Improving Safety and Quality: Competency Based Procedural Credentialing for Interns

Introduction: Develop and implement formal process for competencybased credentialing in frequently-performed clinical procedures for prevocational junior medical staff at a major tertiary public hospital. Method: This project was developed and implemented at Monash Health, a public healthcare service in the South-Eastern suburbs of Melbourne, Australia. Interns commencing at Monash Health were issued with a postgraduate year 1 (PGY1) competencies package and logbook for a suite of frequently-performed clinical procedures which was to be formally assessed and credentialed during the year. Evaluation involved a focus group discussion at mid-year and analysis of data obtained through a feedback form at the end of the year. Result: All 75 interns returned duly completed logbooks at the end of the year. The focus group discussion with 20% of interns revealed a generally positive attitude towards the process. The main barriers to undergoing formal assessment were supervisor availability and intern workload. Most interns (54% of respondents) did not think that formal assessment increased their confidence in performing the procedures. This group felt that they were already competent in some of the basic procedures as result of their medical school training and did not require formal assessment to be credentialed for them. Conclusion: Formal assessment of competence and credentialing of clinical procedures for interns ensure that junior doctors meet the standards of competence recognised by Monash Health before they are allowed to perform the procedures on patients. This outcome should lead to improved quality of care for patients in public hospitals that employ junior doctors.