Peer review is an essential yet flawed process that every health system must conduct. Here is how to get the most from your organization's peer reviews.
Research proves that peer review substantially impacts the quality of care in a medical facility. According to a study published in PubMed, at least 18% of the variance in quality of care results from peer review. Despite being a mandatory process, the quality and consistency of peer reviews vary significantly between organizations. Here are the ways healthcare professionals can reliably avoid these pitfalls.
A hospital can choose between an external or internal expert when reviewing its physicians. In an internal review, another physician at the same facility will be tasked with evaluating the doctor. Internal reviews can be the quickest way to complete a peer review, but biases may reduce the quality of the information. External reviews enlist the help of experts from outside organizations, which can take longer but face less bias as reviewing experts are unlikely to know the physician being evaluated and hold a conflict of interest.
Expert platforms like Medplace expedite this process from months to less than 14 days.
Awareness of biases can help protect the integrity of reviews. For example, internal medicine physician Husam Bader told Medplace that the proximity of peers creates bias. Physicians that work together regularly may be hesitant to give a fair review of one another. Risk leader Terri Schimmer's organization, Cherokee Regional Medical Center, suffered from this phenomenon.
Being a small facility, we just struggled with really good information, because these guys and women work with each other every day eat lunch together. So, it was really hard to peer review each other because they tended to be really soft. It wouldn't be uncommon for me to get one with just no concerns.
Hindsight and outcome bias can also harm the quality of reviews. When a reviewer knows the adverse outcome of a case, they may be likely to see the physician at fault, even if the outcome is influenced by chance. Likewise, hindsight bias causes a reviewer to see the physician's decisions as inevitably leading to the outcome rather than judging the case on the procedures alone. Risk leaders can select reviewers for their cases more effectively by being aware of these biases.
Aside from bias, risk management can properly ensure quality results by selecting the highest quality physicians for a peer review. When possible, match the physician with a peer of the same specialty. This way, the reviewer is familiar with the medical area of the physician being evaluated and can give more thorough feedback.
Many hospital systems require that their physicians conduct reviews for free or during shift hours; however, compensating them for the review will yield the most thorough results, according to Medplace CEO Jerrod Bailey.
Everybody's stretched thin over the last couple of years. We asked our doctors to do peer reviews, but it's not compensated work. So, it ends up being the last thing they do. They may not necessarily pour over it the way that's they might if they were being compensated for it.
Selecting the right experts, navigating bias, and conducting reviews externally may not be realistic for resource-constrained healthcare organizations. However, Medplace combines all the elements for high-quality peer review and places them in an easy-to-use dashboard with automated billing and fast expert matching. Click here to read more about the Medplace approach to peer review or to watch our webinar, An Easy Way to Reimagine Peer Review.
Vice President of Clinical Operations
Adrienne leads the Medplace clinical operations team and oversees the recruitment, onboarding, and training of the network. She holds over 30 years of experience in Medical ICU, Quality & Risk and Medical Malpractice Defense work.
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