Edwards Marc T
QA to QI Consulting, West Hartford, CT 06107, USA.
Am J Med Qual. 2010 Nov-Dec;25(6):474-80. doi: 10.1177/1062860610371224. Epub 2010 Aug 23.
Prior research has shown wide variation in clinical peer review program structure, process, governance, and perceived effectiveness. This study sought to validate the utility of a Peer Review Program Self-Evaluation Tool as a potential guide to physician and hospital leaders seeking greater program value. Data from 330 hospitals show that the total score from the self-evaluation tool is strongly associated with perceived quality impact. Organizational culture also plays a significant role. When controlling for these factors, there was no evidence of benefit from a multispecialty review process. Physicians do not generally use reliable methods to measure clinical performance. A high rate of change since 2007 has not produced much improvement. The Peer Review Program Self-Evaluation Tool reliably differentiates hospitals along a continuum of perceived program performance. The full potential of peer review as a process to improve the quality and safety of care has yet to be realized.
先前的研究表明，临床同行评审项目的结构、流程、治理及感知到的有效性存在很大差异。本研究旨在验证同行评审项目自我评估工具的效用，作为寻求更大项目价值的医生和医院领导者的潜在指南。来自330家医院的数据表明，自我评估工具的总分与感知到的质量影响密切相关。组织文化也起着重要作用。在控制这些因素后，没有证据表明多专科评审流程有好处。医生通常不使用可靠的方法来衡量临床绩效。自2007年以来的高变化率并未带来太大改善。同行评审项目自我评估工具能够在感知到的项目绩效连续体上可靠地区分医院。同行评审作为提高医疗质量和安全性的过程的全部潜力尚未实现。
