Cone Health Implements symplr Quality Review to Revolutionize Peer Review Process

The peer review process plays a substantial role in the success of healthcare organizations and the providers on their teams. It helps ensure regulatory compliance, achieve industry best practices, and provide a range of patient care services distinguished by measurable excellence. To improve its antiquated peer review process, Cone Health worked with symplr to implement symplr Quality Review software across its enterprise. Focusing on the health and wellbeing of every community it serves, the North Carolina healthcare network encompasses five hospitals, five ambulatory care centers, three outpatient surgery centers, seven urgent care centers, two retirement communities, and more than 150 physician practices. 

THE CHALLENGE

Hindered by a cumbersome and outdated peer review process  

Cone Health’s long-established paper-based process was inefficient and outdated, resulting in subpar physician engagement. One of the biggest issues the organization needed to resolve was inefficiencies and wasted staff time, such as the effort required by staffers to correctly track down individuals and interpret hand-written documentation, which prolonged the process to complete peer reviews. This caused delayed results and negatively impacted the quality of patient care. 
 
The Cone Health team needed a fair, efficient, and reliable peer review process to safeguard quality initiatives and ensure compliance, while fostering performance improvement and the professional growth of providers. They also needed to generate better action plans from peer reviews to identify best practices or opportunities to improve, enabling providers to own and engage in the process more comprehensively.

Cone Health wanted a fully digital peer review system to enable providers and reviewers to participate in the process from anywhere at any time, which is significantly more efficient compared to in-person meetings and manual operations.

THE SOLUTION

Partnering with symplr to modernize the peer review process and enhance patient care  

In 2015, Cone Health’s medical staff quality team managed a transition to end the punitive culture of the review process and replace it with a “just culture.” They did this by providing education and coaching to peer review participants, replacing “acceptable” practices with best practices that aligned with the system’s accreditation body, and creating a peer review algorithm as a guide for reviewers. After this initial transition, the team began moving from paper to digital records, employing cloud-based software to replace Excel spreadsheets.  

Cone Health partnered with symplr to implement its quality software solution, symplr Quality Review, and in 2019, providers began training on the software for their roles in committee reviews. Soon after, the COVID-19 pandemic began, which came with a new set of challenges that made quality and staff efficiency more paramount than ever before. With about 200 active peer reviewers at Cone Health, the transition was a significant undertaking that has improved physician engagement and the overall peer review process. Their success was in part due to having a dedicated and reliable software partner providing outside support to guide them through the transition. 

“Elevating our peer review process was mission critical to Cone Health, as it safeguards quality initiatives, ensures compliance, and affects patient outcomes and reimbursement under value-based payment systems. We transformed this process, cutting waste, empowering the team, and engaging peer reviewers. We hope that other provider organizations and their patients will benefit from our learnings and implement initiatives that will garner similar success.” 

 - Michelle Reece, RN, BSN, CPH, Manager of Medical Staff Quality 

THE RESULTS

Creating agents of change, reducing costs and maximizing compliance  

Through its partnership with symplr, Cone Health:

• Obtained 100% use of the digital platform across the organization and recorded an increase in case discussions by up to 72% 
• Reduced the time spent to close cases by nearly 30%  
• Experienced improved engagement in colleague-to-colleague discussions during review meetings that led to more comprehensive reviews  
• Saved employees about 16.5 hours of time per month that could be reallocated to patient care