Establishing a standardized clinical pharmacy practice model within the Veterans Health Administration: Evolution of the credentialing and professional practice evaluation process

Abstract

Developing a standardized practice model and a consistent process for the provision of clinical pharmacy services has been described by some as the “Achilles heel of the clinical pharmacy discipline.” The foundation of a standardized practice model and therefore a consistent care process requires evaluation of the competencies of the providers practicing in the model. The credentialing and privileging process is intended to verify that the health care professional has obtained the requisite qualifications to practice within a certain setting and exhibits the clinical acumen to provide care to patients. The process of credentialing and privileging along with the professional practice evaluation (PPE) process varies across the country. The Clinical Pharmacy Practice Office within the Veterans Health Administration has defined a system‐wide process and solidified the elements essential to clinical pharmacist scope of practice, as well as ensuring the robustness of the pharmacist PPE process within the Department of Veterans Affairs (VA). While specific to the VA, this framework may be considered by other health care systems in creating a process for pharmacist providers.

Role of the US Veterans Health Administration Clinical Pharmacy Specialist Provider: Shaping the Future of Comprehensive Medication Management

“…6 The policy modernized the activities included within the CPS scope of practice, defined the credentialing process for VHA CPS providers, and also defined the procedures for initiation and renewal of the scope of practice, along with the components of peer review (otherwise known as professional practice evaluation), both initial and ongoing, for pharmacists possessing a scope of practice. 7 Prescriptive authority outlined in the scope of practice applies only to noncontrolled substances and is outlined on the basis of VHA policy, rather than by the pharmacy practice legislation for the state where the pharmacist is licensed. If the CPS provider is licensed in a state that allows prescriptive authority for controlled substances and has obtained a DEA (Drug Enforcement Administration) number, the CPS provider's scope of practice may include authority to prescribe controlled substances.…”

Credentialing and privileging for clinical pharmacists

“…However, expanded clinical responsibilities and an increasingly complex health care system call for an expanded credentialing process to ensure that clinical pharmacists practicing in such roles have the knowledge and skills necessary to provide care in a team‐based environment. In addition, use of a credentialing process for clinical pharmacists that mirrors the process used by physicians and other providers promotes consistency and increases understanding and credibility among providers, insurers, and health systems …”

Expanding the pharmacist's scope of practice at the state level: Support for board certification within the credentialing process

“…This is followed by a professional practice evaluation, which includes a peer review of the medical records of patients treated by the clinical pharmacist and other types of assessments. Ongoing professional practice evaluations are required, and advanced practice pharmacists must reapply for privileges every 2 years …”