Let’s face it, regulating clinical privileges can have a major impact on the quality of care provided by healthcare facilities and their physicians. The Joint Commission (TJC) developed the Focused Professional Practice Evaluation (FPPE) and the Ongoing Professional Practice Evaluation (OPPE) as objective standards for the fair assessment of physicians.
While they are both used to assess physician privileges, they serve completely different purposes.
Performed at least more than once annually, OPPE is a continuous process that has a broader application, ensuring all physicians meet the organization’s healthcare standard. FPPE is much more specific in its purpose and serves as a micro utility to be used under 3 conditions:
For FPPE to be effective, the organization granting privileges must have clear guidelines, standards, and criteria for conducting evaluations. Unlike OPPE, the FPPE process is conducted for a limited amount of time and is focused on the scope of the privilege in question. The TJC allows healthcare organizations to develop their own FPPE process as long as they follow specific guidelines:
Created to be interpretive, the FPPE guidelines provide minimal structure for how organizations utilize them. This is mainly due to the large variety of specialties and unique practices within health systems. However, an interpretive guideline can introduce its own challenges in how to effectively apply FPPE.
One major FPPE component is assigning proctors to review physician performance. TJC allows healthcare organizations to assign their own proctors as medical staff members will more commonly tackle this role. However, this can be problematic when the proctors or physicians have highly-sensitive roles or low availability, such as surgeons and pediatricians. In these cases, an outside firm offering Peer Review services may be needed.
What’s the best way to assign proctors for a review? Healthcare organizations should take the context of the review into consideration. Typically, there are three main types of FPPE proctoring methods, each with its own advantages:
What if it’s difficult to determine if a case is an isolated incident or an indicator of a lack of knowledge and skill? This is common with physicians with a low-volume of patients and new physicians who are initially granted privileges. To validate an incident, proctors should consider performing more reviews to find behavior patterns.
However, this can be costly and unfavorable for proctors with limited time. If assessing a low-volume physician’s performance continues to be a problem, then you should consider whether or not the physician needs the privileges in the first place. FPPE was developed to ensure that privileges were given to practitioners who actually use them. A low-volume of patients may be an indicator of a physician who doesn’t require that privilege for their practice.
Healthcare organizations assessing privileges for a new technology may want to find an outside proctor (as mentioned above); especially if they do not have physicians experienced enough to offer a fair assessment. However, finding an external proctor to perform your FPPE privileging can be a lengthy process.
symplr provides healthcare facilities and providers a way to streamline their privileging and FPPE / OPPE processes to help maintain a high standard of care. To learn more about user-friendly solutions with symplr, Schedule a Demo today!
 “What are OPPE and FPPE”. College of American Pathologists. http://www.cap.org/apps/docs/reference/oppe_fppe.pdf
 “Standards BoosterPak for FPPE/OPPE”. The Joint Commission. http://www.mc.vanderbilt.edu/documents/CAPNAH/files/Forms/Competency%20Evaluation%20Forms/TJC%20Booster%20Pack%20FPPE-OPPE.pdf
 “Proctoring/FPPE (Focused Professional Practice Evaluation)”. Health Leaders Media. http://healthleadersmedia.com/content.cfm?content_id=224604&topic=WS_HLM2_LED