In a recent decision, the Court of Appeal for the Fifth Circuit of Louisiana partially reversed a trial court decision ordering the American Board of Orthopaedic Surgery (“ABOS”), a nonparty to the underlying malpractice lawsuit, to produce documents that ABOS had identified in a privilege log related to the defendant physician’s malpractice lawsuit.
Question: Are hospitals required to report professional review action taken against Advanced Practice Providers (i.e., Advanced Practice Registered Nurses and Physician Assistants) to the National Practitioner Data Bank (NPDB)?
Answer: No, professional review action against Advanced Practice Providers is not required to be reported but may be reported. Hospitals and other healthcare entities must report adverse clinical privileges actions to the NPDB that meet NPDB reporting criteria. Mandatory reporting includes any professional review action that adversely affects the clinical privileges of a physician or dentist for a period of more than 30 days or the acceptance of the surrender of clinical privileges, or any restriction of such privileges by a physician or dentist, 1) while the physician or dentist is under investigation by a healthcare entity relating to possible incompetence or improper professional conduct; or 2) in return for not conducting such an investigation or proceeding. Clinical privileges include privileges, medical staff membership, and other circumstances (e.g., network participation and panel membership) in which a physician, dentist, or other healthcare practitioner is permitted to furnish medical care by a healthcare entity.
Act 273 of the 2024 regular session of the Louisiana Legislature becomes effective January 1, 2025. That Act drastically changes the law on non-compete agreements for most Louisiana physicians (but not all).
Disruptive behavior in healthcare settings diminishes employee morale and collegiality and negatively impacts patient safety and quality of care. The Joint Commission previously noted a significant breakdown in team communication resulting from poor behavior and identified a clear link between disruptive behavior and medical errors and other adverse patient events. (Sentinel Event Alert 40: Behaviors That Undermine a Culture of Safety, TJC, June 18, 2021.) The American Medical Association Code of Ethics defines disruptive behavior as “… any abusive conduct, including sexual or other forms of harassment, or forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.”
“Board members should not usurp the role of management and should not micromanage,” according to The Joint Commission standard LD.01.03.01. This article provides insight into why ensuring a hospital’s board stays within its governance role is not only a best practice, but also reduces risk. Key areas of concern include employment/Human Resource issues, workers compensation matters, medical staff and credentialling concerns, professional liability matters, and privacy issues.