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Case Studies >
 Case
Study: Quality of Care Concerns
Situation:
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A small community hospital finds itself facing increasing concerns regarding
the quality of care of its senior family practitioner and #1 admitter
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This physician is a powerful, highly regarded and very litigious member of the
community with a long track record of successfully avoiding and combating all
previous attempts to address performance issues
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Medical Staff leaders and administration have been at a loss for years to
effectively address the perceived concerns
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Agencies external to the hospital (i.e. Workers Compensation) and new medical
staff and administrative leadership have again heightened the awareness of the
organization to these concerns
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Legal counsel has confirmed potential exposure to negligent credentialling
claims
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There is now a new sense of urgency to validate and address the perceived
quality concerns or clarify and lay them to rest
QMCG Team Role: Conducted an independent review of the physician's
clinical performance using a five step process:
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Physician reviewer selection, credentialling and introduction to subject
physician
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Study design including medical record selection and criteria development
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Offsite medical record review, data analysis and trending
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Report development including specifics supporting conclusions reached and
suggested approaches for improvement
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Summary conferences with medical staff leaders
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Summary conference with subject physician
Peer Review Study Conclusions: Significant trends demonstrating
patient management concerns and documentation issues were documented resulting
in the recommendation that the physician should not be managing patient
admissions or care independently.
Medical Staff/Hospital Accomplishments: Since receipt of the QMCG
report and the summary conferences:
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The physician agreed to an immediate leave of absence from hospital privileges
to be followed by announcement of the physician's retirement
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A physician has been recruited to assume the physician's practice
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Patients have been protected
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The physician's dignity has been preserved
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Fair hearing and legal action have been avoided as well as $50,000-$75,000 in
legal fees
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Risks for negligent credentialling and malpractice claims have been reduced
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Damaging community relations has been avoided
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