# Presentation: 896820

## Greater Nashua Medical Reserve Corps Nashua NH Division of Public Health

**Credentialing**
**Dr. Joe Sabato**
**Sabatoj@ci.nashua.nh.us**

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## New Hampshire

**No Seat belt law**
**No Helmet law**
**State Liquor stores on our highways and borders**
**No sales tax**
**No Income tax**

## State motto

**Live Free of Die**

## Credentialing	

*** ******credential :noun*****:** a document attesting to the truth of certain stated facts _**certificate **_
_**certification **_
_**credentials **_
_**Document**_
_**Papers**_
_**written document**_
_** **__**card**_
_**Diploma**_
_**identity card **_
_**sheepskin**_

**OK so we are going to credential you to face known and unknown threats, at known and unknown places and times, with known and unknown skills**

## MRC Credentialing

**Decide what you are going to want people do**
**Some basics like cpr**
**?BDLS****? ADLS****ATLS**
**etc**

**Credentialing: A major headache for every medical practice administrator**
**Credentialing and verification a time consuming, expensive enterprise especially in volunteer organizations**

## Medical Credentialing	

**Minimum of 2-3 hours per credentialing application**
**Take 6 months for processing**
**May have as many as 15 applications or more for each practitioner**

## Credentialing: Why?

**Liability**
**Safety**
**Skills**
**Experience**
**Identification**
**Security**
**Interests**
**Legitimize enterprise**

**Identify needs**
**Competency**
**Character/ethics**
**Interoperability**
**Standardization**
**more**

## Competency

**Basing the credential on scientifically and legally defensible competencies that are linked to job responsibilities....**
**“****Few health professions that are credentialed have data related to credentialings’ impact on practitioner competence, organizations or other outcomes”**
**American journal of public health management and practice Vol 7 iss4 p 38**

## Sure ways to make a physicians day

**You have just been appointed to the credentials committee**
**You are due to meet with the Joint Commission for Accreditation of Hospitals(JCAHO)**
**You need to fill out your credentialing applications**

**The difference between leadership and whining is what you do about it**

## Learning From a Failed Grant Application

**No State Volunteer coordination or oversight for disasters**
**No recognition of MRC**
**No interest group connection**
**No mechanism to promote common interests and opportunities**
**Confusion of state agencies**

## Lessons learned/actions taken

**State Citizen Corps Council**
**Recognition by state as a resource**
**Clarified NH state process and linking agencies**
**Identified interest groups**
**Brought them together**
**Identified key issues and opportunities**

## Participants 

**Northern New England MMRS**
**New Hampshire Hospital Association**
**DHHS**
**NH Medical Society**
**NH Office of Emergency Management**

## NH Effort

**Assumptions:**
**Need statewide and ideally regional system**
**Credentialing and identification are closely related**
**Leverage resources, partners and interests**
**Credentialing, training, and certification should be interoperable and standard**

## Advantages

**Avoid cost of development and implementation of multiple systems**
**Create interoperability**
**Create basic standards**
**Integrate within local, state and regional disaster system**
**Create joint opportunities**
**Leverage resources**

**There are no secrets to success. It is the result of preparation, hard work, and learning from failure. **
_**Colin Powell **_

## Nashua MRC	

**Partner or leverage hospital credentialing**
**Temporary credentialing**
**Paper/electronic database**
**Eventual linkage to MMRS of Northern New England Credentialing and ID system**

## JCAHO December 2001

**Make provisions for quickly evaluating essential credentials of any temporary or volunteer professional staff...**

## Joint Commission

**March 12 2003 recommendations**
**...****.fund and facilitate the creation of a credentialing database to support a emergency volunteer system for health care professionals.**

## Joint Commission of Accreditation of Hospitals

**Standard EC .2.9.1 effective 1/1/03**
**...****.the information and skills required to perform assigned duties during emergencies**
**Testing includes ...at least one drill yearly that includes an influx of volunteers**

## Lessons

**Hospitals are expert at credentialing, use that expertise**
**If someone offers support to make your life easier use it**
**Make it simpler**
**Find partners**

## Progress

**Seize the moment of excited curiosity on any subject to solve your doubts; for if you let it pass, the desire may never return, and you may remain in ignorance. William Wirt (1772 - 1834)**

## ESAR-VHP

**Emergency System for Advance Registration of Volunteer Healthcare Personnel**
**Health Resources and Services Administration November 2003 **

## ESAR-VHP

**The use of credentialed health care volunteers in an emergency or mass casualty event**
**...****inability to verify physician’s identity or basic licensing or credentialing information**
**...****loss of communications that can provide credentialing information**

## ESAR-VHP

**Limited resources to perform verification of education, skills, training, or competencies due to an emergency**
**Jurisdiction over licenses resides at the state level**
**Various agencies and institutions grant certifications resulting in different standards and processes for credentialing and assurance of licensure**

## ESAR-VHP

**Need for system that will support effective and efficient identification of qualified volunteer healthcare personnel**
**There is neither an integrated system that can be accessed containing relevant, verified information about a practitioners education, license and competency nor a widely available model template that can be made available to states to facilitate this type of integrated model.**

## Contact Information	

**Dr. Joe Sabato**
**City of Nashua Division of Public Health and Community Services**
**18 Mulberry Street**
**Nashua NH 03060**
**603-589-4507**
**Sabatoj@ci.nashua.nh.us**