Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Credentialing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,783 records · Page 99Linked to original sources
PubMed1992

Physician relations: an evolving service not meeting its potential.

The relatively new concept of physician relations can help hospitals work with their medical staff as colleagues rather than competitors. Every hospital has someone performing at least some physician relation tasks, but too often that person is at the level of an administrative assistant. Only a few hospitals have full-blown physician relations departments with full responsibility for medical staff relations, quality assurance, credentialing and medical liability.

Florida↗
PubMedDate not supplied

The newest member of the senior management team.

The introduction and operation of an effective information system can be difficult. To meet this challenge health care organizations are beginning to add information specialists to their staff. This article describes the role of the newest member of the senior management team--the chief information officer. It details the background credentials of a good CIO and explains why the position is essential to the development and success of a comprehensive information system.

Canada↗
PubMed1992

Diagnosis related group coding accuracy of the peer review organizations.

Congress created the peer review organizations (PROs), in part, to check the accuracy of diagnosis related groups (DRGs) billed to Medicare. This study determined the accuracy of the peer review organizations' abstraction of DRGs during federal fiscal year 1985. A two-stage cluster design sampled 7050 medical records from 239 hospitals stratified by size. Credentialed medical record professionals used blinded techniques with reliability checks to abstract the ICD-9-CM codes and select the correct DRGs. Physicians reviewed medical records whose abstracted DRG differed from the DRG paid by the fiscal intermediary. The peer review organizations reported abstracting 1715 of these discharges. The peer review organization selected the correct DRG in 75.6 percent of the 1715 abstractions, a significantly lower proportion than the 80.3 percent paid accurately by the fiscal intermediaries. Upcoding compounded the peer review organizations' errors.

Abstracting and Indexing↗
PubMedDate not supplied

Bootstrap finance: the art of start-ups.

Entrepreneurship is more popular than ever: courses are full, policymakers emphasize new ventures, managers yearn to go off on their own. Would-be founders often misplace their energies, however. Believing in a "big money" model of entrepreneurship, they spend a lot of time trying to attract investors instead of using wits and hustle to get their ideas off the ground. A study of 100 of the 1989 Inc. "500" list of fastest growing U.S. start-ups attests to the value of bootstrapping. In fact, what it takes to start a business often conflicts with what venture capitalists require. Investors prefer solid plans, well-defined markets, and track records. Entrepreneurs are heavy on energy and enthusiasm but may be short on credentials. They thrive in rapidly changing environments where uncertain prospects may scare off established companies. Rolling with the punches is often more important than formal plans. Striving to adhere to investors' criteria can diminish the flexibility--the try-it, fix-it approach--an entrepreneur needs to make a new venture work. Seven principles are basic for successful start-ups: get operational fast; look for quick break-even, cash-generating projects; offer high-value products or services that can sustain direct personal selling; don't try to hire the crack team; keep growth in check; focus on cash; and cultivate banks early. Growth and change are the start-up's natural environment. But change is also the reward for success: just as ventures grow, their founders usually have to take a fresh look at everything again: roles, organization, even the very policies that got the business up and running.

Capital Financing↗
PubMed1991

Pharmacy's role within a multidisciplinary, patient-focused model for health care.

In establishing a good multidisciplinary practice plan at Moffitt, the most critical points have been identified as follows: The patient's primary nurse must coordinate the patient's care. Good communications and a shared medical record are absolutely crucial. A clear understanding of basic responsibility for each profession is established via credentialing, inservices, and multidisciplinary policies. Authority to create care plans and document progress and recommendations must be universal across all professions. Patients and students should be the common focus; therefore, it is the results or outcome, not who provided the service, that is important. Nursing tells pharmacy it is wonderful, because it helps them and shares a concern for the patient. Pharmacy tells nursing the same thing for the same reasons. Occurrence reports reflect a collaborative spirit, seeking to resolve patient-related problems rather than cast blame. The two groups have not become generic health care professionals, as each profession has inherent capabilities that should be used. Nor has there developed a defensiveness that will prevent a nurse from interceding in traditional pharmacy issues, or a pharmacist in nursing issues. Statistically, it is not known whether Moffitt's staff has become more effective in providing patient care; however, the members of the team believe it to be true, and the patients exhibit trust in them. The future will be uncertain in health care. A multidisciplinary approach appears essential for optimal patient care and for forecasting and managing the complex administrative and economic issues that will continue. The staff at Moffitt believe that team synergy is a necessary component of a strong future.

Cancer Care Facilities↗
PubMed1992

Using clinical intervention documentation.

The clinical intervention reporting system that we are using at our facility provides pharmacy management, hospital management, and the quality improvement committee with valuable information. Pharmacy management can use the interventions to motivate, train, and evaluate pharmacists, as well as justify full-time equivalent employees. Hospital management can use the data in the budgeting process, in physician credentialing, and as a part of the medical center's cost containment efforts. The quality improvement committee can use the data in drug selection for DUEs, as well as for information in clinical privileging. Now pharmacy can say with confidence, "We are documenting it; we are doing it."

Clinical Pharmacy Information Systems↗
PubMed1994

CCS (Certified Coding Specialist) examination--year 2 results.

Candidate performance on the 1993 CCS examination is very comparable with performance on the 1992 examination. While there was a slightly higher rate of passing on the 1993 examination, it is believed this is due to more potential candidates understanding the specialized nature of the examination and self-evaluating their preparedness. Consistent results across time are important to demonstrate the reliability and validity of the certification program. AHIMA strongly supports the coding specialization, and believes it is important to maintain standards of excellence in order to have the CCS credential convey to the public the value of the coding skill it recognizes.

Abstracting and Indexing↗
PubMed1990

Physician assistants in ophthalmology: a national survey.

Fifty-two physician assistants employed in ophthalmologic practice throughout the United States were identified. Demographic and role-delineation data from 40 PAs agreeing to participate in the study were collected by questionnaire and telephone interviews. The data indicated that the majority of ophthalmologic PAs are employed in large practices that specialize in cataract and radial keratotomy procedures and that those practices are primarily located in the Southeast and Gulf regions of the United States. The authors conclude that most PAs are being utilized appropriately by ophthalmologists, that more formalized educational and credentialing programs may be necessary for the future, and that PAs can be positive adjuncts to ophthalmologic practice.

Employment↗
PubMed1990

The malpractice suit. What to know from the start.

Once the immediate visceral reaction to being slapped with a malpractice suit has subsided, it's time to assess the situation and prepare for the impending legal battle. A successful outcome is more likely if you remain calm; call your insurance company immediately; familiarize yourself with your rights and obligations; cooperate fully with your lawyer; and help to secure credible, credentialed experts to testify on your behalf.

Insurance, Liability↗
PubMed1994

Influencing prescribing practices and associated outcomes utilizing the drug use evaluation process.

Influencing prescribing practices and the implementation of pharmaceutical care utilizing the drug use evaluation (DUE) process at a 891-bed teaching hospital are described. The DUE program has been structured to provide for significant pharmacy involvement while maintaining medical staff responsibility as outlined by the Joint Commission on Accreditation of Healthcare Organizations. A multidisciplinary approach is used to identify problems and develop prescribing criteria and educational initiatives. Pharmacists provide drug therapy monitoring and engage in clinical interventions and documentation of outcomes on a daily basis. DUE program pharmacists help target possible interventions, assure monitoring and outcome documentation, and compile results of all initiatives for reporting purposes to the medical staff and quality assessment program. Specific performance compliance and problems are identified and incorporated into the credentialing process. Corrective measures are determined by the Pharmacy and Therapeutics (P&T) Subcommittee with subsequent actions carried out by peer physicians. The net result is a positive influence on prescribing practices that improves the appropriate and effective use of drugs and improves patient outcomes.

Anti-Bacterial Agents↗
PubMed1994

Constitutional rights versus malpractice insurance settlements.

The increasing costs and complexity of malpractice litigation have created an statutory right that allows malpractice insurance companies to settle malpractice claims regardless of the desires of the defendant physician. In the past, the consequences of settling a malpractice claim out of court were not as important as they are today. The Health Care Quality Improvement Act of 1986 mandates that any settlement in behalf of a physician be documented in the National Practitioner Data Bank (NPDB), which must be consulted every time the physician is credentialed. This NPDB requirement denies due process to health care providers and thus becomes a violation of the federal and many state constitutions. Physician executives and medical leaders must bring these issues to the table and negotiate solutions before damage to practicing physicians and the U.S. health care delivery system caused by this legal paradox become too severe.

Civil Rights↗
PubMed1994

Health plans want to know: are you certified?

Physicians without board certification are finding themselves cut out of managed care. But do their board-certified colleagues have better outcomes, or just better credentials?

Certification↗
PubMed1995

Personal trainer, personal coach.

The increasing number of fresh faces in the management ranks, many of them with highly polished credentials but little in the way of practical experience in the work-a-day management world, has increased the need for a new consulting professional--the personal coach. There simply aren't enough volunteer mentors to accommodate the growing medical management profession. Whatever the conditions under which this new professional's services are sought, both the individual to be coached and the organization for which the individual works should approach the arrangement with care and planning. The author offers some guidance for making the arrangement pay off.

Administrative Personnel↗
PubMed1995

Models of case management in long term home health care. The evolution of for-profit geriatric care management.

Professional geriatric care management has the potential to provide an emotionally satisfying, lucrative career for the social worker or nurse who is self-educated or who has formal continuing professional education in assessment, care options, and care coordination. Yet GCM as an organized profession, or as a career choice for the individual, requires institutional supports to grow and flourish. The GCM profession requires recognition by the states (including certification and credentialing). A network must be developed so that young persons can receive a first professional degree, or at least a concentration within nursing or social work, in the legal and financial implications of elder care as well as the biology of aging and the techniques of hands-on physical care of the elderly. Structures must be created for continuing professional education of the GCM practitioner. The various Medicaid programs that offer home care to the elderly and disabled rely heavily on assessment and case management; so does the entire Medicare system. However, the federal statutes and regulations do not explicitly authorize GCM participation in care planning. More to the point, they do not clearly authorize reimbursement of GCMs as independent professionals or as Medicare/Medicaid service providers. As private long-term care insurance evolves, GCM services should be recognized as proper components of the planning process (and therefore as services that can be reimbursed by the policy). Once this is done, the challenge for GCM professionals is to retain their focus on the needs of the elder and family, rather than to perceive themselves as gatekeepers who function to cut the cost of services instead of optimizing their variety and quality.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Analysis of job satisfaction, burnout, and intent of respiratory care practitioners to leave the field or the job.

BACKGROUND: Increased stress, burnout, and lack of job satisfaction may contribute to a decline in work performance, absenteeism, and intent to leave one's job or field. We undertook to determine organizational, job-specific, and personal predictors of level of burnout among respiratory care practitioners (RCPs). We also examined the relationships among burnout, job satisfaction (JS), absenteeism, and RCPs' intent to leave their job or the field. METHODS: A pilot-tested assessment instrument was mailed to all active NBRC-credentialed RCPs in Georgia (n = 788). There were 458 usable returns (58% response rate). A random sample of 10% of the nonrespondents (n = 33) was then surveyed by telephone, and the results were compared to those of the mail respondents. Variables were compared to burnout and JS scores by correlational analysis, which was followed by stepwise multiple regression analyses to determine the ability of the independent variables to predict burnout and JS scores when used in combination. RESULTS: There were no significant differences between respondents and sampled nonrespondents in burnout scores (p = 0.56) or JS (p = 0.24). Prediction of burnout: The coefficient of multiple correlation, R2, indicated that in combination the independent variables accounted for 61% of the variance in burnout scores. The strongest predictor of burnout was job stress. Other job-related predictors of burnout were size of department, satisfaction with work, satisfaction with co-workers and co-worker support, job independence and job control, recognition by nursing, and role clarity. Personal-variable predictors were age, number of previous jobs held, social support, and intent to leave the field of respiratory care. Prediction of job satisfaction: R2 indicated that, in combination, the independent variables accounted for 63% of the variance observed in satisfaction with work, 36% of the variance observed in satisfaction with pay, 36% of the variance in satisfaction with promotions, 62% of the variance in satisfaction with supervision, and 48% of the variance in satisfaction with co-workers. Predictors of work-satisfaction level were recognition by physicians and nursing, age, burn-out level, absenteeism, and intent to leave the field. Predictors of level of satisfaction with pay were actual salary, job independence, organizational climate, ease of obtaining time off, job stress, absenteeism, intent to leave the field, and number of dependent children. Predictors of level of satisfaction with promotions were recognition by nursing, participation in decision making, job stress, intent to leave the field, past turnover rates, and absenteeism. Predictors of level of satisfaction with supervision included supervisor support, role clarity, independence, and ease of obtaining time off. The strongest predictor of level of satisfaction with co-workers was co-worker support. As overall level of JS increased, level of burnout decreased significantly (r = -0.59, p less than 0.001). As burnout level increased, increases occurred in absenteeism (r = 0.22, p less than 0.001), intent to leave the job (r = 0.48, p less than 0.001), and intent to leave the field (r = 0.51, p less than 0.001). CONCLUSIONS: Reduced job stress, increased job independence and job control, improved role clarity, and higher levels of JS were all associated with lower levels of burnout. Managerial attention to these factors may improve patient care and reduce absenteeism and turnover among RCPs.

Analysis of Variance↗
PubMed1996

Integrating chiropractic in managed care.

Alternatives to traditional health care are emerging as an important element in the mix of services offered by managed care plans. Integrating these nontraditional services, such as chiropractic, presents special challenges for plan managers. ChiroNet, an Oregon-based chiropractic specialty PPO network, has formed partnerships with a variety of managed care plans bringing managed chiropractic services to the PPO, EPO, and HMO environments. Practical experience with benefit design, access protocols, utilization management, quality assurance, provider credentialing, and administrative integration has been developed over the period of the network's cooperation with its managed care partners. Successful integration of these nontraditional provider groups depends on alignment of goals and incentives among all players in the system, including providers, their network, the patients, and the managed care plan.

Back Pain↗
PubMed1991

Compensating hospital medical staff leaders for organizational duties.

Physician leadership in hospital affairs is important to physicians, patients, and the public, as well as to hospitals. In this article, the author advocates payment to medical staff leaders for performance of the patient-protective functions of the traditional organized medical staff, including ensuring the qualifications of practitioners (credentialing) and monitoring their current performance, and focuses on questions concerning specific duties, qualifications, selection, orientation and evaluation of medical staff leaders.

Employee Performance Appraisal↗