Linking performance improvement values to actions

How does a medical staff define its cultural values for peer review? The first requirement is for physician leadership to have a vision of better values. Unless physician leaders can articulate to the staff what they would like the culture to become and why, most people are not interested in change for change’s sake. Typically, development of these values begins with the leader’s recognition that peer review is perceived to be, or actually is, punitive. Then, through outside education, the physician leadership realizes that there is a better way. Communicating this new vision to the staff is essential—but it’s not always easy. Sometimes the leader may return from an education program on peer review and feel like Moses coming down with the tablets, only to find the people dancing around the golden calf.

The second requirement is a process that defines the specific behaviors that demonstrate those values. To create this process, a group of physician leaders and support staff must examine your peer review structure, processes, and data analysis methods to align them with your values. This book provides examples of how different medical staffs have achieved that goal. In my work with hundreds of physician leaders to create a performance improvement–focused peer review culture, seven values seem to resonate most strongly. These values are:

1. Fairness: The structure and processes of peer review do not favor one individual or group over another, and improvement methods are appropriate for the type of improvement opportunity.
2. Transparency: The process and results of peer review are available to the individual physician.
3. Data-driven: Information, rather than opinion, is used to help understand and improve physician performance.
4. Self-improvement: Early in the evaluation cycle, individuals are informed about a potential improvement opportunity and are given a chance to improve their own practice.
5. Collegiality: Interactions are designed to communicate the desire for understanding of all sides of the issue and to foster a dialogue that leads to an accurate conclusion that is accepted by all parties.
6. Acccountability: Both providers and leaders are accountable for participating in the peer review process and addressing improvement opportunities.
7. Pursuit of excellence: Peer review should not simply focus on eliminating poor care to achieve mediocrity; it should drive the achievement of excellence.

Source: Peer Review Benchmarking