Stop Fighting & Develop a Peer Review Program

Peer Review, Peer Review Software, OPPE, FPPEMedicine, a historically conservative and traditional profession, framed on the fundamentals of research, continuing education, and collegial relationships is being challenged by today’s complicated healthcare landscape. From the periphery, this foundation appears as a distraction to the mandate of validating the intimacy of a positive physician/client relationship. Focused and Ongoing Professional Practice Evaluations (FPPE/OPPE), Patient Safety and Meaningful Use are the mantra of healthcare today.

The assault of requirements, mandates and standards drive uncertainty and an atmosphere that’s simply not conducive to or focused on healing. Add decreasing reimbursements, increasing expectations and an aging, wiser clientele and it’s logical that early retirement is fast becoming an attractive option for physicians today. Couple this with an unproductive, heavy handed Peer Review process and the perfect storm is brewing to vent frustrations experienced by healthcare professionals at every level.

Current Issues

The Peer Review process often seems obstructive rather than supportive, argumentative rather than collegial, and insulting rather than validating. The current requirements of peer review create a maze of standards as well as expectations. The components monitored range from PSI, CM, HCAPS facility triggers, AHRQ items, complications, ALOS, readmissions, behavioral issues, professional issues to patient and staff complaints distract even the most ardent practitioner. These items, while important markers of patient care, also seem confining to personal practice and insulting to professional performance and conduct standards.

Physician Participation Lacking

Ask anyone to name some of the reasons for the lack of physician buy-in to Peer Review and you will hear repeating themes described by risk managers and quality directors alike. The most frequent causes for the lack of physician participation are:

  1. Too time consuming

  2. Lack of perceived relevance

  3. Lack of accountability

Future of Peer Review

Although many current peer review programs have issues, the programs were developed thoughtfully and with sincere intent to deliver the most efficient and safe environment for patients to heal. Is it possible for Peer Review to become more constructive, supportive and meaningful? Yes, with creative ideas, simplifying processes and a willingness to review and alter archaic programs. These are key components to moving a cumbersome, unsuccessful program to a supportive, efficient and meaningful system.

In the coming weeks, we’ll examine the peer review processes in an exclusive three part blog series which will discuss options to:

  1. Make Peer Review more efficient for physicians and staff

  2. Make Peer Review more relevant and effective to the daily practice

  3. Shift accountability from a top down punitive approach to one of collegial interest and support.

Join us as we consider the old and the new while sharing options to effect change and increase confidence in your program. You too can move challenges to opportunities and develop your peer review program to be the efficient, pertinent and collegial program it was intended to be.

For more information on the FPPE/OPPE processes, click the image below. As a bonus offer, downloading our white paper will automatically register you to receive the upcoming three part series on Peer Review directly in your inbox.
Provider Credentialing


Melissa Outlaw

About the Author
Melissa Outlaw

Melissa Outlaw is a Vice President, Customer Success with symplr. Melissa and her team assist clients in learning and implementing our provider management software - credentialing, privileging, peer review, quality and event reporting applications. She supports clients in benchmarking current internal practices, identifying potential efficiencies, then driving the integration of technology with process improvement to reduce time of service and operating expenses. She works extensively with decentralized, multi-facility organizations in transitioning to a shared service center as well as assisting healthcare organizations bridge the gap between procedures performed by a provider and their privileges granted.

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