Does your peer review program have F-A-C-E?

Peer review can be as simple or as complex a process as the organization makes it. But it is a process, and like any other process, it should be clearly delineated in a policy that is objective and applied equally. If emotions can run high concerning the proctoring of a physician's privileges, then the ongoing evaluation of competency through a peer review process can go positively nuclear if not handled effectively. A lot depends on the culture of your medical staff and the history of attempts at peer review in your organization.

Given the emotions and the baggage that accompany this subject, it is critically important to have a very clear structure and process delineated in policy (and action) that is evidence-based, equally applied, and led by credible leaders of the medical staff. The following will address the F-A-C-E of peer review and outline some trends and best practices. For those desirous of more in-depth knowledge on this topic, the reader is referred to sources such as Effective Peer Review, Third Edition, available from HCPro.

One framework against which to judge your own peer review program is to answer the question of whether it has F-A-C-E:

• Fairness: Bias has been minimized to every extent possible both on a personal and a group basis
• Accuracy: You have the right data for the right physician
• Consistency: You have standardized expectations, measurements, feedback, evaluation forms, rating processes, and uniformly applied standards
• Efficiency: You don't waste a lot of physician and staff time

—from The Medical Staff Leader's Survival Guide, by William K. Cors, MD, MMM, FACPE.