Performance Privileges - The Value of ​Volume Data

Today every organization collects data. Why? Because data fuels insights that help improve performance. The data healthcare organizations collect is critical in securing patient safety and providing optimal care. Gathering massive amounts of data accurately can help organizations gauge the efficiency of their privileging process, reveal the consistency of their initial monitoring practices, and allow them to compare themselves more accurately to other “like” organizations. In this post, we’ll discuss the value of volume data and how it can be used to help provide the best in patient care.

Why is volume data important?

Volume data tracks exactly how often granted privileges are being exercised by a provider. It tracks procedures completed, including relevant details such as codes, the procedure name, and who was present. It is an excellent tool for powering reliable Professional Practice Evaluations (PPE).

The number of times a provider performs a given privilege or procedure is a key element in determining competency. Volume data enables organizations to:

• Measure provider volumes against peer populations to garner further insight
• Analyze patient-procedure data against provider-privilege data
• Expose low-volume and the performance of non-granted privileges scenarios

Volume data is also important in helping healthcare organizations meet the requirements of the many different regulatory bodies out there, like The Joint Commission. Regulatory bodies want healthcare organizations to track the performance of their individual providers against their peers, and data is critical in allowing for that. In fact, one sentiment that all accreditation bodies share is that when considering a provider’s competency and renewal of privileges, there must be data upon which to base your decision.

There is evidence that suggests a high amount of volume data is associated with improved surgical outcomes. Moreover, the data may reflect more than the provider’s knowledge, experience, and skill, but of the overall institution in its ability to provide a high level of care.

How do organizations use volume data?

According to The Joint Commission, volume data must be used to perform Professional Practice Evaluations (PPE). PPE requirements as they relate to performance privileges are:

“Qualitative and quantitative criteria (data) that have been approved by the medical staff, should be designed into the process. For example, limiting criteria to quantitative data may only represent the presence or absence of information, but may not reflect the quality of the information reviewed.”

In essence, it is critical to have insight into both qualitative and quantitative data to get a full picture of the reality of the situation. Note that The Joint Commission requires this data collection to be completed no more than once per year.

Qualitative and quantitative data used for evaluation include:

• Description of procedures performed
• Periodic chart reviews
• Accuracy documentation
• Tests ordered
• Procedures performed
• Patient outcomes
• Types of patient complaints
• Code of conduct breaches
• Peer recommendations
• Discussion with other individuals involved in the patient’s care

The information resulting from the evaluation needs to be used to determine whether to continue, limit, or revoke any existing privileges at the time the information is analyzed. Based on the data analysis, several actions could be taken:

• No further action is needed: The data has determined the provider is performing well or within desired expectations.
• A focused evaluation is needed: The data show a performance issue exists and that more information is needed before the next step is taken.
• Revoking privileges: The data show the privilege is no longer required.
• Suspending the privilege: This will suspend data collection, and notify the provider that if they wish to reactivate it they must make a request.

With volume data, you get answers to two critical questions:

• What did the provider do during the relevant timeframe?
• How well did the provider do when clinical privileges were exercised?

Answers to these questions help organizations ensure that their providers are always putting their best feet forward, and if not, they can catch issues before any serious complications arise. Early detection is critical.

Summary

A high volume of data is clearly necessary when it comes to evaluating privileges. The more information gathered, the more organizations have to base their privileging decisions on. Feeling confident about an important decision like the granting of privileges comes only with enough data to support any claims made. And, managing clinical privileges doesn't have to be hard, VerityStream can help! If you're looking to standardize your privileges and improve your data collection, look no further. Simply schedule a demo.