QUESTION: We expect to have a surge of coronavirus patients in the next week or two, so we are currently credentialing and privileging practitioners to help with the patient volume. Should we rely exclusively on disaster privileges for this, or should we consider temporary privileges instead? What about emergency privileges?
ANSWER: Emergency privileges are not an ideal tool for dealing with a pandemic. Emergency privileges are intended for scenarios where a patient experiences a sudden emergency and a physician rushes to help. For example, imagine a circumstance where a (seemingly healthy) patient is visiting your hospital and collapses suddenly. Emergency privileges would authorize a physician to provide emergency care at the scene that goes beyond the scope of his or her clinical privileges. That authorization would last only until the emergency was under control.
Consequently, the main question is whether you should grant temporary privileges (for an important patient care need) or disaster privileges. If you have a week or two to prepare for a surge in patient volume, then it may be optimal to consider temporary privileges. If you are part of a system (even if there is not a unified medical staff) you could pass a resolution allowing for the grant of temporary privileges for an important patient care need to any physician, or other practitioner, who has been fully credentialed by any hospital within the system. The only verification that would be necessary would be confirmation from the medical staff office or credentialing verification office that the individual maintains appointment and clinical privileges within the system. Additionally, as with any other grant of clinical privileges, you would have to query the NPDB. This query should be made before the physician starts to work.
Disaster privileges can be used if you need to onboard someone very quickly. Generally speaking, disaster privileges can be granted after you verify a volunteer’s identity and licensure. Accreditation standards place certain timelines on the verification of licensure. Note that the Joint Commission also requires an oversight process for volunteers who are licensed independent practitioners and who have been granted disaster privileges. Specifically, based on the oversight, the hospital must determine within 72 hours if disaster privileges should continue. A similar process must be followed for volunteers who are not licensed independent practitioners but who are “required by law and regulation to have a license, certification, or registration” (e.g., respiratory therapists).
This is a rapidly evolving topic, and it is important to consider your own unique needs and circumstances when evaluating these options.