Peer Review Improves Quality Management

BEST PRACTICE: EXTERNAL PEER REVIEW IMPROVES QUALITY MANAGEMENT FOR RURUAL HOSPITAL

Located in the coastal community of Coos Bay, Oregon, Bay Area Hospital provides care to the 15,000 Coos Bay residents and 80,000 rural inhabitants living between Reedsport and the California border. It has over 1000 employees, 130 doctors and 100 volunteers and is governed by an elected five-member board of directors.

Like many smaller hospitals serving a rural area, it often had trouble finding doctors without a conflict of interest or with suitable medical experience and credentials for conducting peer reviews.

The small staff and close working relationships at Bay Area Hospital have made it difficult to handle hospital physician reviews internally. In addition, its doctors were sensitive to reviewing colleagues with whom they work and often depend on.

With just 130 doctors on staff, conflict of interest makes conducting anonymous peer reviews impossible. Oftentimes, the doctors simply preferred not to review their peers.

Bay Area Hospital was once part of a group of hospitals sharing peer reviews. While sharing reviews with other hospitals lessened the conflict of interest issue, the timeliness of the reviews became an issue, as did finding the right specialists.

As the need for more review specialists and timeliness increased, the hospital began sending cases to an IRO, usually general surgery and orthopedic, and occasionally radiology cases.
Turnaround for these batches of cases has improved nearly 70 percent. Depending on the type of review, the turnaround time can be as little as seven to 10 days.

Bay Area Hospital relies on its skilled doctors to help correct operational failures during patient care. Its small staff of dedicated and concerned doctors are working hard to deliver patients quality care and the facility and understands that peer review is a necessary part of that process. This effort, with a mix of external case and peer reviews, brings about systematic and organizational improvements that increase patient safety for Coos Bay-area residents.

Note: If your organization has a best practice that would help others, e-mail your idea to AllMed at info@allmedmd.com.

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