, HHS/HRSA/BHPr."

Civil Rights↗
PubMed1990

The professional chaplain.

In this technological age, when hospitals run the risk of becoming frightening and impersonal places, pastoral care departments have an obligation to ensure that they provide high-quality, professional service. One of the common themes of contemporary mission statements is the call for "holistic care"-- meeting the physical, emotional, social, and spiritual needs of patients. A second theme is the importance of providing high-quality care. In the past 20 years, the National Association of Catholic Chaplains has developed education and accreditation programs that have led to stronger, more effective pastoral care service and education. Although credentialing is not a panacea for all problems and conflicts, when persons work at developing personal, professional, and theological competencies, they are more successful in resolving conflict. In fact, well-prepared, certified chaplains enhance all aspects of the healthcare ministry. Finally, the effort to improve pastoral care provides an opportunity for all involved to "live the mission." Today's greater emphasis on team ministry allows the pastoral care department to be a model of community and dialogic relationship for the rest of the healthcare facility.

Catholicism↗
PubMed1990

Data bank has operational impact. Proper peer review can protect hospitals from antitrust and defamation suits.

The Health Care Quality Improvement Act of 1986 can help protect medical professionals and healthcare facilities from antitrust and defamation claims and other forms of litigation arising from the peer review process. Some hospitals may need to make major changes in their peer review activity as a result of the act. The healthcare entity, not the physicians involved in peer review, has the burden of complying with the provisions of the act. Failure to comply with the act can lead to loss of immunity from damages, fines, and potential exclusion from the Medicare program. The potential for liability has sparked a need for hospitals to reexamine and possibly reorganize medical staff and update procedures and related governing documents. Healthcare entities may consider changes such as implementing a director of medical affairs function, choosing medical staff for multiple-year terms, and centralizing physician review files. In the 1980s many hospitals created quality assurance and risk management programs. Risk managers need to share data with quality assurance personnel, who must in turn share the information with medical staff involved with credentialing, peer review, and medical affairs management. Legal counsel will need to be familiar with the legalities of the act, as well as the hospital's peer review procedures and operations. General legal counsel should oversee coordination of hospital proceedings and assist in educating staff on the legalities of peer review.

Credentialing↗
PubMed1990

Fair hearings for physicians denied participation in managed care plans.

As a result of the imminent application of the doctrine of corporate negligence to health maintenance organizations and other providers of managed care, those entities are likely to become much more active in the credentialing processes they undertake. Adversely affected physicians should be entitled to the same procedural protection currently afforded by hospitals, a "fair hearing" that at least provides a notice of charges and an opportunity to respond to the charges.

Credentialing↗
PubMed1992

Medical staff privileges and the antitrust laws: a view from the Federal Trade Commission.

This article describes the types of medical staff credentialing and peer review activities that invite the scrutiny of the Federal Trade Commission. To avoid antitrust problems, medical staffs and their members are advised to offer recommendations based on specific quality-of-care concerns. Antitrust problems will arise, however, if the medical staff or its members engage in collective activities that involve threats or coercion directed at the hospital's governing board or that are calculated solely to exclude an entire class of potential competitors.

Antitrust Laws↗
PubMedDate not supplied

A process for objective review of physician performance.

How do you objectively evaluate physicians at reappointment. How do you establish a common ground for the evaluation process that still acknowledges acceptable differences in performance? Perhaps one physician has some difficulty with documentation and attendance at meetings, but has no quality problems clinically. Another physician may have good documentation and meeting attendance, but has some quality problems. Another physician has a behavior pattern that is disruptive, a few documentation problems, but excellent quality. Yet another physician is a marginal practitioner with major problems in several areas, including quality. Reappointment of these physicians might be extremely difficult, especially if the credentials committee is recently appointed and not familiar with the details of the performance data.

Clinical Competence↗
PubMed1993

Advanced human resources planning.

Programs developed to advance the careers of pharmacy staff members are important tools to attract and retain qualified staff members. Integration of career development with the advancement of the department's efforts to achieve pharmaceutical care are integral for the future success of the department. Design of programs for all major positions/classifications should be considered. These programs must be developed in concert with the employees affected. In the future, these programs can demonstrate enhanced outcomes for patient care by ensuring appropriately trained and credentialed employees. This will require a commitment to advanced human resources planning.

Career Mobility↗
PubMedDate not supplied

Quality & access in the managed behavioral healthcare industry.

Building on a study of the costs of behavioral healthcare under managed care first released in the March/April, 1994 issue of this journal, the American Managed Behavioral Healthcare Association has now turned its attention to two other fundamental issues in healthcare reform: access and quality. The following study presents data indicating how managed behavioral healthcare plans assure quality and access in such areas as response time, accreditation, provider credentialing, patient satisfaction and outcomes measurement.

Continuity of Patient Care↗
PubMedDate not supplied

First, do no harm. Second, turn a profit.

In the past, a good bedside manner and nimble fingers were characteristics of a good doc. But in these cost cutting, profit-motivated days, hospital and health plans are now looking for physicians who can boost the bottom line. It's called "economic credentialing." Medical groups don't like it, and they're suing.

American Medical Association↗
PubMedDate not supplied

Reducing legal fees in medical group practices. The role of health care alternative dispute resolution.

Conflict is a growth industry, particularly in an increasingly complex health care system. Litigation is the most common, and most costly, method of settling health care disputes. Highly adversarial, the process of litigation often generates as much, if not more, hostility than the original dispute. In addition, satisfaction with the outcome is very low. The challenge that has arisen is to manage the conflicts so that the underlying needs and interests of all the parties can best be met. Often the techniques and processes of alternative dispute resolution (ADR) can be successfully used in resolving these sorts of conflicts quickly, cheaply and with greater satisfaction for all parties. Various applications of ADR are currently being used or tested in a variety of health care disputes in the United States and Canada. Tremendous success has been achieved in mediating medical malpractice claims, medical staff disputes, economic credentialing conflicts, insurer relations issues and denial of coverage disputes. Professional relations and departmental staff disputes, partnership and employee conflicts, and organizational disputes within clinics, HMOs and large group practices have all been found particularly amenable to ADR. These are all situations in which everyone benefits from quick, non-hostile resolutions and on-going relationships can continue.

Canada↗
PubMed1995

Career opportunities in managed care: what's hot and what's not?

Managed health care is poised for tremendous growth, particularly with the states' plans to increase Medicaid enrollment and the federal government's initiatives to jump-start Medicare enrollment. That means that employment opportunities should become widely available as managed care starts a new period of growth. What job opportunities are out there? What do they pay? What credentials are needed to take advantage of these openings?

Career Choice↗
PubMed1995

Strategic issues requiring public accountability: food for thought.

Although the exact outline of U.S. health reform has become fuzzy because of political events, it seems clear that major changes in the manner in which health care is delivered and financed are under way. The initiative for the most part has been assumed by state government and by the health care field itself, as managed care becomes ever more entrenched and the health care system becomes ever more integrated. An expected outcome of these changes will be demands for greater public accountability on the part of health care providers and organizations. In this article, the author discusses some of the issues--professional compensation, documenting community service, ensuring public input into planning efforts, economic credentialing and quality of care, and managing ethics under managed competition--that will have to be addressed at the local level as these shifts take place.

Community-Institutional Relations↗
PubMed1996

Research review: Perceptions of curriculum enhancement for baccalaureate programs in health information management.

Chairs of 21 baccalaureate programs in health information management in schools of the allied health professions with membership in the Association of Schools of the Allied Health Professions were surveyed in 1994 via a three-round Delphi process to identify desired competencies for graduates beyond those required for professional accreditation and credentialing and appropriate courses to develop them. Eighteen chairs (86 percent) completed the final questionnaire. Statistical analysis, including one-sample, upper-sided mean Z tests, indicated consensus among the 18 chairs that 27 items of knowledge and skills and 13 courses are most important.

Credentialing↗
PubMed1997

PSNs: a new model for Medicare risk contracting.

The 1995 Republican House Medicare reform proposal introduced the provider services network (PSN) concept as a new healthcare delivery model for accepting and administering Medicare risk contracts. A PSN operates much like an HMO, but is not subject to the reserve requirements established for HMOs. Providers that want to enter the Medicare risk contracting arena and exercise more control over the delivery of healthcare services may consider forming a PSN. To form a PSN, providers must be sufficiently capitalized to compete with HMOs, create a formal legal organization, and develop a financial plan. To ensure that its goals are met, the PSN must develop a sales promotion plan, enroll members, control and monitor financial resources and clinical outcomes, and implement a management information system. Other crucial capabilities that a PSN must develop include establishing mechanisms for utilization review, membership information maintenance, claims adjudication, physician credentialing, quality assurance, and member grievance procedures.

Capital Financing↗
PubMedDate not supplied

Getting ready for professional-risk capitation.

California has long stood as the harbinger for things to come to the rest of the health care nation. Based on research in the state, Maurice Penner warns physician group managers to begin developing a geographically-diverse and credentialed network of physicians to attract the coming hoards of managed care plans. Compensation under capitation, he adds, is worth some advance planning.

California↗