Evaluating quality of care: the role of peer review.

Peer review for quality of care is often conducted to address issues such as professional staff conflict, hospital or clinic privileging, identified quality concerns or patient complaints, and group practice membership decisions. Inherent to the definition of peer review is independent and unbiased review of the quality of care by a person or persons in the same profession who are of the same or higher ranking or training. While many studies have outlined the limitations of the peer review process, the reliability of the process can be improved by providing more structured assessments to identify differences in patient management, adjusting systematic bias resulting from the individual reviewer and their professional background, summarizing assessments from multiple independent reviewers, and using structured implicit review based on evidence-based guidelines or performance metrics. Active participation in the process by practicing physicians and healthcare professionals is essential for the success of effective peer review.