GOAL:

To obtain a complete and objective evaluation of an individual practitioner's performance within the health care setting, including technical, clinical judgment, resource utilization, interpersonal and teamwork skills.

WHEN NEEDED:

QMCG Comprehensive Peer Review Service is appropriate to objectively evaluate, clarify and document possible quality concerns identified within the individual practitioner's practice that cannot be effectively addressed through the internal process due to potential anticompetitive, personality, communications, availability, behavioral and/or technical skill issues.

DESCRIPTION:

QMCG will conduct an independent review of the clinical performance of the subject practitioner using the following process:

• Selection and credentialing of a qualified practitioner with appropriate clinical experience who has no bias or conflict of interest with the practitioner(s) to be reviewed

• Offsite medical record reviews

• Onsite clinical performance review including:

• Direct observation of procedures

• Observation of peer and staff interactions

• Interviews of the practitioner, representative peers and clinical team members

• Review of available patient satisfaction information

• Review of available question and answer information used to evaluate practitioner for reappointment purposes

• Onsite conference to debrief findings of direct observation and interviews

• Analysis of trends, concerns and development of conclusions

• Detailed written report followed by a summary conference call to discuss the conclusions reached and alternatives approaches for improvement

• Ongoing support as needed, i.e., testimony at a fair hearing, assistance in the development of a retraining program, etc.

DURATION:

Implementation of the Comprehensive Peer Review of an individual practitioner can be accomplished in 10 to 16 weeks following credentialing of the reviewing practitioner.