Leading up to the 21st century, peer review evolved constantly, undergoing rapid change. New regulations and requirements were implemented both by the Centers for Medicare & Medicaid Services (CMS) in the 1960s and by the establishment of the Health Care Quality Improvement Act of 1986....
Unfortunately, ineffective peer review can and does happen at hospitals across the country. An organization's ineffective peer review system may be brought to light by examining publicly reported performance measurements, successful lawsuits that are the results of poor physician performance, or...
Typically, recommendations for external peer review (EPR) arise from peer review committees that are faced with issues they can't resolve—lack of specialty expertise, conflicts of interest and other potential legal or credibility issues. The board should also have the right to determine whether...
The degree to which credentials files can be protected from discovery in legal proceedings is generally a matter of state law. Most credentialing work is considered a peer review activity performed by the medical staff and governing board. As a result, state laws generally grant some amount of...
In most organizations, the hospital or parent institution incurs the cost of proctoring. In some locales, however, the medical staff treasury pays. It is also reasonable to require the physician under review to cover proctoring costs. Where this is the practice, you should clearly state in the...
Sharing peer review information between healthcare organizations is essential to help medical staffs determine practitioners' competence and make informed privilege-granting decisions. However, medical staffs can find themselves facing legal challenges if the disclosure process is done...
