FEATURE
review on a monthly or even quar- terly basis can help with engagement, Martin says. “If you think you have physicians who do not want to read and sign off on a large number of charts, providing them with a more manageable stack of 15 charts versus 50 can help.”
Ollila says her ASC’s physician
investors take turns performing peer review. “We go alphabetically through our list of physicians so everyone is involved over time. We will usually hear a little grumbling when they are told it is their turn, but they understand the importance of the process and always do a good job.” Martin says ASCs often struggle with determining the number of charts that should undergo peer review. “It is common to hear figures like ‘5 per- cent’ of cases or ‘30 charts.’ There is no rule of thumb. What matters is not the percentage or a set number but rather that the peer review is meaning- ful to the ASC and appropriate to the surgical volume. “If a physician is bringing 100 cases a month and you are looking at only two records, that is probably not very representative of what the physician is doing at your ASC,” she continues. “By the same token, if you have a physician who comes just once per quarter, you should peer review all of the cases.” If there is stress in your ASC con- cerning peer review, focus on the big- ger picture, Vinson says. “Do not look at peer review as a silo. It is one part of your quality program. You are already gathering the data you need to evalu- ate. Then it is just a simple process of transferring that information to a form. If managed correctly, the peer review process can be easy and, more impor- tantly, help minimize risk to your patients, the ASC and the health care practitioners on your team.”
Tie to Recredentialing A common error Martin says she sees ASCs make is forgetting to bring peer
If you want to ensure patients consistently receive the highest quality care, you need to ensure the care they receive is appropriate. Peer review provides that check. It is a vital component of our quality program.”
—Karen Ollila, Orthopedic Surgery Center of Orange County
review forward during the recreden- tialing process. “Most ASCs perform initial cre- dentialing by obtaining outside peer review references on physicians and AHPs,” she says. “Once these provid- ers have been in your facility for the period you credentialed them for, inter- nal peer review provides the means to look at the actual work they performed at your ASC. You want to make sure you bring that information to your cre- dentialing committee and then, ulti- mately, your governing board. They will assess whether that person meets your level of expectation for quality measures to practice at your ASC.” Peer review goes hand in hand with recredentialing at the Orthopedic Sur- gery Center of Orange County, Ollila says. “When it comes time to recre- dentialing someone in our ASC, we
look for abnormalities picked up in peer review. That information, along with possible risk identification reports and anything else deemed noteworthy, gets presented to the MAC.” Such a gathering of information
over an extended period is essential to performing a proper recredential- ing process, Vinson says. “You do not want to wait until the week before reappointment to look into how your peer review is going. You want to con- stantly look at what members are doing to earn their reappointment.” If your ASC is accredited, check your accreditor’s standards on peer review, Martin advises. Some accred- itors have more prescriptive stan- dards than others, and you will want to make sure your process aligns with surveyor expectations.
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