What is it about?
This study looked at the process by which physicians evaluate the clinical performance of other physicians. It followed the evolution of practices at 457 US hospitals from 2007 to 2015. The data from four surveys informed a best practice Quality Improvement (QI) model and a related program self-assessment inventory. It showed that, despite a high rate of major program change, few hospitals have implemented additional best practices. About two-thirds have yet to adopt the QI model.
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Why is it important?
This process, commonly known as clinical peer review, is the dominant method for investigation of adverse events in US hospitals. Few programs incorporate the best practices which would enable them to translate this work into improved quality and safety of care. Prevailing practice is actually antithetical to improvement efforts because it sustains an environment of distrust and fear. In most hospitals, physicians and other clinicians are safer to hide their mistakes. Hospital and physician leaders could potentially accelerate progress in quality and safety by revisiting their clinical peer review practices in light of the evidence-based QI model.
Perspectives
I’m chagrined that so little improvement has occurred despite my past efforts to document the problematic nature of prevailing clinical peer review practice. I hope this article will get the attention it needs.
Dr Marc T Edwards
QA to QI Patient Safety Organization
Read the Original
This page is a summary of: 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, April 2018, Oxford University Press (OUP),
DOI: 10.1093/intqhc/mzy069.
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