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WMC Board revises policies, seeks credentialing firm

 


A new confidentiality agreement related to credentialing of medical staff, and changes to a number of personnel policies at Wrangell Medical Center, were the main topics of discussion and action during the Jan. 16 WMC Board of Trustees meeting.

The board began with a new agreement that each member must sign agreeing to, “hold as confidential all credentialing and privileging information obtained during the course of and following my association with the Wrangell Medical Center Governing Board.”

Members will also not be allowed to make copies of credentialing files, and must turn in any documents seen or notes taken during a credentialing session.

Board president Woody Wilson said the revised agreement was meant to fulfill the requirements of Alaska law.

“In Alaska, credentialing of this nature, in hospitals, is required by law to be confidential,” Wilson said. “We’re doing this to adhere to what Alaska law says we should do.”

WMC administrator Marla Sanger also addressed the issue of credentialing and the expiration of the hospital’s contract with Juneau’s Bartlett Regional Hospital to complete background checks on staff for privileging purposes.

“We recently learned that this contract will end on February 1st, 2013,” she stated. “This poses a significant challenge as no new physician applications for appointment will be accepted. Physician files in process will be completed. Bartlett noted capacity constraints as a key reason for needing to end the agreement but also mentioned the additional workload required to expedite credentialing processes at the request of WMC. These practices are not consistent with industry standards and we are working with AICS to find a solution that updates our procedures while offering a satisfactory experience for all involved.”

After an inquiry by Wrangell resident Bob Maxand as to what involvement PeaceHealth might undertake in the future of WMC, Sanger explained the process used by Bartlett – and stated that she is searching for an alternative agency – including her own employer – to use in the future.

“PeaceHealth is not the place that I looked first because I am sensitive to the fact that when the City and Borough originally approached (us) about seeking help for the absence of the administrator role, to help with the turmoil, PeaceHealth said ‘yes, we’ll step in and provide some help and leadership,’” Sanger said. “A part of that relationship is access to everything else that PeaceHealth has… so that is definitely a place I considered.”

Citing sensitivity issues and the independent streak of Wrangell in general, Sanger added that she looked elsewhere first, however.

“I first looked at other, independent hospitals in Alaska,” she said. “The responses I got were mostly ‘we don’t have the capacity to do that… we’re barely making it to do our own,’ and one organization said (they) would consider it ‘if we have to.’ I’m looking for a partner that wants to and will do a really good job for us. PeaceHealth has offered and unless I have a better suggestion or come up with another idea, that would probably be the most cost-effective plan.”

According to Sanger and Wilson, all credentialing matters currently in the Bartlett pipeline, which may include those of Dr. Greg Salard, will be processed and completed regardless of the Feb. 1 contract deadline.

Even Salard himself chimed in, saying he was comfortable with a late January or early February completion of his credentialing through Bartlett, allowing it to move toward WMC board approval.

“It’s taken longer than I think it should, but I understand,” Salard said. “I certainly hope that it’s going to be taken care of by the end of the month, certainly by very early next month. If that happens, everything will be okay.”

During public comment, Wrangellite Bill Knecht repeated his call for the privileging of Salard – which he has done on numerous other occasions – and related his concerns over what might happen if he were to be hospitalized at WMC.

“There are a lot of patients that would like to have their doctor of choice treat them,” Knecht said. “Right now, if I fell ill, which I hope I don’t, my doctor wouldn’t be able to do anything except look from the clinic side and wave at me and wish me well. I can’t express how much I would like to have (Dr. Salard) back.”

The board also approved a set of four changes to personnel policy at WMC, including procedures regarding attendance. The new policy defines “excessive lateness” as three late start times for a full-time employee. The board also defined “excessive absenteeism” as exceeding paid-time-off, noting a pattern of calling in sick on certain days, the rate of absenteeism exceeds the department or hospital’s establish rate, and has approached an excessive stage as noted by management.

Use of social media at the hospital was also addressed, including a standard that calls for employees to ignore negative statements made about the medical center on social networks.

“If a staff member sees unfavorable opinions, negative comments or criticism about Wrangell Medical Center on a social media site, he or she should not attempt to rebut it nor have it removed as that may escalate the situation. Instead, he or she should forward the information to the CEO,” the policy states in part.

Staff members will also be prohibited from linking their personal blogs or websites to either WMC’s external or internal websites under the new policy.

The final policy issue addressed regards use of technology and is quite clear in its scope and message to WMC employees.

“Staff members should have no expectation of privacy in e-mail or voice mail communication, whether to supervisors, co-workers, or others,” the policy states. “Even if e-mail is deleted from the device, it is not deleted from the system. Internet activity may be monitored by Wrangell Medical Center administration and privileges may be changed or revoked at any time.”

In Sanger’s monthly report to the board she summarized what she feels has been accomplished since her arrival on Nov. 5.

“The recent State Department of Health and Social Services survey called out some opportunities for improvements that have been addressed,” she stated in her report. “A Medical Director position for the Emergency Department has been created and accepted by Dr. Kathie Voigt via a contractual arrangement with AICS. WMC also contracted with a program to provide peer review for Certified Registered Nurse Anesthetists practicing here. By working with Monida Healthcare Network we have access to clinical expert peer reviewers who are credentialed according to the National Committee for Quality Assurance standards.”

 

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