Nursing Peer Review, Second Edition: A Practical, Nonpunitive Approach to Case Review

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Nursing Peer Review, Second Edition: A Practical, Nonpunitive Approach to Case Review

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Nursing Peer Review, Second Edition: A Practical, Nonpunitive Approach to Case Review

Laura Harrington, RN, BSN, MHA, CPHQ, CPCQM
Marla Smith, MHSA

Nursing Peer Review, Second Edition, is a comprehensive guide for establishing a formal case-based nursing peer review program, including all the tools and procedures organizations need to build and manage a structure to conduct systematic evaluation of clinical care. The book takes nurse managers through every step of the process: explaining nonpunitive nursing peer review, creating a system, identifying cases, conducting reviews, and taking appropriate action based on the outcomes of the reviews.

Nurse leaders are responsible for upholding the ANA Code of Ethics, which concerns issues of accountability for the professional nurse and includes requirements for peer review to ensure high-quality patient care. This book offers them the processes to help do this. It provides a framework for nurses to hold them accountable for their practice, reveal educational gaps, help identify system and process errors, and indicate whether changes in practice are necessary to improve patient outcomes.

Inside this book, you will find all the resources you need to get your nursing case-based peer review program up and running, including:

  • Details of the benefits and rationale of case-based nursing peer review
  • Easy-to-follow, multi-step system for implementing a case-based peer review program
  • In-depth content on how to conduct chart reviews
  • Sample case studies to illustrate the case-based peer review process
  • Tips on using case-based peer review data to benchmark performance and track and trend peer review results
  • A comprehensive set of downloadable, customizable tools to create a structured, evidence-based, case-based peer review process
  • The formal structure to conduct a systematic evaluation of clinical care

Meet the Authors:

Laura Harrington, RN, BSN, MHA, CPHQ, CPCQM, is executive director of quality and patient safety at Boston Medical Center. She formerly served as a senior consultant at The Greeley Company, where she specialized in quality and patient safety, external peer review, and risk management.

Marla Smith, MHSA, is a consultant for HCPro who focuses on quality and peer review solutions. She formerly served as an associate consultant for The Greeley Company in the quality and patient safety practice. Her areas of expertise are in medical staff and nursing peer review, medical and hospital quality performance improvement, and physician- and hospital-based data analysis.

Published: December 2014

Table of Contents:


Chapter 1: Defining Incident-Based Peer Review

    The Rise of Peer Review

    How Facilities Use Peer Review

Chapter 2: Benefits, Rationale, and Setting Clear Expectations

    The Roots of Peer Review

    The Nursing Performance Pyramid

    Applying the Pyramid to Nursing Culture

Chapter 3: Immunity, Confidentiality, and Protecting Information From Discovery

    Peer Review Protection Laws


    Privilege: Protection From Discovery

    Confidentiality: Security of Information

Chapter 4: Step 1: Design a Formal Committee to Support the Peer Review Process 

    Functions of Peer Review

    Identify a Formal Structure That Works for You

    Define Committee Roles and Responsibilities

    Set and Communicate Nursing Expectations

    Protect Confidential Information

Chapter 5: Step 2: Establish the Nursing Peer Review Process

    Drafting a Peer Review Policy

    Peer Review Process and Timelines

    Case Identification, Screening, and Assignment of Nurse Reviewer

    Review Ratings

    Communicating Findings

    Tracking Findings

Chapter 6: Step 3: Educate Nurse and Non-Nurse Stakeholders

    Communicating the Mission

    Involving Non-Nurse Stakeholders

    Obtaining Buy-In

    Conducting a Formal Presentation

Chapter 7: Step 4: Implement the Nursing Peer Review Process

    Choose an Implementation Date

    Conducting Chart Review

    Scoring the First Case

    Drafting the First Agenda

    Holding the First Meeting

    Final Determinations

Chapter 8: Step 5: Track and Trend Your Data

    Peer Review as a Performance Improvement Tool

    Measuring Performance and Understanding Indicator Types

    Donabedian Indicators

    Identifying Nursing Indicators

    Benchmarking and Using Performance-Based Data

Chapter 9: Step 6: Use Data to Drive Improvement

    Collecting Comprehensive Indicator Data

    Feedback Report Formats

    Managing Performance With Outcomes

Chapter 10: Driving Forces