First option medical reviews
Written and standardized operating procedures for peer review also need development and adoption by the direct care staff and incorporation into the professional practice model shared governance bylaws. In contrast, professional peer review is conducted within the professional practice model and is not a managerial accountability. There is no one standard composition of peer review bodies, nor are there different names for peer review bodies of varying constituent parts.
They may be carried out by state medical boards with different standards for membership , hospital administration, senior staff, department heads, etc. State medical boards conduct peer review of licentiates, composed of physicians only or including attorneys and other non-physicians, varying by state.
Physicians may be board members in primarily advisory capacities. Medical peer review may be carried out by committees that may include physicians not on the board. The same is true of state boards run by physicians from that state; board physicians or physicians unaffiliated with the board may be in medical peer review committees. In hospitals, only a peer review committee authorized by the physician medical staff is authorized to take action regarding a physician's medical privileges at that institution.
A committee convened by the hospital administration or other group within the hospital may make disciplinary recommendations to the physician medical staff. Departmental peer review committees are composed of physicians, while hospital-based performance-appraisal and systems-analysis committees may include nurses or administrators with or without the participation of physicians. Although medical staff bodies utilize hospital attorneys and hospital funds to try peer review cases, the California Medical Association discourages this practice; California legislation requires separation of the hospital and medical staff.
Nursing professionals have historically been less likely to participate or be subject to peer review. Sham peer review is a name given to the abuse of a medical peer review process to attack a doctor for personal or other non-medical reasons.
Controversy exists over whether medical peer review has been used as a competitive weapon in turf wars among physicians, hospitals, HMOs, and other entities and whether it is used in retaliation for whistleblowing.
Many medical staff laws specify guidelines for the timeliness of peer review, in compliance with JCAHO standards, but state medical boards are not bound by such timely peer review and occasionally litigate cases for more than five years. Abuse is also referred to as "malicious peer review" by those who consider it endemic, and they allege that the creation of the National Practitioner Data Bank under the Healthcare Quality Improvement Act HCQIA facilitates such abuse, creating a 'third-rail' or a 'first-strike' mentality by granting significant immunity from liability to doctors and others who participate in peer reviews.
The American Medical Association conducted an investigation of medical peer review in and concluded that while it is easy to allege misconduct, proven cases of malicious peer review are rare. The California legislature framed its statutes so as to allow that a peer review can be found in court to have been improper due to bad faith or malice, in which case the peer reviewers' immunities from civil liability "fall by the wayside".
Dishonesty by healthcare institutions is well-described in the literature    and there is no incentive for those that lie to the public about patient care to be honest with a peer review committee. Cases of alleged sham peer review are numerous and include cases such as Khajavi v. Tenet,    and Roland Chalifoux. Defenders of the Health Care Quality Improvement Act state that the National Practitioner Data Bank protects patients by helping preventing errant physicians who have lost their privileges in one state from traveling to practice in another state.
Physicians who allege they have been affected by sham peer review are also less able to find work when they move to another state, as Roland Chalifoux did. From Wikipedia, the free encyclopedia. For other uses of "peer review", see Peer review disambiguation. This article has multiple issues. Please help improve it or discuss these issues on the talk page. Learn how and when to remove these template messages. This article needs attention from an expert on the subject.
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Statements consisting only of original research should be removed. September Learn how and when to remove this template message. Quality improvement and Clinical audit. Journal of Clinical Outcomes Manage. Annals of Internal Medicine. Archived from the original on Retrieved 4 April Audit in British hospitals". A systematic review of the effects of audit and feedback". The Annals of Pharmacotherapy.
Annals of Saudi Medicine. A Study in Hospital Efficiency. T Todd Company; Peer review in the USA: Obstetrics and Gynecology Clinics of North America. American Journal of Medical Quality. Journal of Healthcare Management. A Strategy for Quality Assurance. National Academy Press; Archives of Family Medicine. Archived at the Wayback Machine. Journal of Clinical Nursing. Journal of Nursing Care Quality. Peer review in nursing practice. Principles and practice - American Nurse Today".
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Sierra Sacramento Valley Medicine. California law allows "aggrieved physicians the opportunity to prove that the peer review to which they were subject was in fact carried out for improper purposes, i.
Gregg 17 March New England Journal of Medicine. Tenet Healthsystem April 18, Cal. Evidence-based medicine Medical guideline Medical consensus. Clinical audit Health care ratings Health impact assessment Health services research Routine health outcomes measurement Independent medical review Clinical peer review. Hospital accreditation International healthcare accreditation List of international healthcare accreditation organizations. Cost per procedure Cost-effectiveness analysis Cost-minimization analysis Incremental cost-effectiveness ratio.
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