Across settings, organizations are granting official practice authorization using delineation of privilege (DOP) forms that are incomplete, or that seem to be so, according to the AAAHC Quality Roadmap 2016. Missing signatures and empty check boxes are often telltale signs of incongruity between codified processes and current practices.

To carry out board-delegated responsibilities, an effective medical staff needs to control the quality of care rendered by medical staff members and other practitioners granted clinical privileges and to provide a structure whereby physicians have input in the institution’s decision-making. Effective governance requires a solid structure, organization, and strong processes. Governance functions include delineating the structures and processes for credentialing, proctoring, ongoing assessment of competency, peer review, medical staff membership, staff categories, clinical privileges, suspensions, fair hearing rights, due process, medical executive committee composition, other committees, departments (or not), and more.

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