Risk management and peer review

Risk management's relationship with peer review is highly dependent on whether the risk management department is perceived with suspicion or as an aid. This somewhat depends on whether the risk management culture is primarily claims-focused or risk reduction-focused. The former tends to link peer review to medical legal standards, which can restrict physician understanding of individual opportunities for improvement. The latter tends to see the proactive reduction of future risk as the goal and is more conducive to a positive peer review culture.

Working with risk management culture requires a constructive dialog with the medical staff. Framing the question is key. I once heard that if you ask an attorney whether you can do something, the response will be "No" but if you ask how you can do it the response is often helpful.

Another aspect of risk management culture affecting peer review is the organization's reporting culture and system, which also affects the patient safety culture. Case identification for peer review is dependent on good incident reporting systems that are not cumbersome and a culture that supports fair reporting without fear of retribution. Peer review can play a vital role in creating a strong reporting culture when the medical staff adopts methods of evaluation that are perceived as fair and improvement-focused.

Source: Medical Staff Briefing