Clinical Peer Review Research

QA to QI Consulting: Evidence-Based Tools for Healthcare Improvement

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Our Commitment to Advancing Knowledge and Practice

This is not a typical consulting practice. Since 2007, I have devoted at least 1000 hours per year to conduct research and report on best practices in clinical peer review. This area has largely been neglected by academia. This research fulfills my desire to give something back to the profession.

There are no hidden fees to participate in these research projects.

QA to QI products and services are fully informed by this research, but are offered independently. If you find value in my research efforts, please recommend QA to QI Consulting to others.

Our Current Research Agenda

Adding More Detail to the QI Model for Peer Review

• Longitudinal Clinical Peer Review Effectiveness Study: Validating and extending prior work with an exploration of medical staff engagement, strategies for case identification including self-reporting, and the drivers of reviewer participation
• Normative Peer Review Database Project
• Clinical Peer Review Innovation Showcase: Case Studies in Program Improvement

Promoting Adoption of Best Practices

• Ideal Clinical Peer Review Process Collaborative
• Online Peer Review Program Self-Evaluation Tool

Scientific Publications

• Edwards MT, Benjamin EM. The process of peer review in US hospitals. J Clin Outcomes Manage. 2009(Oct);16(10):461-467.
• Edwards MT. Peer review: a new tool for quality improvement. Phys Exec. 2009;35(5):54-59. Request Reprint
• Edwards MT. Measuring clinical performance. Phys Exec. 2009;35(6):40-43. Request Reprint
• Edwards MT. Clinical Peer Review Program Self-Evaluation for US Hospitals. Am J Med Qual. 2010;25(6):474-480. The final definitive version is available online at: http://ajm.sagepub.com/cgi/content/abstract/25/6/474; Request Postprint
  • Abstract
    Prior research has shown wide variation in clinical peer review program structure, process, governance and perceived effectiveness. This study sought to validate the utility of a Peer Review Program Self-Evaluation Tool as a potential guide to physician and hospital leaders seeking greater program value. Data from 330 hospitals show that the Total Score from the Self-Evaluation Tool is strongly associated with perceived quality impact. Organizational culture also plays a significant role. When controlling for these factors, there was no evidence of benefit from a multi-specialty review process. Physicians do not generally use reliable methods to measure clinical performance. A high rate of change since 2007 has not produced much improvement. The Peer Review Program Self-Evaluation Tool reliably differentiates hospitals along a continuum of perceived program performance. The full potential of peer review as a process for improving the quality and safety of care has yet to be realized.
• Edwards MT. The Objective Impact of Clinical Peer Review on Quality of Care. Am J Med Qual. 2011;26(2):110-119. The final definitive version is available online at: http://ajm.sagepub.com/content/26/2/110.short; see the press release.
  • Abstract
    Despite its importance, the objective impact of clinical peer review on the quality and safety of care has not been studied. Data from 296 acute care hospitals show that peer review program and related organizational factors can explain up to 18% of the variation in standardized measures of quality and patient safety. The majority of programs rely on an outmoded and dysfunctional process model. Adoption of best practices informed by continuing study of peer review program effectiveness has potential to significantly improve patient outcomes.
• Edwards MT. Minimizing Bias in Clinical Peer Review. Phys Exec. 2011;37(6):50-54. Request Reprint.
• Edwards MT. Engaging Physicians in Patient Safety through Self-Reporting of Adverse Events and Better Clinical Peer Review Process. Phys Exec. 2012;38 - In Press. Request Preprint
• Edwards MT. A Framework for Patient Safety: Leverage Points for Improvement. Submitted for publication. Request Preprint

Annotated Bibliographies

• Clinical Peer Review Program-Specific Reports
• Clinical Peer Review Methodological Studies
• Anesthesiology Clinical Peer Review

Links

• Clinical Peer Review Process Improvement Resources
• Clinical Peer Review Innovation Showcase
• The QI Model
• The History of the QA Model
• Online Peer Review Program Self-Evaluation Tool
• Normative Peer Review Database Project
• Ideal Peer Review Process Collaborative
• QA to QI Patient Safety Organization
• The Peer Review Enhancement Program^SM

• Evidence-Based Answers

  • Optimal Case Review Volume
  • Pre-Review Screening
  • Centralization of Peer Review
  • Non-Physician Medical Staff Peer Review
  • Morbidity & Mortality Conferences

• Whitepapers

  • Measuring Clinical Performance
  • The Peer Review Improvement Opportunity
  • Reflections on Medical Staff Bylaws
  • Minimizing Bias in Clinical Peer Review
  • Engaging Physicians in Patient Safety
  • A Framework for Patient Safety

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© 2007-2011 Marc T. Edwards

QA to QI LLC Last modified: January 8, 2012