Effective Peer Review, Fourth Edition

Robert J. Marder, MD

Peer review continues to rate as a top challenge in healthcare organizations. Even if they are meeting regulatory standards, organizations struggle to develop a peer review program that is unbiased and meaningful, making it difficult to change physicians’ punitive view of the process.

Now in its fourth edition, Effective Peer Review has been significantly updated and revised, providing even more practical details and policies to help medical staffs reduce peer review bias and implement an approach focused on performance improvement. The book addresses ways to enhance all of the components of a successful competency assessment program, from case review to OPPE and FPPE, with entire chapters dedicated to medical staff culture, multispecialty peer review, and avoiding peer review pitfalls.

New to this edition are chapters that tackle case review from all angles, with detailed guides for peer review coordinators, physician reviewers, and peer review committees. There are also policies for successful OPPE, updated metrics to help measure the effectiveness of your program for case review and OPPE, and guidance on reporting results to the medical executive committee and the board. This edition also looks at how the changing healthcare landscape is affecting competence assessment, such as how to conduct peer review on a healthcare team or outside of the traditional hospital walls.

This book provides:

• Practical, proven techniques to eliminate bias and develop meaningful physician performance improvement opportunities
• A detailed guide to creating a dynamic multispecialty peer review committee
• Proven methods for conducting meaningful case review from case identification to committee decision and follow-up
• Case studies from the field to illustrate key concepts
• A step-by-step guide for peer review self-assessment and redesign
• Approaches to engage physicians in the peer review process
• National Practitioner Data Bank reporting requirements and other regulations related to peer review

This updated edition includes:

• How to conduct case review from every position: peer review coordinator, physician reviewer, and peer review committee
• Metrics to measure the effectiveness of your peer review program
• Information on conducting peer review with a healthcare team
• Sample policies, forms, and procedures for case review, OPPE, and FPPE
• New and expanded case studies

About the Author:

Robert J. Marder, MD, is president of Robert J. Marder Consulting. Marder brings more than 30 years of healthcare leadership, management, and consulting experience to his work with physicians, hospitals, and healthcare organizations nationwide. A highly respected speaker, consultant, and author, he has helped hundreds of hospital medical staffs evaluate and improve their approach to peer review and physician performance measurement. Marder began his full-time involvement in performance improvement in 1988 as the national project director for clinical indicator development and use at The Joint Commission. 

Published: September 2017

Page count: 284
Dimensions: 8.5 X 11
ISBN: 978-1-68308-595-9

Table of Contents

• Chapter 1: Peer Review: Why Do We Need to Evaluate Physician Competence?
• Chapter 2: Avoiding Peer Review Pitfalls: Conflicts of Interest, M&Ms, RCAs, and Sham Peer Reviews
• Chapter 3: From Punitive to Positive: Creating a Performance Improvement Culture for Peer Review
• Chapter 4: Legal Considerations and Risk Management: Impact of Regulations and Liability on Peer Review
• Chapter 5: Peer Review Structures: The Impact of Multispecialty Peer Review
• Chapter 6: Measuring Physician Performance: What to Measure and How to Do It Fairly
• Chapter 7: Case Review: A Brief Overview for Reducing Bias and Improving Efficiency and Effectiveness
• Chapter 8: Case Review Part 1: A Peer Review Coordinator’s Guide
• Chapter 9: Case Review Part 2: A Physician Reviewer’s Guide
• Chapter 10: Case Review Part 3: A Medical Staff Committee’s Guide
• Chapter 11: Selecting Physician-Driven Measures for OPPE: Applying the Six Core Competencies and Improving Physician Attribution
• Chapter 12: The Role of Healthcare Teams in Competency Measurement
• Chapter 13: Evaluating OPPE Data: Using Benchmarks and Targets for OPPE Reports
• Chapter 14: From OPPE to FPPE: Creating Accountability for Physician Performance Improvement
• Chapter 15: Reporting Peer Review: Who Needs to Know and What You Should Tell Them
• Chapter 16: Beyond the Hospital Walls: Peer Review in Ambulatory Facilities and Clinically Integrated Networks
• Chapter 17: Redesigning or Tuning Up Your Program: A Step-by-Step Guide