J Clin Outcomes Manage
The process of peer review in U.S. hospitals
Edwards MT, Benjamin EM
Abstract Objective: To obtain information about peer review as currently practiced in U.S. hospitals. Methods: Leaders from sponsor-affiliated U.S. acute care hospitals were asked to complete a 39-item online questionnaire. Results: Data from 339 hospitals reveal wide variation in medical staff peer review structure, process, and governance. Ordinal logistical regression models for perceived reviewer participation, quality impact, and medical staff satisfaction explain a substantial proportion of the observed variance. Key drivers of the perceived impact on quality include reviewer participation, recognition of excellence, standardization and governance of process, integration with hospital performance improvement activity, reference to pertinent diagnostic studies and identification of contributory clinician-to-clinician issues during case review, turnaround time, case volume, monitoring of adverse events, and trustee involvement. Conclusion: Physician leaders should consider applying quality improvement principles to their organizationís peer review processes, with particular attention to clinical performance measurement methods and program governance.
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