Synergy - January/February 2015 - 26

namss focus

The Critical Role of NAMSS
PASS in Patient Safety
™

By Connie Riedel, BS, CPMSM, CPCS, Past President NAMSS

A

s a Medical Services Professional
(MSP), have you ever really thought
about what we do and why we do it,
day in and day out? If you answered patient
safety, you're absolutely correct! But what if
today's credentialing process is simply not
good enough to ensure that?

MSPs, where do we draw the line saying,
"We did the best we could?" Are we really
doing the best we can? Of course, the ultimate
decision in all tragic situations like the one
described above will be made by the court of
law, and there are never any happy endings
for anyone involved in malpractice cases.

Most of us have probably experienced or
know of someone who has experienced the
following scenario:

There have already been established
legal cases where hospitals are held liable
for not only what we do know about a
practitioner but also what we should have
known ( Johnson v. Misericordia Community
Hospital, 301 N.W.2d 156 Wis. 1981).
Our hospitals rely on us to accomplish this
essential task. To show that we must be
ever vigilant and constantly improve our
credentialing processes, here are additional
cases that involved a practitioner failing to
disclose a previous affiliation or an action
taken at a previous facility, all of which
could have jeopardized patient safety:

* A member of our own medical staff has
allegedly violated certain codes of
conduct, professional ethics, quality of
care standards, or competency standards.
* While these issues are being reviewed,
the administration is not required to
submit an official Adverse Action Report
(AAR) to the NPDB. The practitioner
resigns and is no longer heard from again,
and their case is closed and filed away.
* Sometime in the future, a month, or a year,
or five years, you hear about a patient care
case or even criminal issues regarding this
same practitioner at another facility. This
time a patient may or may not have been
seriously harmed.
* You never received an inquiry about this
practitioner because he/she never disclosed
to that facility that they were ever on staff
at your facility for fear of disqualification.
* This other facility may now be liable for the
damages caused by this practitioner, not to
mention the patient's life-changing injuries,
that could have been prevented had this
hospital known about this practitioner's
true history at other hospitals.
* What if one of these types of practitioners
obtained privileges at your organization,
and you don't even know it?
This is a dilemma faced by MSPs every day.
We can't verify what we don't know. But is
that a good enough explanation to the patient
and his/her family who has been injured,
permanently disabled, or even killed? As
26

/

SYNERGY JANUARY/FEBR UARY 2015

* Dunbar v. Hosp. Auth. of Gwinnett
County, 182 S.E.2d 89 (Ga. 1971)
* Johnson v. Misericordia Community
Hospital, 301 N.W.2d 156 (Wis. 1981)
* Lapidot v. Memorial Medical Center, 494
N.E.2d 838 (Ill. Ct. App. 1986)
* Garrison v. Board of Trustees of Memorial
Hosp. of Laramie County, 795 P.2d 190
(Wyo. 1990)
* Oskooi v. Fountain Valley Reg'l Hosp. and
Medical Center, 49 Cal.Rptr.2d 769 (Cal.
Ct. App. 1996)
* Richstone v. Novello, 726 N.Y.S.2d 188
(N.Y. App. Div. 2001)
* Fine v. Childrens Hospital Los Angeles,
(Cal. Ct. App. 2002)
* Masood v. Kentucky Board of Medical
Licensure, (Ky. Ct. App. 2005)
* Daigle v. Stulc, 794 F.Supp.2d 194 (D.
Me. 2011)
Over several years, NAMSS has been solidifying
our concept of the Ideal Credentialing

Standards (ICS) and has identified 13 critical
data elements that must be assessed for
every practitioner we credential:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.

Identity verification
Residency, and fellowship enrollment/
completion date
ECFMG information
Military information
Professional licensure held in all states
DEA registration and state DPS
certification
Board Certification status
Practitioner affiliation history
Criminal background check
HHS-OIG & GSA Sanction Checks
NPDB
Malpractice carriers
Insurance carrier certificate/reports

There are already data sources that track most
of the above elements, especially education,
training, and licensure. However, one universal
resource that tracks practitioners' affiliation
history did not exist. Imagine if it did?
* You'd have electronic access to a national
database of practitioner affiliations at your
fingertips.
* You'd have the ability to instantly
download a letter of good standing for
your practitioners.
* Your access to this information would
be simple, fast, affordable, and through
NAMSS.
Now this vital resource does exist. NAMSS
PASS™ is a secure, online database that
provides quick, easy, and inexpensive access
to the affiliation history for the practitioners
you credential. NAMSS PASS™ has been
vetted by several highly experienced MSPs
on the NAMSS Board of Directors along
with Horty, Springer and Mattern, one of the
leading healthcare law firms in the nation.
Continued on page 28
Synergy - January/February 2015

Table of Contents for the Digital Edition of Synergy - January/February 2015
