2 functions of peer review

The peer review process, required by CMS and hospital accreditation organizations, must accommodate two functions, the evaluation and oversight functions, according to a whitepaper by Robert Marder, MD, advisory consultant and director of medical staff services with The Greeley Company.

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The evaluation function is the more familiar of the two, according to the whitepaper. This function is the process of evaluating a physician’s performance, evaluating rate measures and rules compliance.

On the other hand, the oversight function is less well-known, Dr. Marder writes, because “in many hospitals, the peer review process is not organized to perform it.” The function involves “all the actions necessary to oversee the [peer review] process and ensure that it is done correctly.” He lays out some responsibilities for effective oversight, including the following:

  • Standardizing and coordinating case review process
  • Ensuring data is systematically collected and analyzed
  • Making sure physician performance data is available for feedback
  • Choosing relevant measures for performance dimensions and competencies

Read the full whitepaper for more.

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