Physician Peer Review

What is Peer Review?

Peer review is an external review of cases for the purpose of evaluating the overall quality of care provided, including outcomes, case selection, and appropriateness. Peer Review emphasizes the review of facts related to specific cases by a peer (i.e., a physician in the same specialty) to provide an opinion on the care provided and any opportunities for improvement, further training, or other education.

Peer review is also used as a tool to endorse best practices as well showcase adherence to clinical practice and/or societal guidelines. The results of peer review should always be shared with providers, and is often shared among peers as well, especially as a learning opportunity.  Peer review can be the means whereby hospitals gather data that highlights clinical quality, which can also be shared with the community.

What key benefit will my program realize with Peer Review?

Peer review, when completed proactively, provides an external opinion on the quality of care being provided by program physicians. The effort measures compliance with established best practices and guidelines, and engages physicians in continued quality improvement (CQI) by sharing valuable feedback. A proactive approach to peer review also establishes a forum to share this information and feedback on a regular basis, which allows the focus to be on holistic program quality, rather than addressing any specific fallouts, or never events when they occur.

Won’t Peer Review make my physicians feel a lack of trust in their ability?

No. In fact, proactive peer review encourages best practices and early identification of opportunities and resolution of problems BEFORE they happen. Evaluating physician performance can provide evidence of best practice, care consistency, and quality outcomes. Again, the peer review forum also allows for open communication related to program quality, and the external third party can maintain confidentiality with the information so as to avoid any interpersonal issues between colleagues who may review each other’s cases.

What are the qualifications of Corazon’s Peer Reviewers?

Corazon’s reviewers are active in the specialty area (e.g. interventional cardiology, cardiac surgery, etc.) in a clinical and/or administrative capacity, and therefore expertly understand the standards by which to review others. Our physicians are experienced with all components of peer review and what drives quality for a cardiovascular program. Corazon also monitors our reviewers’ quality reports and outcomes to ensure they are maintaining high quality in their own practices.

Should I combine Peer Review with Accreditation?

Peer review and Accreditation are two vital components to ongoing program quality. Whether the peer review is incorporated through Corazon’s Platinum Accreditation, or as a parallel engagement, the two approaches allow a hospital to reap the benefits of a full program review. Accreditation can lead to better quality and a continued reflection of best practices and care consistency, which in turn can streamline operations and lower costs. In competitive markets, accreditation can create an edge over programs offering a similar scope of services, and the community perception and reputation of the hospital can be enhanced.

How long does a Peer Review take? Can we choose how many records are included?

Peer Review typically requires two to four weeks to complete following the submission of cases and associated documentation. This process can be expedited, if needed, and will be established at the beginning of any peer review support to ensure feedback is shared at regular intervals and in a timely manner.

The number of cases under review is up to the client; and oftentimes the turnaround for the reviews is contingent on the number of cases submitted. Corazon can provide input based on a percentage of client volumes, as requested, and the number of records can be adjusted as the peer review continues.

What happens if our Peer Review reveals quality issues?

As part of Corazon’s process, quality issues will be identified through the review feedback forms and shared with the client’s primary point of contact. From there, Corazon will recommend the necessary course of action to improve the identified issues (e.g., additional education, proctoring, further peer review, etc.).

Today’s specialty programs are under greater quality scrutiny than ever before. Should a quality issue be identified through the review, a timely and proactive approach in correcting the issue will be far less costly than the alternative of ignoring the issue until a failed outcome results.

What makes Corazon’s Peer Review different from our internal Peer Review processes?

Internal peer review is a valuable component for hospitals to have in place. However, some programs may only have one practice engaged in the program, in which case the peer review process could jeopardize an otherwise positive collegial relationship among physicians. Utilizing an independent third party removes these obstacles and allows for candid feedback. Furthermore, a national firm like Corazon also offers a broader perspective based on the practice patterns and patient mix of various programs across the country, and our reviewers reflect this depth and breadth of expertise and experience.

Why choose Corazon for Peer Review?

Based on the depth and breadth of Corazon’s knowledge and resources, the team can help clients address any issue or question that may arise through the review process. Corazon treats all clients as partners, and therefore the goal of any peer review support is to share in the success of the program and highlight the quality of services being offered.