Who it’s for / Hospitals and health systems
Three hospitals. Three sets of bylaws. One physician asking for privileges.
Your bylaws already name every privilege you grant and what it takes to hold each one. Bip reads them into a delineation you can search, apply to one provider, and stand behind at reappointment.
Delineation of clinical privileges
§ 1. Each applicant for appointment or reappointment to the Medical Staff shall request specific clinical privileges on the form approved by the Medical Executive Committee for the department in which membership is sought. Privileges shall be granted only for those activities in which the applicant has demonstrated current competence, and shall be exercised only at the facility to which they are granted.
§ 2. Core privileges. The core in Obstetrics and Gynecology comprises those procedures customary to the specialty, including antepartum and intrapartum management, cesarean delivery, and abdominal and vaginal hysterectomy. An applicant requesting the core shall hold current certification by the American Board of Obstetrics and Gynecology, or shall be within five years of completing an ACGME-accredited residency and actively pursuing certification.
§ 3. Special privileges. Procedures beyond the core, including operative vaginal delivery by forceps, fetal echocardiography and robotic-assisted laparoscopic surgery, shall be requested individually and supported by documentation of training and of not fewer than twenty (20) cases in the preceding twenty-four (24) months, together with five (5) proctored cases. Each grant shall be subject to a period of focused professional practice evaluation determined by the department chair.
Left: the article as it arrives. Right: the delineation it already defines, with what each privilege takes attached. Illustrative of the structure.
One system, many bylaws
No two of your hospitals define a privilege the same way.
Two hospitals in the same system will call the same procedure by different names, put it in the core at one and make it special at the other, and set different requirements behind it.
There is no version where one delineation serves both. There is also no reason a person should have to read both documents to find out.
What changes
The chain has to hold at every link.
Criteria, evidence, the grant, and everything since.
- 01
The criteria come from your bylaws
Not a template. Your own article becomes named privileges, core and special, each carrying what the text says it takes.
- 02
Evidence carries its origin
What a source returned reads differently from what a provider supplied, and the row says which. Labeling both verified is the indefensible version.
- 03
The grant is recorded, not remembered
Which privileges, granted or conditional, on what date — conditions on the grant, FPPE on the privilege that triggered it.
- 04
Nothing is silently corrected
When a document and the record disagree, both stay and it goes to review. An import that quietly overwrites is one nobody can audit.
Committee review is the governance, not the obstacle. The decision stays theirs; what changes is the state of the file when the meeting opens.
Why it holds up
Complete is not the same as defensible.
A file can hold every document the checklist asked for and still not say what the grant was measured against.
Produce the criteria against which this privilege was evaluated, the evidence relied upon, and the record of the grant.
- What it took
- Article VI § 3, held on the privilege: twenty cases in twenty-four months, five proctored.
- The evidence
- Read against the file as met, unmet or unknown. What Bip cannot see is never scored as met.
- The grant
- Which privileges, on what date, under what conditions, and the FPPE period it started.
- Since then
- Every status change on the grant, dated, in order.
Questions we get
Medical staff offices, plainly.
What is actually primary source verified?
How is this different from the credentialing a provider’s group already did?
Who records the committee’s decision?
Pick a privilege you granted last year.
We will show you the record it would leave, and you can tell us where it falls short of yours.