Is There a Relationship Between Facility Peer Review Findings and Quality in the Veterans Health Administration?

Federal practitioner : for the health care professionals of the VA, DoD, and PHS Pub Date : 2022-05-01 Epub Date: 2022-05-13 DOI:10.12788/fp.0268

Kathryn M Ryder, Megan K Carey, Yuri N Walker, Ronald I Shorr

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Abstract

Background: The aim of clinical peer review (PR) is to improve facility health care quality. However, prior authors have shown that PR may be biased, have rater reliability concerns, or be used for punitive reasons. It is important to determine whether facility PR processes are related to objective facility quality of care.

Methods: We collected proportion of PR findings that "most experienced and competent clinicians may have managed the case differently" or "most experienced and competent clinicians would have managed the case differently" as an objective measure of facility PR processes and outcomes. We correlated these with facility quality metrics for 2019.

Results: PR findings were not associated with facility quality metrics but were strongly associated with previous year findings.

Conclusions: This study describes a potentially new source of bias in PR and demonstrates that objective facility outcomes are not related to individual PR findings.

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退伍军人健康管理机构同行评议结果与质量之间是否存在关系?

背景:临床同行评议(PR)的目的是提高医疗卫生服务质量。然而，先前的作者已经表明PR可能是有偏见的，有更大的可靠性问题，或者被用于惩罚性的原因。确定设施PR过程是否与客观设施护理质量相关是很重要的。方法:我们收集了“最有经验和能力的临床医生可能会以不同的方式处理病例”或“最有经验和能力的临床医生可能会以不同的方式处理病例”的PR发现的比例，作为对设施PR过程和结果的客观衡量。我们将这些与2019年的设施质量指标联系起来。结果:PR调查结果与设施质量指标无关，但与前一年的调查结果密切相关。结论:本研究描述了PR中潜在的新偏倚来源，并证明客观设施结果与个体PR发现无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Federal practitioner : for the health care professionals of the VA, DoD, and PHS

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