A New Year's resolution for peer review

Many people use the coming of a new year as a time to reflect and to make personal resolutions about what they will do differently in the next year. This effort reflects the belief that our life is an evolving process and we are ever optimistic that next year we can achieve greater heights.

Unfortunately, many of these resolutions are quickly abandoned or forgotten because they require a departure from our comfortable patterns of life. For example, I am always resolving to get into a regular exercise routine. Each year, I begin with great enthusiasm and purpose, yet soon I am easily distracted and lapse into my previous bad habits.

Not only do individuals commit to resolutions at the start of the new year, but so do organizations. Last year, I attended several peer review committees meetings at hospitals that The Greeley Company worked with several years ago to redesign their peer review programs. Each hospital had requested that The Greeley Company pay a return visit to assess its progress and help it get to the next level. The common theme in each case was that the hospital had either abandoned or forgotten the policies that we had helped them implement just a few years earlier. Like me with my exercise routine, they had lapsed into familiar patterns from the past. Although I was able to give them some additional tools beyond what we had initially created, the major focus of my advice was to review their current policies and follow them.

So as you begin the new year with regard to peer review, how about a resolution that you will review your peer review policies and procedures and either follow them with greater rigor or fix them if they are not helping your medical staff conduct peer review fairly and efficiently. On a practical level, here are a few things that can help:
 

• Have a copy of your policies available at every peer review meeting
• Every time there is a question about how to proceed, the committee chair, the peer review coordinator, or any member of the committee should ask “what does our policy say?"
• Each year, the committee chair and the peer review staff should review the policies together to be sure that practice has not strayed from policy and make recommendations to the committee to either reinforce the policy or change it to match the practice.

I was recently asked “how can one ensure that peer review will be fair?” The simple answer is to establish fair policies and follow them. If you haven’t been doing that, 2011 is a great time to start.

Robert J. Marder, MD, CMSL, is vice president of The Greeley Company, a division of HCPro, Inc., in Danvers, MA.