The provincial privileging dictionaries were created in response to issues raised in the 2011 Cochrane Report and are designed to support consistency in the oversight of medical staff credentialing and privileging in BC.
A provincial team consulted widely to develop discipline-specific standards, drawing on the expertise of more than 300 frontline medical staff and specialty experts.
The dictionaries set benchmarks and practice expectations for medical staff and have supported criteria-based privileging in BC health authorities since 2015.
Quality Assurance ||
Quality Improvement |
|Define scopes of practice||Guide priorities for continuing professional development and staff-led improvement work|
Updating the dictionaries
The dictionaries are intended to be an ongoing work-in-progress and will be updated in iterative cycles of review. The first scheduled review is planned for 2016-19.
BC MQI welcomes input from practitioners, specialty experts, and governing bodies to dictionary review processes.
Learn more at our dictionary review hub.
Who do the dictionaries apply to?
The dictionaries are used by health organizations in BC to review and grant privileges to practice within their facilities. Currently, the dictionaries apply to:
- Nurse Practitioners
Where and when will I use a dictionary?
Medical staff will use the dictionaries to apply for appointment or reappointment at a facility managed by a BC health authority or affiliate.
Appointment and renewal processes are now completed online in the AppCentral module of the C&P system (Cactus software). You will review the privileging dictionary for your practice area within AppCentral. At that time, you'll identify the privileges that you are applying for and affirm your current experience.
What if I don't meet the dictionary standards – will I lose privileges?
This is not a disqualifier. At the time your privileges are reviewed, you will have a focused discussion with your department head or chief of staff as to how you maintain skill and how have you done so in the past. You will be asked about your level of comfort with an activity and what supports are required to allow you to continue to practice safely in this area.
I work at multiple sites - are the same privileges available at each?
No, not necessarily. AppCentral (Cactus software) lists only the activities that can be supported at the site you have selected. Not all sites can support all types of activity.
Out of scope situations, or when the dictionaries do NOT apply
- Hiring - The dictionaries set provincial standards for qualifications and/or current experience in regard to the privileges a practitioner may request. The dictionaries do not set job parameters, such as job roles, qualifications or responsibilities. that is the function of a job description, which is developed by your employer or department.
- Unplanned care - the scope of privileges granted to any individual practitioner is based on considerations of patient care under "normal circumstances" or in other words: planned care. In the setting of risk to life or limb, the rules of privilege are not meant to constrain practitioners from acting in the best interest of a patient.
What is included in a privileging dictionary?
- objective, discipline-specific privileges and associated standards for medical staff
- standards for diagnostic procedural and non-procedural disciplines
- current experience standards, and what is core to each discipline, as well as what requires extra training (non-core) as defined by members of each discipline-specific panel
What is current experience?
Current experience is the level of experience thought to allow a practitioner to remain skilled in an activity. These may be expressed in hours or numbers of cases.
If you do not meet the current experience criteria in your privileging dictionary, it does not automatically disqualify you from performing that activity. Instead, the criteria may prompt a supportive conversation with your medical leader about how a skill is or will be, maintained.
What is the meaning of core and non-core activities?
Each dictionary will list core and non-core activities.
Core privileges are those activities that a recently graduated member of the discipline can reasonably be expected to perform.
Non-core privileges are activities which are outside of the core privilege, that require further training or demonstration of skill.
Dictionaries may also list context-specific privileges, which are available only at the sites that can support them.
How is dictionary content formed? Or changed?
The original dictionaries were created by over 300 practitioners from across BC. Panels of subject-matter experts were formed for each specialty or sub-specialty and each worked together through a series of meetings to identify appropriate content for each privileging dictionary.
This panel format is also being used for a scheduled review of the dictionaries, taking place from 2016-19. Practitioners are encouraged to provide input or contribute to a panel for their practice area.