- Hospital System Peer Review Evaluation

Hospital System Peer Review Evaluation

The NPRC Hospital System Peer Review Evaluation (HSPRE) is an objective, external analysis that enhances not only the individual operations of the hospital members’ peer review systems but provides the tools for a hospital system to take advantage of the expertise and resources available within the entire system to monitor quality of care.

The HSPRE:

Identifies strengths and weaknesses of the peer review systems of the individual hospitals in the system and provides recommendations for improvement for each hospital.

Details the opportunities for each hospital to elect to participate in a system-wide, centralized peer review structure (“Central Peer Review System”) that not only facilitates peer review within the system (thereby saving money on external peer reviews), but gives the hospital members the opportunity to use the resources of the hospital system to address internal deficiencies within their own peer review systems.

More specifically, improving the individual hospital peer review systems and establishing a Central Peer Review System will allow participating hospitals to:

Create central peer review committees to conduct peer review for:
- Specialties or subspecialties where there are insufficient physicians or insufficient participation by physicians for a viable peer review committee.
- A hospital that is unable or unwilling to conduct a problematic clinical peer review or professional conduct peer review.
Facilitate the exchange and review of individual cases or practitioners by qualified peer reviewers within the hospital system.

Upon request, elect to share a Peer Review Committee Chair to increase the expertise of the physician in charge of peer review and decrease the cost.

Create a central forum for members of the peer review committees of the participating hospitals to:
- Discuss issues relating to coordination of the Central Peer Review System and the hospitals’ individual peer review systems.
- Discuss issues relating to the operation of the Central Peer Review System.
- Discuss issues relating to the operation of the hospitals’ individual peer review systems.
- Provide programs for peer review training and education
- Discuss peer review issues generally.

Negotiate with providers of external peer review for rates and service accommodations to benefit the participating hospitals.

Establish and operate a centralized Physician Effectiveness Committee (impairment committee) as a supplement to, or substitute for, the hospital’s Physician Effectiveness Committee.

Establish and operate a centralized Peer Review Data Committee as a supplement to, or substitute for, the hospital’s Peer Review Data Committee.

In addition to conducting the HSPRE, NPRC and its expert consultants are available, upon request, to assist the individual hospitals in implementing modifications to their peer review systems and to assist the hospital system in establishing or enhancing their current Central Peer Review System, including the training of the peer review participants. NPRC has developed a Peer Review System Manual and a Central Peer Review System Manual to provide written guidance to facilitate this process.