Monday, August 1, 2016

The "July Effect"

Every July, hospitals across the country welcome new medical graduates into their ranks. Many studies have been conducted to examine the so-called “July Effect,” the increase in negative outcomes and rates of medical errors for patients often attributed to this influx of inexperienced doctors. However, according to an article in Modern Healthcare, the “July Effect” may require further examination.

While some studies have found that there is an uptick in medical errors and patient morbidity in July, many doctors and hospitals are arguing that the “July Effect” may have little to do with recent medical graduates entering hospitals and staff turnover, and that the effect may vary by institution. One of the major studies on the “July Effect” posited: “Heterogeneity in the existing literature does not permit firm conclusions about the degree of risk posed, how changeover affects morbidity and rates of medical errors, or whether particular models are more or less problematic.”

Hospitals are staying vigilant, though. Through training programs for interns covering “everything from hand hygiene to advanced cardiac life support” and increased attention to quality and safety in orientations, hospitals are trying to combat the “July Effect,” whether real or perceived.


The Accreditation Council for Graduate Medical Education (ACGME) created the Clinical Learning Environment Review program in 2012 to provide feedback to hospitals on patient safety and other areas. "What we are doing as an organization is driving change by providing that information and then coming back two years later to see what's changed," states Dr. Kevin Weiss, the ACGME's senior vice president for institutional accreditation.

Tuesday, June 28, 2016

NAMSS 2016 Roundtable Report Now Available

The National Association Medical Staff Services (NAMSS) is proud to announce the release of its official report on the 2016 Roundtable: Real Reform through Positive Disruption. This event, the 3rd annual roundtable discussion convened by NAMSS, was held on Thursday, May 19, 2016 at the Gaylord National Resort in National Harbor, MD. This year’s discussion focused on enacting meaningful, impactful change in the health care provider credentialing and licensure processes. NAMSS recognizes that the time for positive disruption is now, and looks forward to continuing to work with its industry partners into the future to create more streamlined, more efficient processes that preserve patient safety.

NAMSS would again like to thank the following industry partners for participating in this important event: the American Association of Physician Assistants (AAPA), the American Health Lawyers Association (AHLA), the American Hospital Association (AHA), the American Medical Association (AMA), the Council for Affordable Quality Healthcare (CAQH), the Federation of State Medical Boards (FSMB), the Health Resources and Services Administration (HRSA), the Medical Group Management Association (MGMA), the National Committee for Quality Assurance (NCQA), The Joint Commission, Cigna, and DNV.


For a full description of this year’s Roundtable - its background, content and next steps - please click here to access the official report.

Thursday, May 26, 2016

NAMSS 2016 Roundtable: Real Reform through Positive Disruption

As part of its ongoing efforts to work with industry leaders on meaningful reforms to the credentialing and licensure processes, the National Association Medical Staff Services (NAMSS) held its 3rd annual roundtable discussion with industry stakeholders on May 19, 2016 at the Gaylord National Resort in National Harbor, MD. This roundtable, titled Real Reform through Positive Disruption, focused on discussing what NAMSS has already accomplished in 2016, as well as beginning to build consensus on additional reforms.

In 2016, NAMSS, along with the American Hospital Association (AHA), Accreditation Council for Graduate Medical Education (ACGME) and Organized Program Directors Association (OPDA), introduced a new Verification of Graduate Medical Education Training Form to alleviate the burden placed on both program directors and Medical Services Professionals (MSPs) in the training verification process. A NAMSS Task Force has also developed a Model Credentialing Application based on best practices from applications across the nation. Roundtable participants were invited to provide feedback on these documents and discuss their implementation.

Moving forward, NAMSS also proposed reforms to the recredentialing and reappointment cycle, as well as the criminal background check process. Again, roundtable participants discussed these reforms at length to identify the most effective ways to streamline the credentialing and licensure processes and reduce inefficiencies.

NAMSS will continue to work with the roundtable participants and others on an ongoing basis to implement the process improvements so direly needed in the industry. Additional information on the background and outcomes of this year’s roundtable will be available when NAMSS releases its full roundtable report in the near future. Stay tuned!


The following organizations participated in this year’s roundtable: American Association of Physician Assistants (AAPA), American Health Lawyers Association (AHLA), American Hospital Association (AHA), American Medical Association (AMA), Cigna, Council for Affordable Quality Healthcare (CAQH), DNV, Federation of State Medical Boards (FSMB), Health Resources and Services Administration (HRSA), Medical Group Management Association (MGMA), National Committee for Quality Assurance (NCQA), and The Joint Commission.

Monday, May 2, 2016

Efforts Underway in 3 Health Systems to Reduce Surgeries By Inexperienced Doctors

According to Kaiser Health News, Johns Hopkins, Dartmouth-Hitchcock and the University of Michigan "pledged that they will require their surgeons and 20 affiliated hospitals to meet minimum annual thresholds for 10 high-risk procedures."

This is the latest development in the longstanding debate over surgery volume and outcomes.As KHN states, "A groundbreaking 1979 Stanford study found that patients who underwent operations at hospitals that did more... surgeries had significantly lower death rates than those treated at hospitals where they were done infrequently. That finding has since been replicated repeatedly across many specialties and found to apply to surgeons as well as hospitals. Last month, a large study found that the risk of complications was far higher among surgeons who performed only one thyroid removal annually than among those who did 25 or more of the tricky procedures per year."

Groups such as the American College of Surgeons and The Joint Commission have expressed concerns about the implementation of these new standards. Mark Chassin, president of The Joint Commission, states, "Volume should never be used by an accrediting organization as a measure of quality."

For the full story from KHN, click here.

Wednesday, April 13, 2016

NAMSS, AHA and ACGME Announce New Verification of Graduate Medical Education Training Form

NAMSS, in partnership with the American Hospital Association (AHA), the Accreditation Council for Graduate Medical Education (ACGME), and the Organization of Program Director Associations (OPDA) and others, developed a workgroup that has been meeting over the past year to discuss options to standardize the training verification process and alleviate these burdens placed on hospitals, medical services professionals, and program directors. This group has also been working with the Federation of State Medical Boards (FSMB) to address the needs for licensure within the form and will continue that collaboration into the future.

In an effort to streamline the credentialing process, NAMSS and our partners have collaborated to create a standardized “Verification of Graduate Medical Education Training” (VGMET) form. To access this form, please click here.

The VGMET form consists of three sections:

1. Verification of Graduate Medical Education Training
2. Additional comments as needed
3. Attestation

For 2016 and future graduates:

The form would be completed once by the program director at the time of completion of the internship, residency or fellowship, with a separate form for each training program completed. The signed form would be placed in the trainee’s file.  The form would be photocopied and sent with a standard cover letter to hospitals or other organizations requesting verification of training.

For pre-2016 graduates:

The form would be completed once – if and when a program receives a request for verification of training. The current program director would review the file and complete the form based on information contained therein, sign and date the form and send to the requesting hospital. Thereafter, that form would be used in response to all requests for training verification – a photocopy of the form, and a signed dated cover letter attesting that the form accurately reflects information about the trainee in the file.

NAMSS is proud of this group’s work to create this new form as it is a significant step toward greater efficiency and will ease the burdens placed on Medical Staff and Credentialing Services Professionals, hospitals, program directors, and other stakeholders. It is a prime example of the type of reforms that are possible when those within the industry identify a problem and work together to achieve a creative solution.

Wednesday, April 6, 2016

AR State Medical Board Policy Changes

From the Arkansas State Medical Board:

Licensure and CCVS Policy Change

In response to requests from the Legislative Branch and other organizations in the state, the Arkansas State Medical Board (ASMB) has approved several changes for licensing and Centralized Credentials Verification Service (CCVS). It is believed these changes may be a factor in helping to reduce the amount of time it takes to license practitioners in this state. These changes are:

- Authorized the use (Not Mandate) of the Federation of State Medical Board’s FCVS credentials program.
- Authorized the utilization (Not Mandate) of the Federation of State Medical Board’s uniform application.
- Reduced the requirement to collect the Work History, including Hospital Privilege History, to only the last 10 years unless circumstances call for the additional information.
- Accept assignments by Locum, Contract or Telemedicine companies for verification of Work History provided by company assignment rather than from collecting verifications from the individual facilities.

*The ASMB/CCVS staff has requested and received approval from NCQA for the use of the FCVS by the CCVS.

Thursday, March 24, 2016

New U. of M. Study Shows Wide Variation in Physician Disciplinary Actions

Based upon data available through the National Practitioner Data Bank (NPDB), researchers at the University of Michigan Medical School have found that lack of standardization across state lines results in wide variation in rates of disciplinary actions and malpractice claims.

"'In one state the punishment for a particular violation could be a fine, while in another state you could lose your license for doing the same thing,' says Dr. Elena Byhoff [one of the study's authors]. 'It has implications for the ability of physicians to move from state to state,' if their punishment in one state is not enough to keep a hospital or practice in another state from hiring them."

For the full story, click here.