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Effective Peer Review The Complete Guide to Physician Performance Improvement, Third Edition Robert J. Marder, MD Peer review continues to rate as a top problematic issue in healthcare organizations. Even if they are meeting regulatory standards, most organizations struggle to develop a peer review program that is meaningful to physicians, causing them to become resistant to this performance measurement tool. This new edition explains the connection between peer review, OPPE, and FPPE. It also contains updated information on OPPE and FPPE as related to The Joint Commission's standards. This book also incorporates three previous books: Effective Peer Review, Peer Review Best Practices, and Measuring Physician Competency. Now readers have one, all-encompassing resource to answer their peer review and physician performance questions. This completely updated book will help you: Engage physicians in the peer review processCreate tools to recognize and celebrate excellenceDesign OPPE profiles and create a plan for distributing the information to physiciansEliminate bias and improve case reviewer efficiencyDetermine if your peer review policies comply with regulatory standards Take a look at the Table of Contents: Chapter 1: Peer Review: Why Do We Need to Measure Physician Competence? What Peer Review IsWhat Peer Review Is NotWho Is a Peer?Impartiality and Conflicts of interestSham Peer ReviewsThe Duty to Perform Effective Peer ReviewShould Physicians Be Paid to Perform Peer Reviews? Chapter 2: From Punitive to Positive: Creating a Performance Improvement Culture for Peer Review How Can Culture Change?Values of a Performance Improvement–Focused Peer Review CulturePeer Review and the Just Culture Chapter 3: Legal Considerations: Impact of Regulations and Liability on Peer Review Redefining Peer Review: OPPE, FPPE, and the Core CompetenciesHow the Standards ApplyPeer Review Protection LawsAffirmative Duty to Keep Information ConfidentialFair HearingsThe National Practitioner Data BankNegligent Peer Review Chapter 4: Peer Review Structures: The Impact of Multi-Specialty Peer Review Peer Review Structures: Three Primary FunctionsGoals for Peer Review RedesignBasic Peer Review ModelsWho Should Oversee Peer Review?Selecting the Right ModelPhysician Behavior: Who Should Handle It? Chapter 5: Measuring Physician Performance: What to Measure and How to Do It Fairly? What Is a Physician Performance Indicator?Indicator Validity: Selecting Physician-Driven MeasuresWhat Are You Required to Measure?What to Measure: Structure, Process, and OutcomeHow to Measure Physicians Fairly: Review, Rate, and Rule IndicatorsUnderstanding and Improving Risk- Adjusted DataUsing Perception Data to Evaluate Physician PerformanceCase Study Indicator Selection Chapter 6: Case Review: Reducing Bias and Improving Reviewer Efficiency and Effectiveness Standardizing the Case Review ProcessCase Identification and ScreeningPhysician Reviewer AssignmentPhysician Review and Initial Case Rating Initial Committee Review and Physician Input Committee Decision and Improvement Opportunity IdentificationCommunication of Findings and Follow-Up AccountabilityCase Rating SystemsCase Review and the Electronic Age Chapter 7: Selecting Physician-Driven Measures for OPPE: Understanding and Applying the Six Core Competencies ACGME, ABMS, and The Joint Commission: Where Did the Core Competencies Come From and How Are They Used?Alternative Frameworks to the Core CompetenciesUsing the Competency Statement and Expectations to Drive Physician Performance MeasuresApplying the Core Competencies to OPPE Chapter 8: Physician Data Attribution: Making OPPE Data Meaningful to |
