7 Strategies for Adopting The Joint Commission’s Appointment Period Change

Medical Services Professionals (MSPs) share a variety of responsibilities, including that of reappointment, the process of re-evaluating a provider’s current competency and qualifications to provide care. Reappointment is a critical component of ensuring patient safety, as it is an opportunity to verify a provider’s performance, medical judgment, clinical skills, and professional behavior in order to ensure they continue to meet your organization’s standards.

In 2021, the National Association of Medical Staff Services (NAMSS) hosted a roundtable demonstrating the shortfalls that a two-year reappointment cycle, alongside continuous monitoring, had on healthcare organizations, and requested a solution. As a result, The Joint Commission (TJC) announced a change to the reappointment process timeline in November 2022, extending it from two to three years.

Extending the practitioner reappointment timeframe is effective immediately, which means organizations with plans to adopt the change must develop a reliable course of action to move through the transition period effectively and without compromising patient safety.

Considerations for a three-year appointment period

Organizations will all have different factors to consider when assessing whether moving to a three-year cycle is beneficial. These include:

• Understanding what different standards (Health Resources and Services Administration, TJC, etc.) require concerning credentialing
• Verifying what state laws must be adhered to
• Some states require providers to be reappointed to medical staff every two years
• If unsure, consult with legal counsel, work with your state association to advocate for change, and see if an exception is possible.
• Reviewing organization bylaws and policies
• Review medical staff policies, and credentialing policies and procedures to identify any needed changes
• Assessing business impact and considerations
• Exploring possible changes with regard to privilege forms, privilege qualifications, Continuing Medical Education (CME), dues, application fees, ongoing monitoring, ongoing professional practice evaluation (OPPE), and personnel utilization within the MSO and CVO framework.
• It's vital to have a robust ongoing monitoring program, especially if you’re moving to a three-year reappointment cycle. You want to ensure that within those three years, you have processes in place to identify any issues that may arise.

With all this information considered, you’ll have what you need to develop a clear recommendation for medical leadership to obtain support required for change.

7 strategies for adopting TJC appointment period changes

After determining it’s time to start the transition process and creating a work distribution plan, you can employ different reappointment methodologies to ensure a seamless progression.

1. Birth Month: As providers join your medical staff, they will be given a three-year appointment based on their birth month. Benefits include:
• Can be standardized across multiple facilities
• Can spread across years more evenly
• Can cross all specialties in a given month
2. Rolling: As providers join your medical staff, they will be given a three-year appointment from the date of board approval. Benefits include:
• Easy to implement
• Keeps it standardized for anyone, no adjustments are required
3. By Specialty: Each specialty is done at once, regardless of the original appointment date. Benefits include:
• Supports updating and reviewing of privileges at the same time
• Larger specialties spread across multiple months
• Aligns with OPPE process
4. Quarterly: Providers are divided into four groups based on the quarter they were originally appointed. Benefits include:
• Easy to implement
5. Yearly: Providers are divided into three groups and reappointment is only done once a year. Benefits include:
• Allows medical staff to focus on other tasks throughout the year
6. License Expiration Date: Providers are reappointed based on the expiration of their license. Benefits include:
• Keeps information together for practitioner focus
7. Social Security Number (SSN): Providers are reappointed based on a digit in their SSN. Benefits include:
• Easy to identify and define

All these methodologies come with their benefits, and challenges too, like heavier appointment months or lack of standardization. This is why it’s important to assess which methodology is right for you. To get a clearer picture of what this transition entails, watch a recording of our recent webinar: Strategies for Adopting the Recent Joint Commission Appointment Period Change. Our experts will walk you through all the details you need to be successful.