A Systematic Approach to Clinical Peer Review in a Critical Access Hospital

作者：Mark Deyo-Svendsen, Michael R. Phillips, Jill K. Albright, Keith A. Schilling, Karl B. Palmer · 发表于：Quality Management in Health Care · 年份：2016 · DOI：10.1097/qmh.0000000000000113 · 被引用次数：12 · 研究领域：Innovations in Medical Education、Patient Safety and Medication Errors、Ethics in medical practice

PURPOSE: Clinical provider peer review (CPPR) is a process for evaluating a patient's experience in encounters of care. It is part of ongoing professional practice evaluation and focused professional practice evaluation-important contributors to provider credentialing and privileging. Critical access hospitals are hindered in CPPR by having a limited number of providers, shortages of staff resources, and relationships among staff members that make unbiased review difficult. Small departments within larger institutions may face similar challenges. METHODS: A CPPR process created at Mayo Clinic Health System is described. It involved a case review questionnaire built on the Institute of Medicine "Six Aims for Changing the Health Care System," a standardized intervention algorithm and tracking tool. OUTCOMES: During 2007 through 2014, a total of 994 cases were reviewed; 31% led to provider dialog and education or intervention. Findings were applied to core measure processes with success rate going from 87% to 97%. Changes were adopted in end-of-life care, contributing to a 50% reduction in all-cause mortality rate. CONCLUSIONS: Providing peer review tools to a critical access hospital can keep peer review within a group with knowledge of the individual provider's practice and can make process improvement the everyday work of those involved.