Clinical peer review

Last updated

Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [1] [2] A discipline-specific process may be referenced accordingly (e.g., physician peer review, nursing peer review).

Contents

Today, clinical peer review is most commonly done in hospitals, but may also occur in other practice settings including surgical centers and large group practices. The primary purpose of peer review is to improve the quality and safety of care. Secondarily, it serves to reduce the organization's vicarious malpractice liability and meet regulatory requirements. In the US, these include accreditation, licensure and Medicare participation. Peer review also supports the other processes that healthcare organizations have in place to assure that physicians are competent and practice within the boundaries of professionally accepted norms. [3]

Overview

Clinical peer review should be distinguished from the peer review that medical journals use to evaluate the merits of a scientific manuscript, from the peer review process used to evaluate health care research grant applications, and, also, from the process by which clinical teaching might be evaluated. All these forms of peer review are confounded in the term Medical Peer Review. Moreover, Medical peer review has been used by the American Medical Association (AMA) to refer not only to the process of improving quality and safety in health care organizations, [4] but also to process by which adverse actions involving clinical privileges or professional society membership may be pursued. [5] In addition, peer review methods are frequently used by state medical boards with respect to licensing decisions and complaint investigation. They are also used by insurance companies with respect to credentialing and utilization management processes.

Medicine

In US hospital settings, clinical peer review encompasses a wide variety of activities, whose scope varies across institutions. [6] Virtually all programs perform retrospective medical record review (aka, case review) of the quality of care. Most also include Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) required by the Joint Commission since 2007. [7] Many also include the management of disruptive behavior (see [8] ) and physician health programs. [6]

Routine clinical peer review activity (performance assessment) is typically organized separately from the credentialing/privileging process (competence assessment), but the results of peer review inform those decisions. [6] From a legal and regulatory perspective, however, the line is blurred. The definition of a peer review body can be broad, including not only individuals but also (for example, in Oregon), "tissue committees, governing bodies or committees including medical staff committees of a [licensed] health care facility...or any other medical group in connection with bona fide medical research, quality assurance, utilization review, credentialing, education, training, supervision or discipline of physicians or other health care providers." [9]

Medical staffs generally rely on generic screens for adverse events to identify cases for peer review, even though that might not be the most efficient or effective method. [6] These are generally applied through administrative data analysis, but referrals for peer review are frequently made by risk managers, nurses and medical staff. The median annual review volume is 1–2% of hospital inpatient admissions. Thus, case review may be the dominant form of adverse event analysis in US hospitals.

Case reviews are typically conducted by individual reviewers, but in nearly 70% of hospitals, most reviews are presented and discussed in a committee prior to final decision-making. Nurses now participate on physician review committees in the majority of programs. [6] This extends the trend of the past decade for adoption of multi-specialty representation in the direction of multi-disciplinary peer review. [10] Some of these committees now routinely assess nursing care during the case review process and may even directly address all improvement opportunities. [6]

Nursing

The American Nurses Association published the first definition of nursing peer review in 1988. [11] It includes the following statements:

The American Nurses Association believes nurses bare primary responsibility and accountability for the quality of nursing care their clients receive. Standards of nursing practice provide a means for measuring the quality of nursing care a client receives. Each nurse is responsible for interpreting and implementing the standards of nursing practice. Likewise, each nurse must participate with other nurses in the decision-making process for evaluating nursing care…Peer review implies that the nursing care delivered by a group of nurses or an individual nurse is evaluated by individuals of the same rank or standing according to established standards of practice…. Peer review is an organized effort whereby practicing professionals review the quality and appropriateness of services ordered or performed by their professional peers. Peer review in nursing is the process by which practicing registered nurses systematically access, monitor, and make judgments about the quality of nursing care provided by peers as measured against professional standards of practice.

In Nursing, as in other professions, peer review applies professional control to practice, and is used by professionals to hold themselves accountable for their services to the public and the organization. Peer review plays a role in affecting the quality of outcomes, fostering practice development, and maintaining professional autonomy. American Nurses Association guidelines define peer review as the process by which practitioners of the same rank, profession, or setting critically appraise each other's work performance against established standards. The professionals who are best acquainted with the requirements and demands of the role are the givers and receivers of the review.

Nursing peer review appears to have gained momentum as a result of growth of hospital participation in the American Nursing Association's Magnet Program. [12] Even so, less than 7% of U.S. hospitals have qualified. Magnet hospitals must have at least 2 years of experience with a peer review evaluation process designed to improve practice and performance for all RNs for at least 2 years. [13] The literature on nursing peer review is more limited than that which has been developed for physician peer review, [14] and has focused more on annual performance appraisal than on case review. [15] No aggregate studies of clinical nursing peer review practices have been published. Nevertheless, more sophisticated studies have been reported. [16]

Nursing professionals have historically been less likely to participate or be subject to peer review. [12] [13] This is changing, [16] [15] as is the previously limited extensiveness (for example, no aggregate studies of clinical nursing peer review practices had been published as of 2010) of the literature on nursing peer review [14]

Mostly what is mistakenly referred to as "peer review" in clinical practice is really a form of the annual performance evaluation. The annual performance review is a managerial process and does not meet the definition or outcomes needed related to peer review. Other organizational practices may violate the peer review guidelines set forth 1988 by the ANA 1988. [11] The most frequent violation is the performance of direct care peer review by managers. One of the reasons for the confusion is that the ANA guidelines for peer review had been out of print prior to being reprinted and updated in 2011. [17]

The early ANA Peer Review Guidelines (1988) and Code of Ethics for Nurses (2001) focus on maintaining standards of nursing practice and upgrading nursing care in three contemporary focus areas for peer review. The three dimensions of peer review are: (a) quality and safety, (b) role actualization, and (c) practice advancement. Each area of contemporary peer review has an organizational, unit, and individual focus. [18] The following six peer review practice principles stem from and are grounded in the 1988 ANA Guidelines and may help to assure an evidence-based and consistent approach to peer review: 1. A peer is someone of the same rank. 2. Peer review is practice focused. 3. Feedback is timely, routine and a continuous expectation. 4. Peer review fosters a continuous learning culture of patient safety and best practice. 5. Feedback is not anonymous. 6. Feedback incorporates the developmental stage of the nurse.

Written and standardized operating procedures for peer review also need development and adoption by the direct care staff and incorporation into the professional practice model (shared governance) bylaws. [19]

Confusion exists about the differences between the Professional Peer Review process, the Annual Performance Review (APR) and the role of peer evaluation. The APR is a managerial human resource function performed with direct reports, and is aimed at defining, aligning and recognizing each employee's contribution to the organization's success. In contrast, professional peer review is conducted within the professional practice model and is not a managerial accountability. Peer evaluation is the process of getting feedback on one's specific role competencies or "at work" behaviors from people that one works within the department and from other departments. "Colleague evaluation" is a more appropriate term than "peer evaluation" as this is not a form of professional peer review. [20]

Pharmacy

There is limited published information about peer review among pharmacists. [21]

History

The first documented description of a peer review process is found in the Ethics of the Physician written by Ishap bin Ali al-Rahawi (854–931) of al-Raha, Syria. His work, as well as later Arabic medical manuals, states that a visiting physician must always make duplicate notes of a patient's condition on every visit. When the patient was cured or had died, the notes of the physician were examined by a local medical council of other physicians, who would review the practicing physician's notes to decide whether his or her performance met the required standards of medical care. If their reviews were negative, the practicing physician could face a lawsuit from a maltreated patient. [22] Such practices are known to have continued into the 11th century. [23]

In the 1900s, peer review methods evolved in relation to the pioneering work of Codman's End Result System [24] and Ponton's concept of Medical Audit. [25] Lembcke, himself a major contributor to audit methodology, in reviewing this history, notes the pre-emptive influence of hospital standardization promoted by the American College of Surgeons (ACS) following WWI. [26] The Joint Commission (on Accreditation of Hospitals) followed the ACS in this role from 1952. Medicare legislation, enacted in 1964, boosted the stature and influence of the Joint Commission because the conditions for hospital participation required a credible medical care review program and the regulations stipulated that Joint Commission accreditation would guarantee payment eligibility. [27] What was once a sporadic process, became hardwired in most hospitals following the medical audit model. The widespread creation of new programs was hampered, however, by limitations in the available process models, tools, training and implementation support. [27]

Medical audit is a focused study of the process and/or outcomes of care for a specified patient cohort using pre-defined criteria. Audits are typically organized around a diagnosis, procedure or clinical situation. [28] [29] It remains the predominant mode of peer review in Europe [30] and other countries. [31] [32]

In the US, however, the lack of perceived effectiveness of medical audit led to revisions of Joint Commission standards in 1980. Those modified standards dispensed with the audit requirement and called for an organized system of Quality Assurance (QA). About the same time, hospital and physicians were facing escalating malpractice insurance costs. In response to these combined pressures, they began to adopt "generic screens" for potential substandard care. These screens were originally developed to evaluate the feasibility of a no-fault medical malpractice insurance plan and were never validated as a tool to improve quality of care. Despite warnings from the developers, their use became widespread. [33] In the process, a QA model for peer review evolved with a narrow focus on the question of whether or not the standard of care had been met. It has persisted despite the many criticisms of its methods and effectiveness. [34] [35] [2] [36] Today, its methods are increasingly recognized to be outdated and incongruent with the Quality Improvement (QI) principles that have been increasingly embraced by healthcare organizations. [35] [36]

There is good evidence that contemporary peer review process can be further improved. The American College of Obstetrics and Gynecology has offered a Voluntary Review of Quality of Care Program for more than 2 decades. Perceived issues with the adequacy of peer review were an explicit reason for requesting this service by 15% of participating hospitals, yet recommendations for improved peer review process were made to 60%. [37] A 2007 study of peer review in US hospitals found wide variation in practice. The more effective programs had more features consistent with quality improvement principles. There were substantial opportunities for program improvement. The implication was that a new QI model for peer review seems to be evolving. [1]

While it is premature to judge the potential effectiveness of this model, a 2009 study confirmed these findings in a separate sampling of hospitals. [38] It also showed that important differences among programs predict a meaningful portion of the variation on 32 objective measures of patient care quality and safety. [39] These findings were extended by cohort follow-up studies conducted in 2011 [10] and 2015–16. [6]

The 2015-16 study refined QI model identifying 20 features that distinguish the most effective programs. These include among other factors: aiming first and foremost at improving quality, standardizing review process, maintaining high quality of case review, promoting self-reporting of adverse events, near misses and hazardous conditions, identifying opportunities for improvement in the review process (as opposed to casting blame), providing timely clinical performance feedback, recognizing clinical excellence, and establishing effective program governance. as additional multivariate predictors of the impact of clinical peer review on quality and safety, medical staff perceptions of the program, and clinician engagement in quality and safety initiatives. [6] The online supplement to the report includes a program self assessment tool which is also available as a free online utility. [40] Despite a persistently high annual rate of major program change, about two-thirds of programs still have significant opportunity for improvement. It is argued that the outmoded QA model perpetuates a culture of blame that is toxic to efforts to advance quality and high reliability among both physicians and nurses. [6]

United States

In the US, peer review activity is generally protected under state statutes. The protection may include confidentiality of the review process and protection to reviewers and institutions for good faith efforts to improve quality and safety through review activity. Such statutes may also specify whether or not the physician conducting the review must be in active practice. The nature of that protection varies widely. For example, Texas is generally considered to have fairly robust protections, [41] whereas Florida protections [42] were undermined by a constitutional amendment that exposed peer review data to discovery. [43] [44]

Health Care Quality Improvement Act

US federal law generally trumps state law. The federal Health Care Quality Improvement Act ("HCQIA"), 42 U.S.C. § 11112, enacted in 1986, sets standards that professional review actions must meet in order to receive protection under the Act. It requires that the action be taken in the reasonable belief that it will advance healthcare quality based on facts obtained through reasonable efforts with due process and fairness to the involved physician. When peer review leads to an action to limit or revoke clinical privileges, the physician is entitled to both a fair hearing and the right of appeal. [45]

Congress explicitly stated the rationale for this legislation as follows:

(1) The increasing occurrence of medical malpractice and the need to improve the quality of medical care have become nationwide problems that warrant greater efforts than those that can be undertaken by any individual State. (2) There is a national need to restrict the ability of incompetent physicians to move from State to State without disclosure or discovery of the physician's previous damaging or incompetent performance. (3) This nationwide problem can be remedied through effective professional peer review. (4) The threat of private money damage liability under Federal laws, including treble damage liability under Federal antitrust law, unreasonably discourages physicians from participating in effective professional peer review. (5) There is an overriding national need to provide incentive and protection for physicians engaging in effective professional peer review. [46]

From the time of the HCQIA, there has been good alignment between regulatory and accrediting bodies with respect to due process requirements for physician disciplinary actions. These formalities apply primarily to questions of competence (credentialing and privileging) rather than performance (routine clinical peer review). It would be most unusual to find a hospital whose medical staff bylaws did not conform.

National Practitioner Data Bank

HCQIA enabled the creation of a National Practitioner Data Bank and required hospitals, state medical boards and other health care entities who engage in formal peer review activities to report all disciplinary actions that affect clinical privileges for more than 30 days. This includes incidents in which a provider voluntarily resigns privileges while under investigation. An entity that fails to report as required may lose HCQIA protections for three years. [47]

The HCQIA (§ 11135) requires hospitals to query the NPDB in their initial credentialing and bi-annual provider re-credentialing processes. [47] Structurally, this process fulfills the congressional intention of restricting movement of incompetent physicians. Disciplinary actions may be a red flag for issues of global incompetence, but the problem may be focal, not global. Thus, the NPDB has been criticized for having the unintended consequence of having adverse economic impact on providers who were reported regardless of the magnitude of the issue. [48] Even so, gross under-reporting of adverse actions remains an issue. [49]

Patient Safety and Quality Improvement Act

The Patient Safety and Quality Improvement Act of 2005 ("Patient Safety Act"), Public Law 109–41, USC 299b-21-b-26 [50] amended title IX of the Public Health Service Act to create a general framework to support and protect voluntary initiatives to improve quality and patient safety in all healthcare settings through reporting to Patient Safety Organizations (PSO). This was intended to include peer review. The final rule promulgated by the Agency for Healthcare Research and Quality in 2008 at 42 CFR Part 3 [51] also includes protections against reprisals for good-faith reporters of adverse events, near misses and hazardous conditions. Several Florida health systems subsequently formed PSOs in expectation of using federal statutory protections to maintain the confidentiality of peer review activity that would have been exposed under Amendment 7. The subsequent legal challenges to this strategy go beyond the scope of this article.

External peer review

In the US, following enactment of the HCQIA, executives from various national medical associations and health care organizations formed the non-profit American Medical Foundation for Peer Review and Education [52] to provide independent assessment of medical care.

A 2007 study showed that the vast majority of physician peer review is done "in house": 87% of US hospitals send less than 1% of their peer review cases to external agencies. The external review process is generally reserved for cases requiring special expertise for evaluation or for situations in which the independent opinion of an outside reviewer would be helpful. The process is significantly more costly than in-house review, since the majority of hospital review is done as a voluntary contribution of the medical staff.

Mandated external peer review has not played an enduring role in the US, but was tested back in the 70s. A 1972 amendment to the Social Security Act established Professional Standards Review Organizations (PSRO) with a view to controlling escalating Medicare costs through physician-organized review. [53] The PSRO model was not considered to be effective and was replaced in 1982 by a further act of Congress which established Utilization and Quality Control Peer Review Organizations (PROs). This model too was fraught with limitations. Studies of its methods called into question its reliability and validity for peer review. [54] A survey of Iowa state medical society members in the early 90s regarding perceptions of the PRO program illustrated the potential harm of a poorly designed program. [55] Furthermore, the Institute of Medicine issued a report identifying the system of care as the root cause of many instances of poor quality. As a result, in the mid-90s, the PROs changed their focus and methods; and began to de-emphasize their role as agents of external peer review. The change was completed by 2002, when they were renamed Quality Improvement Organizations. [56] [57]

In contrast, external peer review has been used by German hospitals to lower their standardized mortality rate [58]

Abuse

Sham peer review is a name given to the abuse of a medical peer review process to attack a doctor for personal or other non-medical reasons. [59] State medical boards have withheld medical records from court to frame innocent physicians as negligent. [60] [61] Another type of review similar to sham peer review is "incompetent peer review," in which the reviewers are unable to accurately assess the quality of care provided by their colleagues. [62]

Controversy exists over whether medical peer review has been used as a competitive weapon in turf wars among physicians, hospitals, HMOs, and other entities and whether it is used in retaliation for whistleblowing. Many medical staff laws specify guidelines for the timeliness of peer review, in compliance with JCAHO standards, but state medical boards are not bound by such timely peer review and occasionally litigate cases for more than five years. Abuse is also referred to as "malicious peer review" by those who consider it endemic, and they allege that the creation of the National Practitioner Data Bank under the 1986 Healthcare Quality Improvement Act (HCQIA) facilitates such abuse, creating a 'third-rail' or a 'first-strike' mentality by granting significant immunity from liability to doctors and others who participate in peer reviews.

The American Medical Association conducted an investigation of medical peer review in 2007 and concluded that while it is easy to allege misconduct, proven cases of malicious peer review are rare. [63] Parenthetically, it is difficult to prove wrongdoing on behalf of a review committee that can use their clinical and administrative privileges to conceal exculpatory evidence. [64] [65]

The California legislature framed its statutes so as to allow that a peer review can be found in court to have been improper due to bad faith or malice, in which case the peer reviewers' immunities from civil liability "fall by the wayside". [66]

Dishonesty by healthcare institutions is well-described in the literature [67] [68] [69] and there is no incentive for those that lie to the public about patient care to be honest with a peer review committee. [65] [70] [71]

Incidents of alleged sham peer review are numerous and include cases such as Khajavi v. Feather River Anesthesiology Medical Group, [63] [72] [73] Mileikowsky v. Tenet, [74] [75] [76] and Roland Chalifoux. [77] [78]

Defenders of the Health Care Quality Improvement Act state that the National Practitioner Data Bank protects patients by helping preventing errant physicians who have lost their privileges in one state from traveling to practice in another state. Physicians who allege they have been affected by sham peer review are also less able to find work when they move to another state, as Roland Chalifoux did. [78] Moreover, neither opponents or supporters of the NPDB can be completely satisfied, as Chalifoux' case shows that just as physicians who were unjustly accused may be deprived of work in this way, those who have erred might still find work in other states.

See also

Related Research Articles

A medical error is a preventable adverse effect of care ("iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, infection, or other ailments.

Clinical audit is a process that has been defined as a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change

<span class="mw-page-title-main">Nurse practitioner</span> Mid-level medical provider

A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications and formulate treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion.

A clinical nurse specialist (CNS) is an advanced practice nurse who can provide advice related to specific conditions or treatment pathways. According to the International Council of Nurses (ICN), an Advanced Practice Nurse is a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice.

Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.

A patient safety organization (PSO) is a group, institution, or association that improves medical care by reducing medical errors. Common functions of patient safety organizations are data collection, analysis, reporting, education, funding, and advocacy. A PSO differs from a Federally designed Patient Safety Organization (PSO), which provides health care providers in the U.S. privilege and confidentiality protections for efforts to improve patient safety and the quality of patient care delivery

Case management is a managed care technique within the health care coverage system of the United States. It involves an integrated system that manages the delivery of comprehensive healthcare services for enrolled patients. Case managers are employed in almost every aspect of health care and these employ different approaches in the control of clinical actions.

<span class="mw-page-title-main">Nursing in the United States</span> Overview of nursing in the United States of America

Nursing in the United States is a professional health care occupation. It is the largest such occupation, employing millions of certified professionals. As of 2023, 3,175,390 registered nurses were employed, paid a median income of $86,070.

The medical home, also known as the patient-centered medical home (PCMH), is a team-based health care delivery model led by a health care provider to provide comprehensive and continuous medical care to patients with a goal to obtain maximal health outcomes. It is described in the "Joint Principles" as "an approach to providing comprehensive primary care for children, youth and adults."

The Healthcare Quality Improvement Act of 1986 (HCQIA) was introduced by Congressman Ron Wyden from Oregon.

The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is a certification body for nursing board certification and the largest certification body for advanced practice registered nurses in the United States, as of 2011 certifying over 75,000 APRNs, including nurse practitioners and clinical nurse specialists.

Maintenance of Certification (MOC) is a recently implemented and controversial process of physician certification maintenance through one of the 24 approved medical specialty boards of the American Board of Medical Specialties (ABMS) and the 18 approved medical specialty boards of the American Osteopathic Association (AOA). The MOC process is controversial within the medical community, with proponents claiming that it is a voluntary program that improves physician knowledge and demonstrates a commitment to lifelong learning. Critics claim that MOC is an expensive, burdensome, involuntary and clinically irrelevant process that has been created primarily as a money-making scheme for the ABMS and the AOA.

<span class="mw-page-title-main">Society of Hospital Medicine</span>

The Society of Hospital Medicine (SHM) is a membership society for hospitalists, physicians, and other caregivers who practice the specialty of hospital medicine.

Glenn Laffel is a physician and health IT entrepreneur. He formerly served as the Senior Vice President of Clinical Affairs for Practice Fusion, a San Francisco-based company that offers a Web-based Electronic Health Record (EHR) for free to physicians.

Clinical point of care (POC) is the point in time when clinicians deliver healthcare products and services to patients at the time of care.

<span class="mw-page-title-main">Holistic nursing</span> Medical care practice

Holistic nursing is a way of treating and taking care of the patient as a whole body, which involves physical, social, environmental, psychological, cultural and religious factors. There are many theories that support the importance of nurses approaching the patient holistically and education on this is there to support the goal of holistic nursing. The important skill to be used in holistic nursing would be communicating skills with patients and other practitioners. This emphasizes that patients being treated would be treated not only in their body but also their mind and spirit.. Holistic nursing is a nursing speciality concerning the integration of one's mind, body, and spirit with his or her environment. This speciality has a theoretical basis in a few grand nursing theories, most notably the science of unitary human beings, as published by Martha E. Rogers in An Introduction to the Theoretical Basis of Nursing, and the mid-range theory Empowered Holistic Nursing Education, as published by Dr. Katie Love. Holistic nursing has gained recognition by the American Nurses Association (ANA) as a nursing specialty with a defined scope of practice and standards. Holistic nursing focuses on the mind, body, and spirit working together as a whole and how spiritual awareness in nursing can help heal illness. Holistic medicine focuses on maintaining optimum well-being and preventing rather than just treating disease.

The National Practitioner Data Bank (NPDB) is a database operated by the U.S. Department of Health and Human Services that contains medical malpractice payment and adverse action reports on health care professionals. Hospitals and state licensing boards submit information on physicians and other health care practitioners, including clinical privileges restrictions, actions against physicians' licenses, and medical malpractice payments that is kept in the NPDB database. Only authorized users are permitted by statute to "query" this information in the NPDB.

Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.

Credentialing is the process of establishing the qualifications of licensed medical professionals and assessing their background and legitimacy.

There are more than 100 different titles that are used as another name to Transfusion Practitioner (TP). The most common titles used include Transfusion Practitioner, Haemovigilance Officer, Transfusion Safety Officer, Transfusion Nurse, Patient Blood Management (PBM) Practitioner, and PBM Nurse.

References

  1. 1 2 Edwards MT, Benjamin EM (2009). "The process of peer review in US hospitals" (PDF). Journal of Clinical Outcomes Management. 16 (10): 461–467.
  2. 1 2 Dans, Peter E. (1 April 1993). "Clinical peer review: burnishing a tarnished icon". Annals of Internal Medicine . 118 (7): 566–8. doi:10.7326/0003-4819-118-7-199304010-00014. PMID   8442628. S2CID   45863865.
  3. ↑ Haines, S. (1984). "Hospital peer review systems: an overview". Health Matrix. 2 (4): 30–2. PMID   10272757.
  4. ↑ "page 131" (PDF).
  5. ↑ "AMA – Medical Peer Review". www.ama-assn.org. Archived from the original on 2009-02-11.
  6. 1 2 3 4 5 6 7 8 9 Edwards, Marc T (October 2018). "In pursuit of quality and safety: an 8-year study of clinical peer review best practices in US hospitals". International Journal for Quality in Health Care. 30 (8): 602–607. doi: 10.1093/intqhc/mzy069 . PMID   29635470.
  7. ↑ "High Reliability Healthcare". www.jointcommission.org.
  8. ↑ "Commission. Behaviors that Undermine a Culture of Safety. Sentinel Event Alert 40 (2008). (last accessed 1/30/19)". Archived from the original on 2022-01-23. Retrieved 2021-03-21.
  9. ↑ "Oregon Peer Review Statute".
  10. 1 2 Edwards, M. T. (2013). "A longitudinal study of clinical peer review's impact on quality and safety in U.S. Hospitals". Journal of Healthcare Management. 58 (5): 369–84, discussion 384–5. doi:10.1097/00115514-201309000-00011. PMID   24195344. S2CID   38480374.
  11. 1 2 American Nurses Association. (1988). Peer review in nursing practice. Kansas City, MO
  12. 1 2 "Growth of the Program – American Nurses Credentialing Center – ANCC". Archived from the original on 2011-08-05. Retrieved 2011-07-23.
  13. 1 2 Davis, Karen K.; Capozzoli, Joe; Parks, Joyce (2009). "Implementing peer review: guidelines for managers and staff". Nursing Administration Quarterly. 33 (3): 251–7. doi:10.1097/NAQ.0b013e3181accb62. PMID   19546745. S2CID   5883834.
  14. 1 2 Rout, Amelia; Roberts, Paula (February 2008). "Peer review in nursing and midwifery: a literature review". Journal of Clinical Nursing. 17 (4): 427–42. doi:10.1111/j.1365-2702.2007.01934.x. PMID   17419775.
  15. 1 2 Hitchings, Kim S.; Davies-Hathen, Nancy; Capuano, Terry Ann; Morgan, Georgiann; Bendekovits, Rita (2008). "Peer case review sharpens event analysis". Journal of Nursing Care Quality. 23 (4): 296–304. doi:10.1097/01.NCQ.0000324210.34497.f5. PMID   18528303. S2CID   23046105.
  16. 1 2 Pearson, Marjorie L.; Lee, Jan L.; Chang, Betty L.; Elliott, Marc; Kahn, Katherine L.; Rubenstein, Lisa V. (November 2000). "Structured implicit review: a new method for monitoring nursing care quality". Medical Care. 38 (11): 1074–91. doi:10.1097/00005650-200011000-00003. JSTOR   3767807. PMID   11078049. S2CID   31948125.
  17. ↑ Haag-Heitman, Barb; George, Vicki (11 September 2011). "Nursing peer review: Principles and practice". American Nurse Today. 6 (9): 48–53.
  18. ↑ Haag-Heitman, B. & George, V. (2011). Peer Review In Nursing: Principles for Successful Practice. Sudbury, MA: Jones and Bartlett
  19. ↑ Haag-Heitman, B. & George, V. (2010). Guide for Establishing Shared Governance: A Starter's Tool Kit. Sliver Spring. MD: American Nurses Credentialing Center (ANCC)
  20. ↑ George, Vicki; Haag-Heitman, Barb (March 2011). "Nursing peer review: the manager's role". Journal of Nursing Management. 19 (2): 254–9. doi: 10.1111/j.1365-2834.2011.01225.x . PMID   21375629.
  21. ↑ Milchak, J. L.; Shanahan, R. L.; Kerzee, J. A. (2012). "Implementation of a peer review process to improve documentation consistency of care process indicators in the EMR in a primary care setting". Journal of Managed Care Pharmacy. 18 (1): 46–53. doi:10.18553/jmcp.2012.18.1.46. PMC   10438320 . PMID   22235954.
  22. ↑ Spier, Ray (2002). "The history of the peer-review process". Trends in Biotechnology. 20 (8): 357–358 [357]. doi:10.1016/s0167-7799(02)01985-6. PMID   12127284.
  23. ↑ Ajlouni KM, Al-Khalidi U (1997). "Medical records, patients outcome, and peer review in eleventh-century Arab medicine". Annals of Saudi Medicine. 17 (3): 326–327. doi:10.5144/0256-4947.1997.326. PMID   17369732.
  24. ↑ Codman EA. A Study in Hospital Efficiency. Boston, MA: T Todd Company; 1917.
  25. ↑ Ponton TR, "Gauging efficiency of hospital and its staff. Modern Hospital 1928;31(Aug):64–68.
  26. ↑ Lembcke PA (1967). "Evolution of the medical audit". JAMA. 199 (8): 543–550. doi:10.1001/jama.1967.03120080077012. PMID   5335644.
  27. 1 2 Legge D (1981). "Peer review in the USA: an historical perspective". Medical Journal of Australia. 1 (13): 709–711. doi:10.5694/j.1326-5377.1981.tb135967.x. PMID   7024757. S2CID   6762159.
  28. ↑ Shaw, Charles D. (31 May 1980). "Aspects of audit. 2. Audit in British hospitals". British Medical Journal. 280 (6227): 1314–6. doi:10.1136/bmj.280.6227.1314. PMC   1601590 . PMID   7388522.
  29. ↑ Jamtvedt, Gro; Young, Jane M.; Kristoffersen, Doris T.; O'Brien, Mary Ann; Oxman, Andrew D. (December 2006). "Does telling people what they have been doing change what they do? A systematic review of the effects of audit and feedback". Quality & Safety in Health Care. 15 (6): 433–6. doi:10.1136/qshc.2006.018549. PMC   2464905 . PMID   17142594.
  30. ↑ van Herk R, Klazinga NS, Schepers RMJ, Casparie (2001). "threat or opportunity for the medical profession. A comparative study of medical audit among specialists in general hospitals in the Netherlands and England, 1970–1999". Soc Sci Med. 53 (12): 1721–32. doi:10.1016/s0277-9536(00)00458-5. PMID   11762896.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  31. ↑ Ivers, Noah M; Barrett, Jon (June 2018). "Using report cards and dashboards to drive quality improvement: lessons learnt and lessons still to learn" (PDF). BMJ Quality & Safety. 27 (6): 417–420. doi: 10.1136/bmjqs-2017-007563 . PMID   29317464.
  32. ↑ "Toward Clinical Excellence: An Introduction to Clinical Audit, Peer Review and Other Clinical Practice Improvements". Ministry of Health NZ.
  33. ↑ Sanazaro PJ, Mills DH. A critique of the use of generic screening in quality assessment. JAMA. 1991;265(15):1977–1981.
  34. ↑ Goldman RL (1994). "The reliability of peer assessments: A meta-analysis". Evaluation and the Health Professions. 17 (1): 3–21. doi:10.1177/016327879401700101. PMID   10132480. S2CID   28236596.
  35. 1 2 Berwick DM (1990). "Peer review and quality management: are they compatible?". Quality Review Bulletin. 16 (7): 246–51. doi:10.1016/s0097-5990(16)30377-3. PMID   2120663.
  36. 1 2 Edwards MT. "Peer review: a new tool for quality improvement. The Physician Executive Journal of Medical Management 2009;35(5):54-59. reprint requests
  37. ↑ Lichtmacher A. Quality assessment tools: ACOG Voluntary Review of Quality Program, peer review reporting system. Obstet Gynecol Clin North Am. 2008;35(1):147–162.
  38. ↑ Edwards, Marc T. (2010). "Clinical Peer Review Program Self-Evaluation for US Hospitals". American Journal of Medical Quality. 25 (6): 474–480. doi:10.1177/1062860610371224. PMID   20733206. S2CID   23236198.
  39. ↑ Edwards, Marc T. (15 December 2010). "The Objective Impact of Clinical Peer Review on Hospital Quality and Safety". American Journal of Medical Quality. 26 (2): 110–119. doi:10.1177/1062860610380732. PMID   21169223. S2CID   34522712.
  40. ↑ "Clinical Peer Review Program Self-Assessment Inventory | QA2QI Consulting".
  41. ↑ "Texas Peer Review Statute".
  42. ↑ "Florida Peer Review Statute".
  43. ↑ (last accessed 1/30/19)
  44. ↑ "Florida Patient's Right to Know, Amendment 7 (2004)". Ballotpedia.
  45. ↑ "[USC02] 42 USC 11101: Findings". uscode.house.gov.
  46. ↑ "[USC02] 42 USC 11101: Findings".
  47. 1 2 "The NPDB – Home Page". www.npdb.hrsa.gov.
  48. ↑ Livingston EH, Harwell JD (2001). "Peer review". Am J Surg. 182 (2): 103–109. doi:10.1016/s0002-9610(01)00679-1. PMID   11574078.
  49. ↑ Baldwin LM, Hart GL, Oshel RE; et al. (1999). "Hospital peer review and the National Practitioner Data Bank: clinical privileges action reports". JAMA. 281 (4): 349–355. doi: 10.1001/jama.282.4.349 . PMID   10432032.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  50. ↑ "govinfo". www.govinfo.gov.
  51. ↑ "Electronic Code of Federal Regulations (eCFR)". Electronic Code of Federal Regulations (eCFR).
  52. ↑ "American Medical Foundation for Peer Review and Education". American Medical Foundation for Peer Review and Education.
  53. ↑ Institute of Medicine, Lohr KN, ed. Medicare: A Strategy for Quality Assurance. Washington, DC: National Academy Press; 1990. (see chapter 7)
  54. ↑ Rubin, HR; Rogers, WH; Kahn, KL; Rubenstein, LV; Brook, RH (1992). "Watching the doctor watchers: how well do peer review organization methods detect hospital quality of care problems?". JAMA. 267 (17): 2349–2354. doi:10.1001/jama.1992.03480170075032.
  55. ↑ Roth, RR; Porter, PJ; Bisbey, GR; May, CR (1993). "The attitudes of family physicians toward the peer review process". Archives of Family Medicine. 2 (12): 1271–5. doi:10.1001/archfami.2.12.1271. PMID   8130910.
  56. ↑ "Quality Improvement Organizations | CMS". www.cms.gov.
  57. ↑ The American Health Quality Foundation. Quality Improvement Organizations and Health Information Exchange. Archived 2009-01-08 at the Wayback Machine Washington, DC: March 6, 2006. (page 14)
  58. ↑ Krahwinkel W, Schuler M, Liebetrau; et al. (2016). "The effect of peer review on mortality rates". Int J Qual Health Care. 28 (5): 594–600. doi: 10.1093/intqhc/mzw072 . PMID   27424326.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  59. ↑ Roland Chalifoux, Jr (2005). "So What Is a Sham Peer Review?". Medscape General Medicine. 7 (4): 47. PMC   1681729 . PMID   16614669.
  60. ↑ "Mishler v. State Bd. of Med. Examiners, 849 P.2d 291, 109 Nev. 287 (1993)". 1993. p. 291. Retrieved 26 April 2016.
  61. ↑ "Mishler v. Nevada State Bd. of Medical Examiners, 896 F.2d 408 (9th Cir. 1990)". 1990. p. 408. Retrieved 26 April 2016.
  62. ↑ "CHAGANTI v. MISSOURI BOARD OF REGISTRATION FOR HEALING ARTS, No. WD 77746 (Mo. Ct. App. Mar. 10, 2015)". 2015. p. 391. Retrieved 26 April 2016.
  63. 1 2 ""Inappropriate Peer Review. Report of the Board of Trustees of the American Medical Association."".
  64. ↑ Deming, W (1 June 2008). "Clinical peer review: a plea for fairness". Catheterization and Cardiovascular Interventions. 71 (7): 1000–1. doi:10.1002/ccd.21544. PMID   18383176. S2CID   20779536.
  65. 1 2 Drew, David (2014-09-28). Little Stories of Life and Death @NHSwhistleblowr. Matador. ISBN   9781783065233.
  66. ↑ Abrams, Greg (May 2006). "Attacking Bad Faith Peer Review: Is It a SLAPP?". Sierra Sacramento Valley Medicine. 57 (3). Archived from the original on 2011-07-21. California law allows "aggrieved physicians the opportunity to prove that the peer review to which they were subject was in fact carried out for improper purposes, i.e., for purposes unrelated to assuring quality care or patient safety".
  67. ↑ Bakaeen, Faisal G.; Blaustein, Alvin; Kibbe, Melina R. (6 August 2014). "Health Care at the VA". JAMA. 312 (5): 481–2. doi:10.1001/jama.2014.8054. PMID   24945974.
  68. ↑ Holmes, D (16 February 2013). "Mid Staffordshire scandal highlights NHS cultural crisis". Lancet. 381 (9866): 521–2. doi:10.1016/s0140-6736(13)60264-0. PMID   23424727. S2CID   5421485.
  69. ↑ Hutchison, JS (March 2016). "Scandals in health-care: their impact on health policy and nursing" (PDF). Nursing Inquiry. 23 (1): 32–41. doi:10.1111/nin.12115. PMID   26189555.
  70. ↑ Bloche, M. Gregg (17 March 2016). "Scandal as a Sentinel Event — Recognizing Hidden Cost–Quality Trade-offs". New England Journal of Medicine. 374 (11): 1001–1003. doi:10.1056/NEJMp1502629. PMID   26981930.
  71. ↑ Titcombe, James (November 30, 2016). Anderson-Wallace, Murray (ed.). Joshua's Story: Uncovering the Morecambe Bay NHS Scandal. Anderson Wallace Publishing. p. 250. ISBN   9780993449208.
  72. ↑ Arnold MS (2000). ""Employment: Physician Not Protected From Termination For Advocating Medically Appropriate Health Care"—Khajavi v. Feather River Anesthesia Medical Group, 100 Cal. Rptr. 2d 627 (Cal. App. 3d 2000)". American Journal of Law & Medicine.
  73. ↑ California Appeals Court (October 10, 2000). "Khajavi v. Feather River Anesthesia Medical Group, Inc".
  74. ↑ Mileikowsky v. Tenet Healthsystem (April 18, 2005) 128 Cal.App.4th 531, 27 Cal.Rptr.3d 171.
  75. ↑ "Health Policy in the Courts – California Medical Association's participation in Amicus Curiae Briefs – January 2007" (PDF). California Medical Association. January 2007. Archived from the original (PDF) on 2006-10-05. Retrieved 2015-06-20.
  76. ↑ Mileikowsky v. West Hills Hosp. and Medical Center (2009) 45 Cal.4th 1259, 203 P.3d 1113, 91 Cal.Rptr.3d 516.
  77. ↑ Horvit M and Jarviss J, "Board revokes doctor's license," Fort Worth Star-Telegram (TX), 12 June 2004, p.1B
  78. 1 2 Mitchell M, "Former Texas neurosurgeon granted licenses in West Virginia," Fort Worth Star-Telegram (TX), 7 July 2005

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.