Volume-based credentialing: Practical steps to promote high quality, safe care

Abstract

All hospitals engage in credentialing to evaluate the qualifications of practitioners who request clinical privileges. Credentialing always includes verifying an applicant’s education, training, licensure and board certification, and evaluating information provided by references who have worked with the applicant. Far fewer hospitals consider whether a practitioner’s volume of cases is sufficient to demonstrate proficiency in a specialty area. This is surprising, given the well-established relationship in the medical literature between volume and proficiency. The authors identified several reasons for hospitals’ reluctance to use volume-based credentialing. These include the fear of lawsuits by physicians and the practical difficulties of satisfying volume requirements in smaller hospitals with fewer patients. The authors conclude that legal challenges to volume-based credentialing are unlikely to be successful and that techniques exist to enable small hospitals to use volume-based credentialing to promote high quality and safe care.