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Health Services Research & Development

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2009 HSR&D National Meeting Abstract

National Meeting 2009

2007 — Back to the Future? The Role of Peer Review in Health System Quality

Francis J (Office of Quality and Performance), Enderle M (Office of Quality and Performance), Phillips Y (Office of the Medical Inspector), Hofer T (COE - Ann Arbor)

Workshop Objectives:
Historically, health care quality improvement (QI) has been driven by professionals reviewing other professionals’ care of individual patients (implicit peer review). Concerns over the objectivity of this approach, plus widespread acceptance of “industrial QI,” have recently caused a shift towards explicit measurement focused on processes of care for specific conditions. Nonetheless, implicit peer review remains an important activity of health systems, particularly for cases of complex decision-making and judgment under uncertainty. This workshop will highlight recent examples of how reliable and objective peer review can complement explicit metrics and identify quality concerns despite “on-target” performance data. After participating in this workshop, the attendee will be able to: 1)Identify important lessons from recent organizational QI case studies; 2) Understand the relative strengths and weaknesses of explicit versus implicit QI approaches; 3) Apply insights from recent empirical research in peer review; and 4) Articulate key priorities and questions for future research and policymaking.

Presenters will share organizational case studies as well as results of empiric research. Discussion will focus on how health services research can assist VHA in adopting sound national policy for quality improvement.

Target Audience:
Clinical and health system leaders who desire to improve the reliability and validity of implicit peer review, as well as health services researchers interested in exploring opportunities to compare quantitative (measurement-based) with qualitative (judgment-based) approaches to assessing performance.

Assumed Audience Familiarity with Topic:
Audience members should have a basic familiarity with the principles of quality measurement, quality improvement, evidence-based medicine, and professional peer review.

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