Hospital standards worth your attention

Strong medical staffs are key to patient safety.

Editorial. Dec. 18, 2006.

It's easy to let one's eyes glaze over in boredom when stumbling upon news about the Joint Commission on Accreditation of Healthcare Organization's proposed revisions to Standard MS.1.20.

But that's a mistake.

The Standard MS.1.20 title may sound like bureaucratic hooey to the average physician. Something that someone else will handle while you tend to patients. Maybe it even sounds like something that really isn't going to matter in the everyday practice of medicine.

Behind that dull, flat-sounding title, though, lie words that could give hospitals the power to take away a medical staff's independence and to interfere with the medical staff's effectiveness -- two items that are key to protecting patient care and patient safety.

The Joint Commission has proposed changing this standard so certain items such as credentialing and medical staff structure don't have to be included in the medical staff bylaws that doctors vote on and approve. Instead, the commission would allow hospitals to include items like these in the administrative rules, regulations and policies that hospital board and medical executive committees control. It would more easily allow rules to be manipulated.

In turn, that creates an even bigger problem when disputes between medical staffs and physicians wind up in court because the courts are more likely to view medical staff bylaws as binding contracts instead of the administrative rules. And landing in court is not a stretch. Disputes that pit medical staffs against their hospitals are increasingly common.