Ask the expert: What are best practices for conducting retrospective FPPE?

The following are best practices to use when conducting retrospective focused professional practice evaluations (FPPE):

• Standardize the case review method and scoring system to remove bias and make evaluation reports comparable across the board, as is done with concurrent or prospective FPPE. Many medical staffs use the same scoring method they developed for their peer review case process for FPPE. This method may work for your medical staff if the information gathered for peer review matches that needed for focused review. If not, design a unique report and scoring method. 
• Assign a nonphysician reviewer to prescreen the medical record to increase the efficiency of the reviewer and ease the problem of increased time consumption for review. The nonphysician reviewer can identify the major issues and outcomes in the case, preventing the physician reviewer from having to wade through record stacks. It also allows information to be abstracted as desired by the medical staff for any given medical record. 
• Obtain input from the practitioner on areas of concern before a final assessment is made. Doing so helps lend the process a more collegial tone. This method can also involve gathering input from other caregivers to round out the picture of care provided by the physician. The final rating in a retrospective analysis should consider all possible factors. 
• Use retrospective FPPE in conjunction with other focused review methods. Retrospective FPPE is a powerful tool for the medical staff, but it has limitations.

This week’s question and answer are excerpted from Proctoring and FPPE: Strategies for Verifying Physician Competence, by Robert J. Marder, MD, CMSL, and Mark A. Smith, MD, MBA, CMSL.