How Does Your Peer Review System Stack Up?

We surveyed hospitals to find out how their peer review systems were working. Find out how your organization’s peer review system compares and how to identify opportunities for improvement.

Peer review, both internal and external, is a core hospital strategy to improve physician performance, patient safety, and quality of care. It is also a vital risk management tool and helps engender higher levels of transparency and accountability in the organization. Considering how important peer review is on all of these levels, how does your system stack up compared to other hospital systems?

We surveyed hospitals to determine what they saw as their areas of strength as well as areas of concern relating to peer review and here are our results:

The first area we asked about was whether participants felt that their peer review system had a clearly defined structure, including policies and procedures that are consistently followed. While 80% of those responding did feel that they had a clearly defined peer review system, another 20% felt that this vital hospital safety and quality improvement measure was either not clearly defined or not followed on a consistent basis.

We next asked whether or not participants felt that their hospital had a policy that describes when external peer review should be done and how to obtain an external review. 66% of respondents felt that their hospital had a policy like this in place, leaving fully one-third of hospitals without a policy that allows them to access and rely on external review as an outside resource to either respond to issues as they come up or work to prevent them proactively.

An important area of concern for hospital systems is the length of time that lapses between the reporting of issues and the actual follow-up and this was demonstrated by the results of our survey. 83% of respondents to our hospital survey felt that in their organization peer reviews of individual cases and performance concerns were not completed within 30 days of initiation. This left only 17% of systems responding with a timeliness that would allow quick corrective action to take place to achieve the best opportunity for performance improvement.

Another area of concern we found with hospitals was in what should trigger a peer review in the first place. 50% of respondents answered that their organization did not have triggers that define when a practitioner should undergo a focused evaluation and/or that those triggers are not consistently applied by all medical staff departments. Unfortunately, without these defined set of triggers and an inconsistent application, the peer review system can often be seen as punitive rather than as the learning opportunity that is the ideal.

Consider the same questions in relation to your organization. Do you have a peer review system in place that is clearly defined and consistently followed? Do you have a policy that lays out when and how to use external peer review resources to augment your internal system? Are your peer reviews conducted within a quick time frame connecting the action to the correction, to provide a learning environment? Does your hospital have clearly defined triggers for when a focused evaluation should be performed and are they consistently applied across all of your departments? Answering these four questions will give you a preliminary idea of how your peer review system stacks up against those of other hospitals.