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I am having an ongoing debate as to the discoverability of evidence in credentialing files. As the facility relies on these documents in making decisions about whether to allow of renew staff privileges are they not a business decisions document??

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Is this Aussie law?

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Reply to LegalEagle, LLC's Post: Aussie law?? I work in a Performance IMprovement/ Peer Review division of a hospital-in Texas and was cautioning the staff about the wording of documents placed in the physicians credentialing file. Some facilities separate the credentials file and their (the physicians) quality file thinking that the physical separation of the files creates disctinction in what is discoverable .While in fact regulatory agencies require that facilities maintain a review and reporting process for physician performanceand these documents are an integral part of the appointment and reappointment decision. In fact physician performance is the yardstick of appointment decisions.

LOL...I had a similar "discovery" question under Australian laws this week that included a lot of the same principles that you are discussing. Let me refer this to some of our other experts to see if we have a peer review specialist on staff.

Edited by LegalEagle, LLC on March 2 2007 at 11:58 AM

LegalEagle had referred this to other experts.

As a physician board certified in QA/UR - most experts I have talked with DO recommend keeping peer review files SEPERATE from credentialing files to offer at least a DEGREE of protection against discovery.

The problem with the mixing of the files - people other than physicians have access to the credentialing files in many cases (including administrative staff). The approach that can be used is have PEER review remain exclusively withing MEDICAL STAFF, with a place on the application/approval for the Chair of the QA Committee or the Medical Director of QA to sign off a question such as:

Is there any quality issue from peer review that should prevent the applicant from being granted the following privileges?
(The exact wording of course would be approved by the hospital attorney)

If there is NO issue - then the files remain protected from view by non-medical. Keeping it truly PEER review (physician) helps maintain the non-discoverablity. If there is NO quality issue identified by peer review, the information should not be in the credentials files for someone looking to go on fishing expedition.

Edited by FamilyPhysician on March 2 2007 at 10:47 PM

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The question was not whether it is a good ides to keep quality and credentials files separate. In all instances files are accessible to administratiive staff few physicians, in my experoience, maintain files/documents.
The question was (see initial question..

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