Content area
Abstract
Peer review, and the resulting privileging process, is an environment rich with improvement opportunities in many hospitals. Probably the biggest challenge is that members of the medical staff increasingly are reluctant to evaluate the quality of care delivered by their peers. From the perspective of internal processes, peer review should feed information to others within the hospital of potential further investigation of system-wide performance improvement opportunities. The internal peer review process would involve one or more layers of peer review by clinical department members and or the chief of the clinical service. At some point this internal or screening process would result in one of two decisions: 1. no further individual privileges action required, and 2. further review for possible privileges change. Prior to any recommendation for privilege changes, external review should be secured. There are several strategies for minimizing the cost of external review. The most obvious is establishing networks of hospitals that agree to exchange charts needing external review.