All that changed in July of 2014 when CMS announced revisions for Acute Care and Critical Access hospitals. Under the new guidance, CMS will allow for either a unique medical staff for each hospital or for a unified and integrated medical staff shared by multiple hospitals within a hospital system.
Accrediting organizations have moved quickly to align their standards with CMS. In order for hospital systems to take advantage of the allowance, four requirements must be met:
Members holding privileges at the medical staff of each hospital must vote on whether or not they wish to integrate into a single medical staff. If a medical staff does not wish to integrate, they must be allowed to remain separate and distinct.
For those medical staffs that choose to integrate, they must form a common set of bylaws, rules, and requirements that describe processes for self-governance, appointment, credentialing, privileging, and oversight, as well as its peer review policies and due process rights guarantees.
The integrated medical staff must be established in a manner that takes into account each hospital’s unique circumstances and any significant differences in patient populations and services offered in each hospital.
The integrated medical staff must give due consideration to the needs and concerns of its members regardless of practice or location, and mechanisms must be in place to assure that issues localized to particular hospitals are considered and addressed.
There’s a case to be made for an integrated medical staff. Efforts to adopt evidence-based practices and standardize care processes are more efficient when managed through a single medical staff structure versus the often unwieldy and time consuming process of working with multiple medical staffs. To be sure, the road towards creating a single integrated medical staff will be one full of challenges and unforeseen obstacles. At least, though, hospital systems now finally have the ability to embark on this long awaited journey.