When I was growing up, my friends and I loved playing the game Telephone. If you’re unfamiliar, the game is played as a group, and begins with one person whispering a message to another. The message is then passed through a line of people until the last player receives and announces the message to the entire group. Errors accumulate as the message is passed along with the end result becoming unrecognizable from the original, often with hilarious results. The game highlights how quickly information becomes distorted by indirect communication. While endlessly amusing on the playground, corrupted information is no laughing matter when it comes to privileges.
Unfortunately, the game of Telephone is likely being played in your environment today. There’s an unfounded belief that hospital privileges can be transferred from one facility to another without the message getting lost or distorted. What’s worse, and poses significant risk, is the likelihood you discover the game is over - and you’re the last player trying to compare your message with the original.
Corrupted Privileges Are No Laughing Matter
Privileges require thorough documentation, and should be continually researched and updated. Without accurate and timely criteria, providers perform outdated procedures - resulting in decreased patient satisfaction. Low patient satisfaction scores impact reputation, increase risk, decrease profits and will discourage high-quality providers from applying or joining your staff. In spite of the potential negative impact, I continue to see the constant churn of information from one medical staff person to another in the creation of privilege delineations.
More often than not, staffers don’t have time to ask where a privilege came from, when it was last reviewed, or who originally created it. I’ve even seen publishers request copies of privileges from staffers with intent to incorporate them into their publications - only to sell them back to another hospital! All this happens without a single care as to the authenticity or validity of the documentation. Can your organization afford entrusting your privileging structure to free resources, low cost publications with unverified content or worse, being last in line in the game of Telephone?
Hang Up The Telephone
Continual access and updates to accurate, verifiable privilege content and criteria isn’t a choice, it’s a requirement. Those you partner with or employ for privilege creation and updates should validate that all privileges are researched using ABMS and AOA certification requirements, and ACGME and AOA residency programs. Privileges should include feedback from teaching institutions and medical directors, as well as FDA and medical device manufacturers' information for new procedures and technology. Your final step is verifying the creator of your privilege content and criteria will provide access to contributing experts should your organization have questions.
When it comes to having confidence in delivering quality care, much can be linked to knowing your organization’s providers are appointed with the most current and accurate privilege information available, and not simply the recipients of a diluted message via Telephone!