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Credentialing and Privileging 101: A Primer for New Practitioners

By Lindsey Clark posted 05-24-2016 09:42

  

As our healthcare system becomes increasingly focused on quality and safety, establishing a process to ensure the competence and capabilities of health care professionals, including pharmacists, is becoming increasingly important. This process is known as credentialing and privileging.

A credential is documented evidence of professional qualifications, such as the Pharm.D. degree. Credentialing is the process in which an institution validates professional licensure, clinical experience, and other qualifications necessary for professional practice.1,2 For example, a hospital  will confirm that a newly hired pharmacist has obtained both the professional degree and licensure necessary to engage in pharmacy practice. 

A privilege is an authorization granted to a professional by a hospital or other institution to provide a specific patient care service, such as pharmacokinetic dosing. Privileging is the process in which a health care institution reviews and evaluates the credentials and performance of a healthcare professional, then grants the professional the authority to provide a patient care service within the institution.1,2

There are several types of certifications and credentials available to pharmacists. These certifications and credentials help establish a pharmacist’s qualifications, demonstrate their ability to provide quality care, and advance the profession of pharmacy. The Council on Credentialing in Pharmacy’s mission is to provide leadership, guidance, public information, and coordination for the profession of pharmacy’s credentialing programs. To this end, they have developed a list of available certification programs for pharmacists that provides information on certification requirements and eligibility (http://pharmacycredentialing.org/Files/CertificationPrograms.pdf).

The certifications most widely known in pharmacy are those provided by the Board of Pharmacy Specialties (BPS). The BPS certification is a process by which a pharmacist’s knowledge and skills in a particular specialty area are verified beyond basic licensure requirements. BPS board certification is considered the gold standard in determining which pharmacists are qualified to provide an advanced level of care to patients.

Several other multidisciplinary organizations provide certifications in specialty areas such as diabetes, HIV, toxicology, and pain management. Additionally, post-graduate residency and fellowship programs allow pharmacists to receive certificates that demonstrate an advanced level of knowledge, skills, and experience.

These types of credentials are essential to the pharmacy profession due to the expanding role of pharmacists in direct patient care and the need to assure patients, payers, and employers of competence.

There are a variety of ways that credentialing and privileging can be implemented. On an individual basis, this could mean preparing for and taking a BPS or other certification exam. At an institutional level, this could mean starting a new residency program or working with prescribers to create a collaborative practice agreement. The ASHP Credentialing and Privileging Resource Center (link below) lists multiple individual and health-system examples under the “getting started” section.

How you encounter credentialing and privileging will depend on your institution’s policies and procedures as well as the degree to which you seek out opportunities for advancement. For example, one author of this blog post is actively studying for the BPS pharmacotherapy spring exam. At another author’s institution, they require classroom-based training, several clinical competencies, and one on one practical experience prior to a new pharmacist being allowed to work independently.

For greater detail, the Council on Credentialing in Pharmacy Resource Paper (http://www.pharmacycredentialing.org/Files/CCP_Special_Feature.pdf) is a good place to start.  This document discusses how individuals are credentialed, creating a credentialing and privileging process, and many other helpful topics.  It also highlights several specific examples of credentialing and privileging that have appeared in literature.

The Council on Credentialing in Pharmacy website (http://www.pharmacycredentialing.org/) also contains other useful documents. It provides information on the guiding principles of certification, scope of practice and professional development as well as information regarding technician education and advancement.

As mentioned above, the ASHP Resource Center has a section devoted to Credentialing and Privileging available at: http://www.ashp.org/menu/PracticePolicy/ResourceCenters/Credentialing-and-Privileging-Resource-Center.  This site has background information as well as links to resources such as AJHP papers, a nurse practitioner credentialing guide, collaborative practice agreements, and relevant Veterans Affairs documents.

Also on the ASHP web site is a webinar titled "Credentialing and Privileging for Pharmacists: Preparing for the Future of Pharmacy Practice Advancement" (http://www.ashp.org/menu/MemberCenter/Webinars)

A live educational session will occur during the 2016 Midyear Clinical Meeting in Las Vegas, NV.  "Credentialing and Privileging: A Primer for Pharmacy Residents and New Practitioners" will occur on Sunday, December 4, from 4:15 PM to 5:15 PM.  This session was developed by the New Practitioner Forum Professional Practice Advisory Group and we hope you'll join us as we learn more about the topic.

 

References

  1. Rouse MJ, Vlasses PH, Webb CE; Council on Credentialing in Pharmacy. Credentialing and privileging of pharmacists: a resource paper from the Council on Credentialing in Pharmacy. Am J Health Syst Pharm. 2014 Nov 1;71(21):1891-900.

  2. ASHP Credentialing and Privileging Resource Center: Introduction to Credentialing and Privileging. Available at: http://www.ashp.org/menu/PracticePolicy/ResourceCenters/Credentialing-and-Privileging-Resource-Center/Introduction.html

 

Special thanks to Lindsey Clark, Pharm.D., Emily Kirkwold, Pharm.D., Jamie Sebaaly, Pharm.D., BCPS, and Tracy Carter, Pharm.D., BCPS of the New Practitioner Forum Professional Practice Advisory Group.




#Quality #PharmacyStudents #AmbulatoryCarePractitioners #AmbulatoryCare #NewPractitioners #InpatientCarePractitioner #PharmacyPracticeManagers #Resident #Leadership #Professionalism #PPMI
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