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Learn MoreHealthcare organizations juggle a variety of priorities, but the one of most important is patient safety. And one of the main ways to keep patients safe is to ensure the physicians they’re working with are providing the best care. There are many ways to ensure physicians are performing to the best of their ability, and one of those methods is Peer Review. In this post, we’ll go over both Peer and Case Review, and look into strategies for accurately evaluating provider performance.
Healthcare organizations, through their medical staff, are responsible for the quality of care and patient safety. Peer Review is a process that helps healthcare organizations ensure they are providing the highest level of care and patient safety possible. Peer Review involves members of a medical staff within a healthcare organization participating in activities that measure, evaluate, and help to improve the performance of providers within the healthcare organization.
There are both federal and state protections in place for Peer Review.
FEDERAL | STATE |
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To claim Peer Review protection, all Peer Review information must be treated as confidential and/or privileged. All documents, such as Case Review documents, must cite confidential and privileged protection. If an organization doesn’t cite protection language on its documents, or they make information available outside the review process, courts may find that the organization has waived its right to protection.
Case Review and Peer Review are related as case review is a medical staff–led initiative. Case Review is defined as:
A medical review in which the clinical care is cross checked against a specific set of standards, such as Medical Necessity Criteria. A reviewer (peer or physician) will look at a patient's level of care, intensity of treatment, and other care specifications to ensure that the care that was ordered, or provided by a physician or healthcare organization was appropriate and necessary.
A successful Case Review process usually involves eight best practice steps.
It is quite a monumental task, isn’t it? The good news is, there are ways to streamline the process to ensure nothing falls by the wayside. With HealthStream's Evaluate, you can view every provider in your health setting, while you measure and monitor their performance and share that data with relevant parties. Learn more about it here, and if you have any questions, we’re always here to help, just reach out.
HealthStream’s learning management system and healthcare training solutions support medical training initiatives and allow for the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceBe confident in your staff’s ability to reduce risk by providing compliance training that changes behavior.
View All ProductsDevelop next-level people for next-level care by prioritizing quality and safety improvements.
View All ProductsEstablish a culture of belonging with education supporting DEI, wellness, engagement, and leadership development.
View All ProductsUtilize patient access solutions and advanced reimbursement solutions to manage clinical denials and improve your organization’s reimbursement strategy.
View All ReimbursementExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ProductsOur competency development solutions personalize learning for clinicians to bridge the gap between theory and practice for your nurse residents.
View All ProductsEnhance maternal & child nursing care with solutions focused on improving the quality of care for mothers, infants, and children.
View All ProductsAddress staffing orientation challenges to easily achieve and maintain certification with our emergency and acute care training solutions.
View All ProductsAs a premier provider of healthcare education, we are committed to promoting safer, more successful surgical and sedation outcomes for each and every patient.
View All ProductsOur solutions are designed to cater to the needs of patients, healthcare professionals, and organizations dealing with illnesses or chronic conditions.
View All ProductsOnline clinical placement software allows schools, healthcare organizations, and students to seamlessly manage clinical and nursing rotations.
View All ProductsComprehensive, industry-leading provider onboarding and credentialing software that validates health outcomes and supports provider assessment.
View All CredentialingOur affordable CVO credentialing services establish patient safety by enabling primary source verification for your healthcare organization.
View All ProductsIntegrate with Epic to validate and add new providers directly to your provider master file.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare workforce management is essential. We provide advanced scheduling solutions for organizations to solve issues such as nurse retention
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