Clinical peer review , also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. A discipline-specific process may be referenced accordingly (e.g., physician peer review , nursing peer review ).
89-406: The Du Bois Review: Social Science Research on Race is a peer-reviewed academic journal covering multidisciplinary and multicultural social science research and criticism about race . The journal was established in 2004 and is published by Cambridge University Press for the W. E. B. Du Bois Institute for African and African American Research at Harvard University . The journal covers
178-417: A lawsuit from a maltreated patient. Such practices are known to have continued into the 11th century. In the 1900s, peer review methods evolved in relation to the pioneering work of Codman's End Result System and Ponton's concept of Medical Audit. Lembcke, himself a major contributor to audit methodology, in reviewing this history, notes the pre-emptive influence of hospital standardization promoted by
267-419: A sociology journal is a stub . You can help Misplaced Pages by expanding it . See tips for writing articles about academic journals . Further suggestions might be found on the article's talk page . Peer review Peer review is the evaluation of work by one or more people with similar competencies as the producers of the work ( peers ). It functions as a form of self-regulation by qualified members of
356-626: A [licensed] health care facility...or any other medical group in connection with bona fide medical research, quality assurance, utilization review, credentialing, education, training, supervision or discipline of physicians or other health care providers." Medical staffs generally rely on generic screens for adverse events to identify cases for peer review, even though that might not be the most efficient or effective method. These are generally applied through administrative data analysis, but referrals for peer review are frequently made by risk managers, nurses and medical staff. The median annual review volume
445-481: A certain threshold, and effective peer review requires a certain level of expertise. For non-professional writers, peer review feedback may be overlooked, thereby affecting its effectiveness. Elizabeth Ellis Miller, Cameron Mozafari, Justin Lohr and Jessica Enoch state, "While peer review is an integral part of writing classrooms, students often struggle to effectively engage in it." The authors illustrate some reasons for
534-495: 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
623-748: A diagnosis, procedure or clinical situation. It remains the predominant mode of peer review in Europe and other countries. In the US, however, the lack of perceived effectiveness of medical audit led to revisions of Joint Commission standards in 1980. Those modified standards dispensed with the audit requirement and called for an organized system of Quality Assurance (QA). About the same time, hospital and physicians were facing escalating malpractice insurance costs. In response to these combined pressures, they began to adopt "generic screens" for potential substandard care. These screens were originally developed to evaluate
712-557: A fundamental process in academic and professional writing, serving as a systematic means to ensure the quality, effectiveness, and credibility of scholarly work. However, despite its widespread use, it is one of the most scattered, inconsistent, and ambiguous practices associated with writing instruction. Many scholars questioning its effectiveness and specific methodologies. Critics of peer review in classrooms express concerns about its ineffectiveness due to students' lack of practice in giving constructive criticism or their limited expertise in
801-448: A group of nurses or an individual nurse is evaluated by individuals of the same rank or standing according to established standards of practice…. Peer review is an organized effort whereby practicing professionals review the quality and appropriateness of services ordered or performed by their professional peers. Peer review in nursing is the process by which practicing registered nurses systematically access, monitor, and make judgments about
890-415: A longitudinal study comparing two groups of students (one majoring in writing and one not) to explore students' perceptions of authority. This research, involving extensive analysis of student texts, concludes that students majoring in non-writing fields tend to undervalue mandatory peer review in class, while those majoring in writing value classmates' comments more. This reflects that peer review feedback has
979-501: A means of critiquing each other's work, peer review is often framed as a way to build connection between students and help develop writers' identity. While widely used in English and composition classrooms, peer review has gained popularity in other disciplines that require writing as part of the curriculum including the social and natural sciences . Peer review in classrooms helps students become more invested in their work, and
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#17327795396261068-459: A medical peer review process to attack a doctor for personal or other non-medical reasons. State medical boards have withheld medical records from court to frame innocent physicians as negligent. Another type of review similar to sham peer review is "incompetent peer review," in which the reviewers are unable to accurately assess the quality of care provided by their colleagues. Controversy exists over whether medical peer review has been used as
1157-562: A peer review evaluation process designed to improve practice and performance for all RNs for at least 2 years. The literature on nursing peer review is more limited than that which has been developed for physician peer review, and has focused more on annual performance appraisal than on case review. No aggregate studies of clinical nursing peer review practices have been published. Nevertheless, more sophisticated studies have been reported. Nursing professionals have historically been less likely to participate or be subject to peer review. This
1246-432: A profession within the relevant field . Peer review methods are used to maintain quality standards, improve performance, and provide credibility. In academia , scholarly peer review is often used to determine an academic paper 's suitability for publication. Peer review can be categorized by the type of activity and by the field or profession in which the activity occurs, e.g., medical peer review . It can also be used as
1335-655: A range of disciplines, including economics , political science , sociology , anthropology , law , communications , public policy , psychology , linguistics , and history . Each issue of the Du Bois Review contains four major sections: The editors-in-chief are Lawrence D. Bobo ( Harvard University ) and Michael C. Dawson ( University of Chicago ). The journal is abstracted and/or indexed in: CSA Worldwide Political Science Abstracts , PAIS International , ProQuest Research Library, Sociological Abstracts , SocINDEX, and Scopus . This article about
1424-450: A result, in the mid-90s, the PROs changed their focus and methods; and began to de-emphasize their role as agents of external peer review. The change was completed by 2002, when they were renamed Quality Improvement Organizations. In contrast, external peer review has been used by German hospitals to lower their standardized mortality rate Sham peer review is a name given to the abuse of
1513-412: A teaching tool to help students improve writing assignments. Henry Oldenburg (1619–1677) was a German-born British philosopher who is seen as the 'father' of modern scientific peer review. It developed over the following centuries with, for example, the journal Nature making it standard practice in 1973. The term "peer review" was first used in the early 1970s. Since 2017 a monument to peer review
1602-440: A team of peers with assigned roles. Technical peer reviews are carried out by peers representing areas of life cycle affected by material being reviewed (usually limited to 6 or fewer people). Technical peer reviews are held within development phases, between milestone reviews, on completed products or completed portions of products. The European Union has been using peer review in the "Open Method of Co-ordination" of policies in
1691-448: A time and given an amount of time to present the topic that they have researched. Each speaker may or may not talk about the same topic but each speaker has something to gain or lose which can foster a competitive atmosphere. This approach allows speakers to present in a more personal tone while trying to appeal to the audience while explaining their topic. Peer seminars may be somewhat similar to what conference speakers do, however, there
1780-466: A tool to reach higher order processes in the affective and cognitive domains as defined by Bloom's taxonomy . This may take a variety of forms, including closely mimicking the scholarly peer review processes used in science and medicine. Scholarly peer review or academic peer review (also known as refereeing) is the process of having a draft version of a researcher's methods and findings reviewed (usually anonymously) by experts (or "peers") in
1869-462: A visiting physician had to make duplicate notes of a patient's condition on every visit. When the patient was cured or had died, the notes of the physician were examined by a local medical council of other physicians, who would decide whether the treatment had met the required standards of medical care. Professional peer review is common in the field of health care, where it is usually called clinical peer review . Further, since peer review activity
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#17327795396261958-428: A visiting physician must always make duplicate notes of a patient's condition on every visit. When the patient was cured or had died, the notes of the physician were examined by a local medical council of other physicians, who would review the practicing physician's notes to decide whether his or her performance met the required standards of medical care. If their reviews were negative, the practicing physician could face
2047-573: A wide variety of activities, whose scope varies across institutions. Virtually all programs perform retrospective medical record review (aka, case review) of the quality of care. Most also include Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) required by the Joint Commission since 2007. Many also include the management of disruptive behavior (see ) and physician health programs. Routine clinical peer review activity (performance assessment)
2136-408: Is 1–2% of hospital inpatient admissions. Thus, case review may be the dominant form of adverse event analysis in US hospitals. Case reviews are typically conducted by individual reviewers, but in nearly 70% of hospitals, most reviews are presented and discussed in a committee prior to final decision-making. Nurses now participate on physician review committees in the majority of programs. This extends
2225-571: Is a more appropriate term than "peer evaluation" as this is not a form of professional peer review. There is limited published information about peer review among pharmacists. The first documented description of a peer review process is found in the Ethics of the Physician written by Ishap bin Ali al-Rahawi (854–931) of al-Raha, Syria . His work, as well as later Arabic medical manuals, states that
2314-446: Is aimed at defining, aligning and recognizing each employee's contribution to the organization's success. In contrast, professional peer review is conducted within the professional practice model and is not a managerial accountability. Peer evaluation is the process of getting feedback on one's specific role competencies or "at work" behaviors from people that one works within the department and from other departments. "Colleague evaluation"
2403-480: Is argued that the outmoded QA model perpetuates a culture of blame that is toxic to efforts to advance quality and high reliability among both physicians and nurses. In the US, peer review activity is generally protected under state statutes. The protection may include confidentiality of the review process and protection to reviewers and institutions for good faith efforts to improve quality and safety through review activity. Such statutes may also specify whether or not
2492-631: Is at the Higher School of Economics in Moscow. Professional peer review focuses on the performance of professionals, with a view to improving quality, upholding standards, or providing certification. In academia, peer review is used to inform decisions related to faculty advancement and tenure. A prototype professional peer review process was recommended in the Ethics of the Physician written by Ishāq ibn ʻAlī al-Ruhāwī (854–931). He stated that
2581-412: Is changing, as is the previously limited extensiveness (for example, no aggregate studies of clinical nursing peer review practices had been published as of 2010) of the literature on nursing peer review Mostly what is mistakenly referred to as "peer review" in clinical practice is really a form of the annual performance evaluation. The annual performance review is a managerial process and does not meet
2670-427: Is commonly segmented by clinical discipline, there is also physician peer review, nursing peer review, dentistry peer review, etc. Many other professional fields have some level of peer review process: accounting, law, engineering (e.g., software peer review , technical peer review ), aviation, and even forest fire management. Peer review is used in education to achieve certain learning objectives, particularly as
2759-427: Is easy to allege misconduct, proven cases of malicious peer review are rare. Parenthetically, it is difficult to prove wrongdoing on behalf of a review committee that can use their clinical and administrative privileges to conceal exculpatory evidence. 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
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2848-405: Is generally reserved for cases requiring special expertise for evaluation or for situations in which the independent opinion of an outside reviewer would be helpful. The process is significantly more costly than in-house review, since the majority of hospital review is done as a voluntary contribution of the medical staff. Mandated external peer review has not played an enduring role in the US, but
2937-594: Is incorporated into the California Health and Safety Code Section 57004. Peer review, or student peer assessment, is the method by which editors and writers work together in hopes of helping the author establish and further flesh out and develop their own writing. Peer review is widely used in secondary and post-secondary education as part of the writing process. This collaborative learning tool involves groups of students reviewing each other's work and providing feedback and suggestions for revision. Rather than
3026-551: Is more time to present their points, and speakers can be interrupted by audience members to provide questions and feedback upon the topic or how well the speaker did in presenting their topic. Professional peer review focuses on the performance of professionals, with a view to improving quality, upholding standards, or providing certification. Peer review in writing is a pivotal component among various peer review mechanisms, often spearheaded by educators and involving student participation, particularly in academic settings. It constitutes
3115-413: Is still a method used in classrooms to help students young and old learn how to revise. With evolving and changing technology, peer review will develop as well. New tools could help alter the process of peer review. Peer seminar is a method that involves a speaker that presents ideas to an audience that also acts as a "contest". To further elaborate, there are multiple speakers that are called out one at
3204-432: Is that peer review is not just about improving writing but about helping authors achieve their writing vision." Feedback from the majority of non-professional writers during peer review sessions often tends to be superficial, such as simple grammar corrections and questions. This precisely reflects the implication in the conclusion that the focus is only on improving writing skills. Meaningful peer review involves understanding
3293-507: Is the only U.S. state to mandate scientific peer review. In 1997, the Governor of California signed into law Senate Bill 1320 (Sher), Chapter 295, statutes of 1997, which mandates that, before any CalEPA Board, Department, or Office adopts a final version of a rule-making, the scientific findings, conclusions, and assumptions on which the proposed rule are based must be submitted for independent external scientific peer review. This requirement
3382-494: Is to improve the quality and safety of care. Secondarily, it serves to reduce the organization's vicarious malpractice liability and meet regulatory requirements. In the US, these include accreditation, licensure and Medicare participation. Peer review also supports the other processes that healthcare organizations have in place to assure that physicians are competent and practice within the boundaries of professionally accepted norms. Clinical peer review should be distinguished from
3471-488: Is typically organized separately from the credentialing/privileging process (competence assessment), but the results of peer review inform those decisions. From a legal and regulatory perspective, however, the line is blurred. The definition of a peer review body can be broad, including not only individuals but also (for example, in Oregon ), "tissue committees, governing bodies or committees including medical staff committees of
3560-865: The Quality Improvement (QI) principles that have been increasingly embraced by healthcare organizations. There is good evidence that contemporary peer review process can be further improved. The American College of Obstetrics and Gynecology has offered a Voluntary Review of Quality of Care Program for more than 2 decades. Perceived issues with the adequacy of peer review were an explicit reason for requesting this service by 15% of participating hospitals, yet recommendations for improved peer review process were made to 60%. A 2007 study of peer review in US hospitals found wide variation in practice. The more effective programs had more features consistent with quality improvement principles. There were substantial opportunities for program improvement. The implication
3649-532: The peer review that medical journals use to evaluate the merits of a scientific manuscript, from the peer review process used to evaluate health care research grant applications, and, also, from the process by which clinical teaching might be evaluated. All these forms of peer review are confounded in the term Medical Peer Review . Moreover, Medical peer review has been used by the American Medical Association (AMA) to refer not only to
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3738-412: The 1988 ANA Guidelines and may help to assure an evidence-based and consistent approach to peer review: 1. A peer is someone of the same rank. 2. Peer review is practice focused. 3. Feedback is timely, routine and a continuous expectation. 4. Peer review fosters a continuous learning culture of patient safety and best practice. 5. Feedback is not anonymous. 6. Feedback incorporates the developmental stage of
3827-448: The Act. It requires that the action be taken in the reasonable belief that it will advance healthcare quality based on facts obtained through reasonable efforts with due process and fairness to the involved physician. When peer review leads to an action to limit or revoke clinical privileges, the physician is entitled to both a fair hearing and the right of appeal. Congress explicitly stated
3916-571: The American College of Surgeons (ACS) following WWI. The Joint Commission (on Accreditation of Hospitals) followed the ACS in this role from 1952. Medicare legislation, enacted in 1964, boosted the stature and influence of the Joint Commission because the conditions for hospital participation required a credible medical care review program and the regulations stipulated that Joint Commission accreditation would guarantee payment eligibility. What
4005-614: 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. Moreover, neither opponents or supporters of
4094-871: The Journal of the Royal Society of Medicine. “That’s boring.” This is also particularly evident in university classrooms, where the most common source of writing feedback during student years often comes from teachers, whose comments are often highly valued. Students may become influenced to provide research in line with the professor’s viewpoints, because of the teacher’s position of high authority. The effectiveness of feedback largely stems from its high authority. Benjamin Keating, in his article "A Good Development Thing: A Longitudinal Analysis of Peer Review and Authority in Undergraduate Writing," conducted
4183-526: The NPDB in their initial credentialing and bi-annual provider re-credentialing processes. Structurally, this process fulfills the congressional intention of restricting movement of incompetent physicians. Disciplinary actions may be a red flag for issues of global incompetence, but the problem may be focal, not global. Thus, the NPDB has been criticized for having the unintended consequence of having adverse economic impact on providers who were reported regardless of
4272-429: The author's writing intent, posing valuable questions and perspectives, and guiding the author to achieve their writing goals. Magda Tigchelaar compares peer review with self-assessment through an experiment that divided students into three groups: self-assessment, peer review, and no review. Across four writing projects, she observed changes in each group, with surprisingly results showing significant improvement only in
4361-431: The classroom environment at large. Understanding how their work is read by a diverse readership before it is graded by the teacher may also help students clarify ideas and understand how to persuasively reach different audience members via their writing. It also gives students professional experience that they might draw on later when asked to review the work of a colleague prior to publication. The process can also bolster
4450-426: The confidence of students on both sides of the process. It has been found that students are more positive than negative when reviewing their classmates' writing. Peer review can help students not get discouraged but rather feel determined to improve their writing. Critics of peer review in classrooms say that it can be ineffective due to students' lack of practice giving constructive criticism, or lack of expertise in
4539-499: The creation of a National Practitioner Data Bank and required hospitals, state medical boards and other health care entities who engage in formal peer review activities to report all disciplinary actions that affect clinical privileges for more than 30 days. This includes incidents in which a provider voluntarily resigns privileges while under investigation. An entity that fails to report as required may lose HCQIA protections for three years. The HCQIA (§ 11135) requires hospitals to query
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#17327795396264628-417: The creation of the National Practitioner Data Bank under the 1986 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 2007 and concluded that while it
4717-946: The definition or outcomes needed related to peer review. Other organizational practices may violate the peer review guidelines set forth 1988 by the ANA 1988. The most frequent violation is the performance of direct care peer review by managers. One of the reasons for the confusion is that the ANA guidelines for peer review had been out of print prior to being reprinted and updated in 2011. The early ANA Peer Review Guidelines (1988) and Code of Ethics for Nurses (2001) focus on maintaining standards of nursing practice and upgrading nursing care in three contemporary focus areas for peer review. The three dimensions of peer review are: (a) quality and safety, (b) role actualization, and (c) practice advancement. Each area of contemporary peer review has an organizational, unit, and individual focus. The following six peer review practice principles stem from and are grounded in
4806-504: The feasibility of a no-fault medical malpractice insurance plan and were never validated as a tool to improve quality of care. Despite warnings from the developers, their use became widespread. In the process, a QA model for peer review evolved with a narrow focus on the question of whether or not the standard of care had been met. It has persisted despite the many criticisms of its methods and effectiveness. Today, its methods are increasingly recognized to be outdated and incongruent with
4895-531: The feedback with either positive or negative attitudes towards the text, resulting in selective or biased feedback and review, further impacting their ability to objectively evaluate the article. It implies that subjective emotions may also affect the effectiveness of peer review feedback. Pamela Bedore and Brian O’Sullivan also hold a skeptical view of peer review in most writing contexts. The authors conclude, based on comparing different forms of peer review after systematic training at two universities, that "the crux
4984-417: The fields of active labour market policy since 1999. In 2004, a program of peer reviews started in social inclusion . Each program sponsors about eight peer review meetings in each year, in which a "host country" lays a given policy or initiative open to examination by half a dozen other countries and the relevant European-level NGOs . These usually meet over two days and include visits to local sites where
5073-437: The impact of clinical peer review on quality and safety, medical staff perceptions of the program, and clinician engagement in quality and safety initiatives. The online supplement to the report includes a program self assessment tool which is also available as a free online utility. Despite a persistently high annual rate of major program change, about two-thirds of programs still have significant opportunity for improvement. It
5162-627: The inefficiency of peer review based on research conducted during peer review sessions in university classrooms: This research demonstrates that besides issues related to expertise, numerous objective factors contribute to students' poor performance in peer review sessions, resulting in feedback from peer reviewers that may not effectively assist authors. Additionally, this study highlights the influence of emotions in peer review sessions, suggesting that both peer reviewers and authors cannot completely eliminate emotions when providing and receiving feedback. This can lead to peer reviewers and authors approaching
5251-547: The magnitude of the issue. Even so, gross under-reporting of adverse actions remains an issue. The Patient Safety and Quality Improvement Act of 2005 ("Patient Safety Act"), Public Law 109–41, USC 299b-21-b-26 amended title IX of the Public Health Service Act to create a general framework to support and protect voluntary initiatives to improve quality and patient safety in all healthcare settings through reporting to Patient Safety Organizations (PSO). This
5340-529: The most effective programs. These include among other factors: aiming first and foremost at improving quality, standardizing review process, maintaining high quality of case review, promoting self-reporting of adverse events, near misses and hazardous conditions, identifying opportunities for improvement in the review process (as opposed to casting blame), providing timely clinical performance feedback, recognizing clinical excellence, and establishing effective program governance. as additional multivariate predictors of
5429-454: The most ideal method of guaranteeing that distributed exploration is dependable and that any clinical medicines that it advocates are protected and viable for individuals. Thus, the terminology has poor standardization and specificity, particularly as a database search term. In engineering , technical peer review is a type of engineering review. Technical peer reviews are a well defined review process for finding and fixing defects, conducted by
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#17327795396265518-614: The nurse. 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. Confusion exists about the differences between the Professional Peer Review process, the Annual Performance Review (APR) and the role of peer evaluation. The APR is a managerial human resource function performed with direct reports, and
5607-424: The peer review process can be segmented into groups, where students present the papers to be reviewed, while other group members take notes and analyze them. Then, the review scope can be expanded to the entire class. This widens the review sources and further enhances the level of professionalism. With evolving and changing technology, peer review is also expected to evolve. New tools have the potential to transform
5696-441: The peer review process. Mimi Li discusses the effectiveness and feedback of an online peer review software used in their freshman writing class. Unlike traditional peer review methods commonly used in classrooms, the online peer review software offers a plethora of tools for editing articles, along with comprehensive guidance. For instance, it lists numerous questions peer reviewers can ask and allows for various comments to be added to
5785-480: 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. Incidents of alleged sham peer review are numerous and include cases such as Khajavi v. Feather River Anesthesiology Medical Group, Mileikowsky v. Tenet, and Roland Chalifoux. Defenders of
5874-545: The physician conducting the review must be in active practice. The nature of that protection varies widely. For example, Texas is generally considered to have fairly robust protections, whereas Florida protections were undermined by a constitutional amendment that exposed peer review data to discovery. US federal law generally trumps state law. The federal Health Care Quality Improvement Act ("HCQIA"), 42 U.S.C. § 11112, enacted in 1986, sets standards that professional review actions must meet in order to receive protection under
5963-524: The physician's previous damaging or incompetent performance. (3) This nationwide problem can be remedied through effective professional peer review. (4) The threat of private money damage liability under Federal laws, including treble damage liability under Federal antitrust law, unreasonably discourages physicians from participating in effective professional peer review. (5) There is an overriding national need to provide incentive and protection for physicians engaging in effective professional peer review. From
6052-471: The policy can be seen in operation. The meeting is preceded by the compilation of an expert report on which participating "peer countries" submit comments. The results are published on the web. The United Nations Economic Commission for Europe , through UNECE Environmental Performance Reviews , uses peer review, referred to as "peer learning", to evaluate progress made by its member countries in improving their environmental policies. The State of California
6141-462: The procedure is called dual-anonymous peer review. Medical peer review may be distinguished in four classifications: Additionally, "medical peer review" has been used by the American Medical Association to refer not only to the process of improving quality and safety in health care organizations, but also to the process of rating clinical behavior or compliance with professional society membership standards. The clinical network believes it to be
6230-649: The process by which practitioners of the same rank, profession, or setting critically appraise each other's work performance against established standards. The professionals who are best acquainted with the requirements and demands of the role are the givers and receivers of the review. Nursing peer review appears to have gained momentum as a result of growth of hospital participation in the American Nursing Association's Magnet Program. Even so, less than 7% of U.S. hospitals have qualified. Magnet hospitals must have at least 2 years of experience with
6319-513: The process of improving quality and safety in health care organizations, but also to process by which adverse actions involving clinical privileges or professional society membership may be pursued. In addition, peer review methods are frequently used by state medical boards with respect to licensing decisions and complaint investigation. They are also used by insurance companies with respect to credentialing and utilization management processes. In US hospital settings, clinical peer review encompasses
6408-503: The quality of nursing care provided by peers as measured against professional standards of practice. In Nursing, as in other professions, peer review applies professional control to practice, and is used by professionals to hold themselves accountable for their services to the public and the organization. Peer review plays a role in affecting the quality of outcomes, fostering practice development, and maintaining professional autonomy. American Nurses Association guidelines define peer review as
6497-422: The quality of nursing care their clients receive. Standards of nursing practice provide a means for measuring the quality of nursing care a client receives. Each nurse is responsible for interpreting and implementing the standards of nursing practice. Likewise, each nurse must participate with other nurses in the decision-making process for evaluating nursing care…Peer review implies that the nursing care delivered by
6586-416: The rationale for this legislation as follows: (1) The increasing occurrence of medical malpractice and the need to improve the quality of medical care have become nationwide problems that warrant greater efforts than those that can be undertaken by any individual State. (2) There is a national need to restrict the ability of incompetent physicians to move from State to State without disclosure or discovery of
6675-434: The same field. Peer review is widely used for helping the academic publisher (that is, the editor-in-chief , the editorial board or the program committee ) decide whether the work should be accepted, considered acceptable with revisions, or rejected for official publication in an academic journal , a monograph or in the proceedings of an academic conference . If the identities of authors are not revealed to each other,
6764-548: The scope of this article. In the US, following enactment of the HCQIA, executives from various national medical associations and health care organizations formed the non-profit American Medical Foundation for Peer Review and Education to provide independent assessment of medical care. A 2007 study showed that the vast majority of physician peer review is done "in house": 87% of US hospitals send less than 1% of their peer review cases to external agencies. The external review process
6853-503: The selected text. Based on observations over the course of a semester, students showed varying degrees of improvement in their writing skills and grades after using the online peer review software. Additionally, they highly praised the technology of online peer review. Clinical peer review Today, clinical peer review is most commonly done in hospitals, but may also occur in other practice settings including surgical centers and large group practices. The primary purpose of peer review
6942-579: The self-assessment group. The author's analysis suggests that self-assessment allows individuals to clearly understand the revision goals at each stage, as the author is the most familiar with their own writing. Thus, self-checking naturally follows a systematic and planned approach to revision. In contrast, the effectiveness of peer review is often limited due to the lack of structured feedback, characterized by scattered, meaningless summaries and evaluations that fail to meet author's expectations for revising their work. Stephanie Conner and Jennifer Gray highlight
7031-425: The time of the HCQIA, there has been good alignment between regulatory and accrediting bodies with respect to due process requirements for physician disciplinary actions. These formalities apply primarily to questions of competence (credentialing and privileging) rather than performance (routine clinical peer review). It would be most unusual to find a hospital whose medical staff bylaws did not conform. HCQIA enabled
7120-517: The trend of the past decade for adoption of multi-specialty representation in the direction of multi-disciplinary peer review. Some of these committees now routinely assess nursing care during the case review process and may even directly address all improvement opportunities. The American Nurses Association published the first definition of nursing peer review in 1988. It includes the following statements: The American Nurses Association believes nurses bare primary responsibility and accountability for
7209-442: The value of most students' feedback during peer review. They argue that many peer review sessions fail to meet students' expectations, as students, even as reviewers themselves, feel uncertain about providing constructive feedback due to their lack of confidence in their own writing. The authors further offer numerous improvement strategies across various dimensions, such as course content and specific implementation steps. For instance,
7298-505: The writer or the editor to get much out of the activity. As a response to these concerns, instructors may provide examples, model peer review with the class, or focus on specific areas of feedback during the peer review process. Instructors may also experiment with in-class peer review vs. peer review as homework, or peer review using technologies afforded by learning management systems online. Students that are older can give better feedback to their peers, getting more out of peer review, but it
7387-616: The writing craft at large. Peer review can be problematic for developmental writers, particularly if students view their writing as inferior to others in the class as they may be unwilling to offer suggestions or ask other writers for help. Peer review can impact a student's opinion of themselves as well as others as sometimes students feel a personal connection to the work they have produced, which can also make them feel reluctant to receive or offer criticism. Teachers using peer review as an assignment can lead to rushed-through feedback by peers, using incorrect praise or criticism, thus not allowing
7476-488: The writing craft overall. Academic peer review has faced considerable criticism, with many studies highlighting inherent issues in the peer review process. The editorial peer review process has been found to be strongly biased against ‘negative studies,’ i.e. studies that do not work. This then biases the information base of medicine. Journals become biased against negative studies when values come into play. “Who wants to read something that doesn’t work?” asks Richard Smith in
7565-539: Was fraught with limitations. Studies of its methods called into question its reliability and validity for peer review. A survey of Iowa state medical society members in the early 90s regarding perceptions of the PRO program illustrated the potential harm of a poorly designed program. Furthermore, the Institute of Medicine issued a report identifying the system of care as the root cause of many instances of poor quality. As
7654-592: Was intended to include peer review. The final rule promulgated by the Agency for Healthcare Research and Quality in 2008 at 42 CFR Part 3 also includes protections against reprisals for good-faith reporters of adverse events, near misses and hazardous conditions. Several Florida health systems subsequently formed PSOs in expectation of using federal statutory protections to maintain the confidentiality of peer review activity that would have been exposed under Amendment 7. The subsequent legal challenges to this strategy go beyond
7743-427: Was once a sporadic process, became hardwired in most hospitals following the medical audit model. The widespread creation of new programs was hampered, however, by limitations in the available process models, tools, training and implementation support. Medical audit is a focused study of the process and/or outcomes of care for a specified patient cohort using pre-defined criteria. Audits are typically organized around
7832-501: Was tested back in the 70s. A 1972 amendment to the Social Security Act established Professional Standards Review Organizations (PSRO) with a view to controlling escalating Medicare costs through physician-organized review. The PSRO model was not considered to be effective and was replaced in 1982 by a further act of Congress which established Utilization and Quality Control Peer Review Organizations (PROs). This model too
7921-548: Was that a new QI model for peer review seems to be evolving. While it is premature to judge the potential effectiveness of this model, a 2009 study confirmed these findings in a separate sampling of hospitals. It also showed that important differences among programs predict a meaningful portion of the variation on 32 objective measures of patient care quality and safety. These findings were extended by cohort follow-up studies conducted in 2011 and 2015–16. The 2015-16 study refined QI model identifying 20 features that distinguish
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