Healthcare Provider Peer Review, 2nd edition details information and tools needed for an effective peer review program by any medical organization. It includes policies & procedures, competency and behavioral assessment tools and strategies, Committee structure, medical staff resources, legal resources and web links. Managing the disruptive physician or other healthcare provider is a renewed JCAHO focus in 2006. Extensive references and resources are also included.
Contents
Preface, Disclaimers
Medical Staff Services
Introduction to Peer Review
Mental Illness
Key requirements of the HCQIA of 1986
Immunity from damages
National Practitioner Data Bank
Reportable NPD actions - table
The Healthcare Integrity and Protection Data Bank (HIPDB)
Web resources related to data banks
State statutes protecting peer review
New case law
Fair Hearing and Appeal Rights for all staff
Criminal Background Checks
‘High risk’ providers – the impaired physician
Burnout
Physician well-being
Early detection
Confronting aberrant or disruptive physician behaviors
Detection related to the staff application process
Focused reviews
Rehabilitation Programs
Legal notes
Provider sanctions
Sanction levels
Peer Review Plan
Routine biennial performance evaluation
Non-routine practitioner peer review – corrective action
Fair Hearing Plan and Appellate Review Procedures
Dispute Resolution
Confidentiality, Indemnification and Immunity
Confidentiality Statement Examples
Scoring System for Peer Review
Peer Review Committee minutes – example format
Peer review confidentiality safeguards
Corrective Action Plan – specific to an individual practitioner
Cautions regarding the peer review process
Physician/physician or other professional colleague peer evaluation form
Physician performance evaluation process; Santa Barbara Medical Foundation
Quality Assessment Review Form
Physician Profiling to Measure Clinical Performance
Physician Chart Review Profile Form
‘Boot Camps/Traffic Schools’ for “dyscompetent” physician
References and Resources
Selected ‘benchmark’ case law citations
Web Site Resources - Medical staff bylaws, rules and regulations; Peer review
Legal Briefs
