Case Study: Chief of Staff Requests Self Review

Situation: A small rural healthcare facility's Chief of Staff experiences complications and patient dissatisfaction on a general surgery approach to a urologic condition. There is no Urologist on staff and no internal peer review potential.

• Chief of Staff desires an objective evaluation
• Risk management case potential
• Physician sits on all facility performance improvements boards, thereby system is nonobjective by design

QMCG Team Role: Conduct an objective urologic standard of care review of the surgical and medical care management.

• Utilized a Board certified Urologist to review surgical care against Urologic standards as requested
• Review criteria reflective of surgical and urologic appropriateness
• Determination of surgical intervention appropriateness on a urologic complaint

Peer Review Study Conclusions:

• Care rendered was appropriate for surgeon with urologic experience and urologic case volume
• Opportunity to improve offered was for facilitation of urological back-up in complicated cases, or arrangement for transport to tertiary urologic care as needed

Medical Staff/Hospital Accomplishments:

• Cognizant of legal standing for any potential legal actions brought against the facility
• Opportunities for care improvements and case used as a "lesson learned" and as a performance improvement project
• Chief of Staff can educate Medical Staff members on patient management decisions facing rural Medical Staffs with patient complications