Credentialling by health service organisations is a process used to verify the qualifications and experience of primarily medical practitioners to determine their ability to provide safe, high quality health care services within a specific health care setting. Credentialling by organisations is the focus of the Commission's work.
Credentialling has the potential to improve safety for patients by ensuring clinicians practice within the bounds of their training and competency, and within the capacity of the service in which they are working.
Credentialling is part of a wider organisational quality and risk-management system designed primarily to protect patients.
The term credentialling is used by specialist nursing associations and groups in a different way to address the lack of agreement about nursing specialty categories.
Credentialling in Australia
A Standard for Credentialling and Defining the Scope of Clinical Practice: a national standard for credentialling and defining the scope of clinical practice of medical practitioners, for use in public and private hospitals (PDF 272 KB) was developed by the former Australian Council for Safety and Quality in Health Care in 2004.Implementation of the National Credentialling Standard is underway in all jurisdictions and across the private hospital sector. The structures and processes being used vary between states and different health care settings.
Credentialling by health services has largely focused on specialist medical practitioners, but it has the potential for wider application to other health professions.
The Commission is seeking to improve the consistency and effectiveness of credentialling nationally, by:
- Engaging with medical colleges on their involvement in the development of national framework for scope of practice;
- Engaging with the national professional registration body to maximise access to information that can support credentialing by making administrative processes more efficient; and
- Developing a National Peer Review Guideline.
Definitions
The terms "credentialling" and "defining the scope of clinical practice" are used in a variety of ways within the health care industry. The Commission has adopted the definitions used by the former Australian Council for Safety and Quality in Health Care.'Credentialling' refers to the formal process used to verify the qualifications, experience, professional standing and other relevant professional attributes of medical practitioners for the purpose of forming a view about their competence, performance and professional suitability to provide safe, high quality health care services within specific organisational environments [1]. These processes are generally mandatory for specialist medical practitioners in the public and private hospital sector.
Defining the 'scope of clinical practice' involves defining the extent of an individual medical practitioner's clinical practice within a particular organisation based on the individual's credentials, competence, performance and professional suitability, and the needs and the service role or clinical delineation which specifies the capability of the organisation to support the medical practitioner's scope of clinical practice. The term "clinical privileging" is also widely used as an alternative to the phrase "defining the scope of clinical practice"[2, 3].
Peer Review
Review by Peers - A guide for professional, clinical and administrative processes (PDF 1174 KB) has been developed by the Commission.The overall objective of a peer review process is to improve health outcomes for patients. Increasing the rigour with which peer review processes are applied has the potential to increase the reliability of the outcomes of peer review.
Poorly designed or conducted peer review however may either create a false sense of confidence that the quality of clinical care is adequate when it is not, or, it may raise unfounded concerns.
In June 2009, a literature review (PDF 476 KB) was completed for the Australian Commission on Safety and Quality in Health Care on peer review. This analysis identified a number of features that increased the rigour of peer review processes.
Information from the literature review was developed into a users guide. This 'how to' guide will assist health service organisations, managers and medical practitioners maximise the effectiveness of peer review. It is based on the available evidence, current best practice and expert opinion.
A consultation draft Review by Peers: in professional and administrative process was distributed to jurisdictions, private hospitals and professional colleges inviting them to provide comments on this document. Other organizations and individuals were also advised the draft was available on the Commission's website and were encouraged to provide comments.
Details of the written submissions received can be accessed through the link Draft Review by Peers: in professional and administrative process - Stakeholder Written Submissions.
The final Review by Peers: A guide for professional and administrative process will be available for information from June 2010.
Contact
Ms Margaret Banks
Senior Program Advisor
Ph: (02) 9263 3633; Fax: (02) 9263 3613
mail@safetyandquality.gov.au
