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Management Services: Comprehensive Peer Review
Review of two-years (privileging cycle) of fallout, trended or problematic cases
is supported. Post-peer review options include direct observation of technique,
one on one discussion with the requesting Committee and subject practitioner,
as well as, other onsite services. Comprehensive peer review reporting with the
focus on collegial focused opportunities for improvement are core. Deviation
from standards of care are discussed and optional care management are offered.
All project discussions are confidential and proposals are complimentary.
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GOAL:
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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.
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WHEN NEEDED:
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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.
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DESCRIPTION:
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QMCG will conduct an independent review of the clinical performance of the
subject practitioner using the following process:
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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
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Offsite medical record reviews
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Onsite clinical performance review including:
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Direct observation of procedures
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Observation of peer and staff interactions
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Interviews of the practitioner, representative peers and clinical
team members
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Review of available patient satisfaction information
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Review of available question and answer information used to
evaluate practitioner for reappointment purposes
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Onsite conference to debrief findings of direct observation and
interviews
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Analysis of trends, concerns and development of conclusions
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Detailed written report followed by a summary conference call to
discuss the conclusions reached and alternatives approaches for improvement
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Ongoing support as needed, i.e., testimony at a fair hearing,
assistance in the development of a retraining program, etc.
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DURATION:
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Implementation of the Comprehensive Peer Review of an individual practitioner
can be accomplished in 10 to 16 weeks following credentialing of the reviewing
practitioner.
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