A Framework for Collaborative Peer Review

February 6, 2014
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I titled this post “Collaborative Peer Review” because peer review brings out strong feelings. It’s like taking strong medicine. We dislike being asked to do peer-review reports and certainly don’t like being the subject of a peer-review report, but recognize that peer review is here to stay. Receiving a report on one of our patients narrates judgment and technique gone awry, which humbles us and reminds us that we are human.  It may take years to acknowledge that feedback makes us better physicians.

I titled this post “Collaborative Peer Review” because peer review brings out strong feelings. It’s like taking strong medicine. We dislike being asked to do peer-review reports and certainly don’t like being the subject of a peer-review report, but recognize that peer review is here to stay. Receiving a report on one of our patients narrates judgment and technique gone awry, which humbles us and reminds us that we are human.  It may take years to acknowledge that feedback makes us better physicians.

Being asked to do a peer-review report often comes when we have other things to do, so that the goal becomes, “How can I check off the questions and get it done as quickly as possible.  Yet, none of us likes being told that s/he did not do a good enough job and scowls at the prospect of rework.

A Framework for Collaborative Peer Review

It was in the spirit of “do it right the first time” that Steve Babitsky and I traveled to a hospital system to teach physicians how to write effective peer-review reports, using a three-pronged approach:

  • Gather input from physicians: before imposing a new system on doctors, find out what works well and build on it; similarly, asking them about the challenges that they face, such as conflict of interest and reporting negligence, encourages self-appraisal, brainstorming, and problem solving
  • Help them develop a checklist: this approach helps them make the best use of limited time and provides a replicable process that leads to learning, growth, and mastery
  • Use examples of actual peer review reports to demonstrate the difference between effective and ineffective report writing: asking participants to review three reports and tell us what they should continue and what they need to improve engaged them in adult learning and allowed them to benefit from colleagues’ insights
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Using this approach, participants left with  a clearer idea of how to write effective peer-review reports that educate physicians not only about evidence-based medicine but also about communication that facilitates patient transitions and the role that well-designed systems play in enhancing care outcomes.

“Peer review is like being a detective,” according to one of our participants, who enjoyed the role of clinical problem-solver.

In general, physicians have done everything asked of them, from studying hard in college to get into medical school to working 80+ hour work-weeks, so that clinical issues that matter to patients do not fall between the cracks.  By giving them a field-tested approach to collaborative peer review, we make it easier for them to succeed at this important task instead checking off the boxes to get it done quickly.

This post is an overview of the peer-review reporting process.  A detailed approach to writing more effective peer-review reports will appear in the March 2014 issue of the Healthcare Collaboration newsletter.  To sign up to receive this newsletter, please contact us as soon as possible, so that we may add your name to the mailing list of over 1900 healthcare leaders who receive our complimentary newsletter.  It takes just two minutes to read, and you may unsubscribe at any time.

As always, I welcome your input to improve healthcare collaboration where you work. Please send me your comments and suggestions for improvement.

Kenneth H. Cohn

© 2014, all rights reserved

Disclosure:

I have not received any compensation for writing this content. I have no material connection to the brands, topics and/or products that are mentioned herein.

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