How to make peer reviewers more comfortable

Q: We’re performing a review of Care Appropriate cases, but reviewers are very uncomfortable reviewing the cases after they have been reviewed by a department/section. Do you have suggestions on how to perform this review and about the physician uncertainty in this process?

Robert J. Marder, MD, president of Robert J. Marder Consulting: What you’ve got here is a culture issue. You have a culture where the department chairs and sections are reviewing cases. They’re not part of the peer review process, but they’re reviewing them as morbidity and mortality (M&M) reviews or other things. That makes it difficult.

You definitely have to separate the M&Ms from the peer review process so it’s a clear statement from the medical staff saying, “We’re doing an independent review, and if there’s information from the M&M that can help us, that can be brought to the attention of the committee.” We want to avoid department or section bias.

It’s really a culture issue and a discussion for the medical staff of what is the role of the reviewers and training those reviewers to know that we just want their opinions. When reviewers are uncomfortable, they need this committee to bolster their confidence and say, “You’re not condemning anybody; use the case as you see it; nobody will know you reviewed it because that’s not going to be available.”

All communication will go out to the provider and others from the committee, not the reviewer. If you’re having reviewers contacting the providers under review, that would also make them uncomfortable in reviewing those cases as well.

Source: News & Analysis