Move Toward Best Practices for Hospital Peer Review
An independent review organization can quickly help hospital litigation teams and quality managers understand litigation cases and provide outside insight into a peer review case.
Often, the first time hospitals come to an Independent Review Organization (IRO) seeking medical peer review services, they have cases that are in litigation — sometimes for months or even years. Other times they bring cases subject to potential litigation. An IRO can quickly help hospital litigation teams and quality managers understand these situations better. This makes their decisions about the next course of action easier. With a case in litigation, if a hospital discovers that their physician is at fault, then they can cut their losses and settle the case quickly, rather than incurring more expense on a case that they are not likely to win.
Once hospitals resolve a case successfully using an outsourced peer reviewer, they begin to see long-term benefits of using an IRO and how that can become a best practice. Organizations working to reduce negative patient outcomes and sentinel events by applying “best practices” to the peer review process will improve their quality of care. When they understand this, the hospital will invariably send a percentage of its peer review committee cases to the IRO for review.
Some hospitals will send cases in groups. They ask an IRO not to look just at “bad outcomes,” but at good cases that provide a broader context of the hospital. For example, several “bad outcome” cases might be interspersed in a larger sampling of cases where nothing went wrong. This approach assures that an IRO´s peer specialists are getting a representative sampling of cases and allows for a higher degree of objectivity in the review.
Many hospitals have gone from a successful experience outsourcing sensitive cases to an IRO to using an IRO as part of an ongoing quality management process. AllMed and other IROs work with oncology groups, radiology groups and other specialty groups inside hospitals establishing a proactive, systematic approach for sending out sensitive cases. We also have reviewed samplings for other specialty areas including general surgery, orthopedics and neurosurgery — all with excellent results. These results are helping to make outsourced peer review for hospitals and medical groups a rapidly-adopted “best practice”.
