Peer review processes at hospitals and ASCs face numerous challenges in today's regulatory environment. Conflicts-of-interest resulting from social and professional relationships among medical staff can result in bias and increased liability.
The term "peer review" makes people think about picking up a chart, opening it, looking at the documentation, asking questions, and assessing it. However, peer review is much more. It is a truly professional review by a peer or body of peers that monitors both physician competence and professional conduct in order to promote the highest quality medical care and patient safety. A good peer review system includes both internal and external peer review to achieve these goals.
There are a number of risks associated with poor peer review. The number one risk is the development of a punitive culture where reviewers feel that they are not being asked to assess a fellow practitioner, but rather to punish him or her. Poor peer review can also lead to poor quality, the loss of reputation or competitive positioning, high malpractice costs, and expensive litigation. Government audits can also result and payments may be withheld in situations in which care did not meet the appropriate standards.
Peer review is vital to ensuring high-quality patient care, managing risk, and monitoring physician performance for hospitals and ambultory surgery centers. An effective peer review process includes both internal and external peer review to achieve evidence-based, unbiased determinations. We are going to take a closer look at peer review through three studies of the peer review process.
Conflict of interest is a threat to the peer review process of every hospital. Understanding the consequences of failing to manage COI as well as the guidelines for effectively eliminating it from the peer review process helps to ensure both patient safety and the quality of care.
An effective peer review process is vital to protect your organization, the peer review committee, and the peer reviewers themselves. Failed peer review systems lead to three major areas of risk: failure to achieve its purpose, financial implications, and litigation.
The purpose of peer review is to improve quality of care, which extends to review of qualifications and complaints as well as professional conduct. To promote effective peer review and encourage physician participation, there are two very important legal protections that can be extended to peer review committees and participants: immunity and confidentiality. However, these legal protections are not a given and only apply if the peer review process meets certain statutory requirements at the state and federal levels.
Your medical staff bylaws are a vital element in creating a quality peer review process for your organization. Learn more about what should be included in your bylaws to ensure that your peer review system is legally defensible.
External peer review offers an unbiased, evidence-based approach to evaluating a physician's performance. It is a vital supplement to any effective peer review program in cases where conflicts of interest can arise in internal peer review processes and provides a depth of specialty expertise that some facilities lack.
Early detection and resolution of issues reduces negative consequences for both physicians and hospi-tals. In addition to minimizing harm to patients, it also minimizes liability exposure of practitioners and the hospital’s financial losses. Peer review not only detects and resolves physician performance issues that can lead to loss, but also prevents medical errors through increased transparency and accountability, reduces negative consequences and costs for both the physician and the hospital, and reduces risk of litigation between facility and physicians, when managed properly.
We surveyed hospitals to find out how their peer review systems were working. Find out how your organization’s peer review system compares and how to identify opportunities for improvement.
The working environment of the ED is a unique, complex, and dynamic environment, which is highly vulnerable to error and claims of malpractice. Learn what factors increase the risk of litigation for this department to better understand how to mitigate exposure and financial penalties.
C-sections are one of the most common procedures performed in hospitals, with rates rising over the past two decades. While Cesarean birth is a relatively safe procedure, it is not without risk to the patient and baby and can come with increased liability for the institution. Click the title above to learn more about the importance of reducing the rate of C-sections and the primary reasons behind the wide variance in rates from hospital to hospital.
C-sections are one of the most common procedures performed in hospitals and rates have continued to rise. Learn more about how to reduce the rate of Cesarean births, improve quality, and promote risk management, including the revised labor guidelines from the American College of Obstetrics and Gynecology.
Using Performance Data to Drive Quality Improvement in Maternity Care and Decrease the Cesarean Rate
While Cesarean deliveries can be life-saving, they should only be performed when medically necessary for the mother and child. Supporting vaginal birth whenever possible provides the safest option for patients as well as the facility. One way to drive this quality improvement effort is through the use of performance data. Learn the internal and external strategies to implement and take a look at the results of three pilot programs to reduce C-section rates.