Clinical Peer Review Program Self-Evaluation for US Hospitals

Abstract

Prior research has shown wide variation in clinical peer review program structure, process, governance, and perceived effectiveness. This study sought to validate the utility of a Peer Review Program Self-Evaluation Tool as a potential guide to physician and hospital leaders seeking greater program value. Data from 330 hospitals show that the total score from the self-evaluation tool is strongly associated with perceived quality impact. Organizational culture also plays a significant role. When controlling for these factors, there was no evidence of benefit from a multispecialty review process. Physicians do not generally use reliable methods to measure clinical performance. A high rate of change since 2007 has not produced much improvement. The Peer Review Program Self-Evaluation Tool reliably differentiates hospitals along a continuum of perceived program performance. The full potential of peer review as a process to improve the quality and safety of care has yet to be realized.

The Objective Impact of Clinical Peer Review on Hospital Quality and Safety

“…That analysis has been reported separately. 18 The current study confirmed the 2007 findings of wide variation among programs, a high rate of change, a general lack of attention to program metrics, and the wholesale failure to reliably measure individual clinical performance during case-based review. What is interesting is that it also showed that physician leaders use the language of QI to characterize the factors that enhance or block program effectiveness, even if they have yet to systematically apply such principles to clinical peer review practice.…”

A Medical Staff Peer Review System in a Public Teaching Hospital—An Internal Quality Improvement Tool

“…We evaluated the quality of our peer review system using the Peer Review Program Self‐Evaluation Tool developed and validated by Edwards (, , ). The tool has 13 aspects of evaluation and has a total score of 100.…”

“…Despite limited resources and mounting known challenges, we have developed and imple-mented an electronic MS-PRS that includes mortality reviews of 100% of deaths, an ongoing random review for reappointment and operative procedures, and morbidity peer reviews. We evaluated the quality of our peer review system using the Peer Review Program Self-Evaluation Tool developed and validated by Edwards (2009aEdwards ( , 2009bEdwards ( , 2010. The tool has 13 aspects of evaluation and has a total score of 100.…”

“…Edwards (, ) developed and published a Peer Review Program Self‐Evaluation Tool, which can be used to rate current peer review programs. Using this validated tool, it was found that its score is strongly associated with perceived quality impact (Edwards, ). Data from 296 acute care hospitals show that the majority of programs rely on an outmoded and dysfunctional process model and that adoption of best practices informed by the continuing study of peer review program effectiveness has the potential to significantly improve patient outcomes (Edwards, ).…”

Peer Review – Legal and Ethical Issues Faced by Medical Staff: The Mandate for Physician Leadership

“…Regulation of peer reviews should result in a two-fold effect: improvement in quality and decreased abuse of the process through sham reviews. 18 National standardization efforts for peer reviews remain challenging, as the process is costly, time intensive, and requires extensive resources. Several models at diverse US hospitals have shown that standardization and structuring of the review process can improve medical care.…”