OPPE Evaluation – Key Factors for Improvement

It’s time to look at OPPE again.  While performing mock surveys, we frequently see issues with OPPE documentation.  There are some organizations that still are not doing ongoing professional performance evaluations on the credentialed licensed independent professionals, including credentialed physician assistants, nurse practitioners, etc.  Others are using generalized performance measurement indicators instead of specialty-specific indicators.

Ongoing Professional Practice Evaluation (OPPE) is intended as a means of evaluating professional

performance on an ongoing basis for three reasons:

  • As part of the effort to monitor professional competency
  • To identify areas for possible performance improvement by individual practitioners
  • To use objective data in decisions regarding the continuance of practice privileges

OPPE Performance Measurement Indicators

OPPE performance measurement indicators should be specific to the area of specialty that the practitioner is practicing.  OPPE needs to be ongoing throughout the year. The actual frequency for data review is set by the organization. Most organizations around the country collect data for OPPE evaluations quarterly, others every six months.  A well-designed OPPE process includes qualitative and quantitative data that support re-privileging decisions based on the hospital’s defined re-appointment schedule.  Care providers practicing in non-inpatient areas are also required to have performance evaluations if that setting is included within the scope of the hospital survey. This could include outpatient services, hospital-owned physician office practices, and other types of settings.

Common areas discovered that need improvement include one or more of the following:

  • Defined inpatient and outpatient performance measurement indicators for all practitioners, specific to their practice specialty
  • Lack of qualitative data
  • Lack of quantitative data
  • Lack of data on low-volume practitioners
  • Weak analysis of data and missed opportunities to identify improvement opportunities.

Note: The privileges granted in outpatient locations must be limited to those services that can be performed in the outpatient care setting. If the non-inpatient settings do not have the same clinical record system or information technology, collecting data may be more difficult, but if the privileges are the same, the data collected should be the same.

Another issue we frequently see on surveys is lots of data; however, no analysis of the data. In order for the data collected to be meaningful during the re-privileging process, the information needs to be analyzed, reviewed, and action taken. From this data, the department chair and credentialing committee can determine what action(s) to take.  Remember, any determination of revocation or suspension of privilege is reportable to the National Practitioner Data Bank.

And remember, although the main intent of this data collection is for the OPPE program, this data can also be de-identified and potentially used to fulfill other data collection opportunities,

Additional information on OPPE can be found on the Courtemanche and Associates website in the June newsletter.

Please contact us for questions or more information at  704-573-4535 or info@courtemanche-assocs.com.

Courtemanche & Associates specializes in Healthcare Accreditation and Regulatory Compliance Consulting Services. With over 29 years of being in business and 100+ years of healthcare experience amongst our consulting team, we are ready to assist with your accreditation and regulatory compliance needs.

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