Purtell D L
Health Prog. 1990 Nov;71(9):66-71.
The Health Care Quality Improvement Act of 1986 can help protect medical professionals and healthcare facilities from antitrust and defamation claims and other forms of litigation arising from the peer review process. Some hospitals may need to make major changes in their peer review activity as a result of the act. The healthcare entity, not the physicians involved in peer review, has the burden of complying with the provisions of the act. Failure to comply with the act can lead to loss of immunity from damages, fines, and potential exclusion from the Medicare program. The potential for liability has sparked a need for hospitals to reexamine and possibly reorganize medical staff and update procedures and related governing documents. Healthcare entities may consider changes such as implementing a director of medical affairs function, choosing medical staff for multiple-year terms, and centralizing physician review files. In the 1980s many hospitals created quality assurance and risk management programs. Risk managers need to share data with quality assurance personnel, who must in turn share the information with medical staff involved with credentialing, peer review, and medical affairs management. Legal counsel will need to be familiar with the legalities of the act, as well as the hospital's peer review procedures and operations. General legal counsel should oversee coordination of hospital proceedings and assist in educating staff on the legalities of peer review.
1986年的《医疗保健质量改进法案》有助于保护医疗专业人员和医疗机构免受反垄断和诽谤指控以及同行评审过程中产生的其他形式的诉讼。由于该法案，一些医院可能需要对其同行评审活动进行重大变革。医疗保健实体，而非参与同行评审的医生，有责任遵守该法案的规定。不遵守该法案可能导致丧失损害赔偿豁免权、罚款以及可能被排除在医疗保险计划之外。责任风险促使医院重新审视并可能重组医务人员队伍，更新程序和相关管理文件。医疗保健实体可考虑进行一些变革，如设立医疗事务主任一职、选择任期为多年的医务人员以及集中管理医生评审档案。在20世纪80年代，许多医院设立了质量保证和风险管理项目。风险管理人员需要与质量保证人员共享数据，而质量保证人员必须将这些信息与参与资格认证、同行评审和医疗事务管理的医务人员分享。法律顾问需要熟悉该法案的法律规定，以及医院的同行评审程序和运营情况。总法律顾问应监督医院程序的协调工作，并协助对工作人员进行同行评审法律知识的培训。
