Credentialing and Clinical Privileges

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Credentialing and Clinical Privileges
Shirley Willis
Florida Southern College

Credentialing and Clinical Privileges
With an ever-widening scope of practice and professional responsibility, more nurse practitioners are obtaining hospital privileges. Continuity of care is improved when nurse practitioners and other advanced practice registered nurses who care for patients in primary care settings can follow their patients and their families when they are admitted to the hospital. Complexities of care, coordination of care, and transitions into and out of the community during illness require a transparent and logical process that allows providers to gain access to the patients they have cared for and know best. Coordination of care and teamwork among all health providers is not only advantageous but necessary for efficient and cost-effective care. Unfortunately, in many communities, APRN practice is severely restricted by hospitals’ unwillingness to credential and privilege APRNs (Brassard & Smolenski, 2011). Credentialing and privileging were originally applicable only to physicians. Physicians were granted the privilege of admitting patients to the facility with the authority to order or perform all tests, diagnostic procedures, and treatments. When specialization of physician practice and board certification gained acceptance and hospital accreditation became the norm; the need for a more specialized privileging process arose. Credentialing and privileging intended to ensure that practitioners have the necessary qualifications to direct the clinical care provided to patients in hospitals (Brassard & Smolenski, 2011). The first advanced practice nurses to obtain hospital credentialing and privileges were Oregon midwives in the 1970’s. Around the same time, Oregon also passed legislation allowing nurse practitioners to seek hospital privileges. The laws stated that nurse practitioners were subject to the credentialing hospital’s bylaws and that...