Breaking Down Silos: Key Steps to Implementing a Multidisciplinary Peer Review in Your Hospital

As a top-tier healthcare executive, have you ever found yourself questioning the effectiveness of your organization's medical staff peer review process? Is it perceived as punitive? Are you seeking a more collaborative approach overseeing your hospital's quality of care???

If your answer to any of these questions is a resounding yes, then it's high time we explore the significant, yet often overlooked, Multidisciplinary approach to peer review.

The Challenge with Traditional "Silo” or “Specialty Specific" Approaches??

Traditionally, peer reviews in healthcare have been specialty-specific (i.e., peer review committees made up of the same specialty only), often described as a silo approach, because there is no sharing across specialties. While this approach has its merits, it lacks the broad perspective necessary to assess the complex and interdependent processes that characterize modern healthcare.

The quality literature clearly states the cause of a majority of errors are due to process problems and not an individual. According to a report by The Joint Commission, as of 2021, 60% of sentinel events - unanticipated events in healthcare resulting in serious physical or psychological injury - were attributed to communication failures across multiple areas.

A siloed peer review process contributes to these failures by limiting the scope of communication and collaboration across different healthcare disciplines. Where a multidisciplinary approach would look at an issue from multiple perspectives and share the learning across the enterprise.

Embracing the Multidisciplinary Approach??

Multidisciplinary peer review brings together physicians from various disciplines into one committee to assess and discuss quality issues. This broad-based approach offers several benefits:

• Holistic Evaluation: It ensures a more comprehensive evaluation of clinical performance, considering all aspects of patient care, including diagnosis, treatment, hospital processes, equipment and patient experience to name a few.
• Enhanced Communication: It fosters improved communication and collaboration among different healthcare disciplines, ultimately leading to a more cohesive patient care team.
• Shared Learning: It encourages shared learning and the exchange of best practices among different healthcare professionals, enhancing overall patient care.

??Actionable Tips: Introducing a Multidisciplinary Approach to Your Peer Review Process

As you consider shifting towards a multidisciplinary approach, here are some practical steps you can take:

1. Build a Diverse Peer Review Committee:??

The first step is to assemble a peer review committee comprising representatives from various disciplines (start with primary care: Medicine, Pediatrics, Obstetrics, Surgery and ED for example). Note: Ensure you have representation from administration in an ex officio capacity (CEO, CMO, CNO). Remember, they are the people who can change processes immediately. If they are not included in the conversation, it can take longer to make a change.??

To ensure you have the broadest range of insights, go beyond merely assembling a team from various disciplines. You may need to use Subject Matter Experts (SMEs) occasionally when the committee doesn’t have the expertise to evaluate an issue. Identify key individuals who bring diverse perspectives and experiences, from different levels of the organizational hierarchy. Additionally, to increase acceptance and adoption of the new approach, consider issuing staggered terms that lead to?rotating membership to allow more staff the opportunity to participate.

??Action Item: Develop a matrix that identifies various roles and departments in your hospital. Use this as a guide to ensure diverse perspectives are represented in your multidisciplinary review committee. It doesn’t have to include all specialties. Just a sub committee that is empowered to bring in sub-specialists as needed for broader input.

2. Establish Clear Guidelines:??

Develop clear, fair, and transparent policy for conducting reviews. This includes defining the review process, establishing the criteria for evaluation, and outlining the roles and responsibilities of committee members. This will insure consistency and standardization for all cases reviewed.

In addition to developing a policy, make it easily accessible to all team members. Clearly articulate the purpose and scope of the peer review process to reduce misunderstandings and ensure that everyone is working towards the same goals.

??Action Item: Draft a comprehensive policy detailing the peer review process and guidelines. Organize a meeting to go through this document with the committee and address any concerns or questions.

3. Encourage Open Communication:???

Promote a culture of open and respectful communication within the committee. Remember, the goal is not to point fingers or assign blame, but to identify opportunities for improvement and develop action plans to address them.

While promoting open communication, it is essential to create a 'safe space' where individuals feel comfortable expressing their views without fear of reprisal. Encourage all members to actively participate and ensure that their feedback is acknowledged and respected. Note: remember the peer review process is confidential and generally protected from legal discovery. Any violation of that confidentiality could lead to discoverability of your process and content.

??Action Item: Schedule regular meetings where all members have the chance to review cases. Allow reviewers to get input from the physician(s) who were involved in the care so you have more than just the documentation in the chart to formulate your recommendations.

4. Provide Training:???

Training should be viewed as an ongoing process rather than a one-time event. Regularly schedule workshops or sessions focused on building skills such as giving and receiving feedback, conflict resolution, and collaboration. It may be beneficial to bring in external experts for specialized training sessions.

??Action Item: Set up a training calendar and identify internal or external resources who can lead the sessions. Consider getting feedback from team members on specific areas they'd like to receive training in.

5. Evaluate and Refine:??

Finally, regularly evaluate the effectiveness of your multidisciplinary peer review process and make necessary adjustments. This could involve soliciting feedback from committee members, medical staff members and others who can identify potential?areas for improvement.

??Action Item: Establish key performance indicators (KPIs) to objectively assess the effectiveness of the peer review process. These could include measures like: Speed to Resolution of the Issue, Improvement in outcomes, Severity Level of issues brought to the committee, to name a few.

As healthcare leaders, the future of our industry rests firmly in our hands. We are the torchbearers of change, the innovators who dare to break from tradition and venture into new ways of improving patient care. Embracing a multidisciplinary approach to peer review is a significant stride towards achieving this goal.??

In taking these steps, you're not just initiating a new process; you're spearheading a transformative culture shift in your organization. A shift that values diverse perspectives, champions open communication, and places shared learning at its core. A shift that acknowledges the intricacies of patient care, recognizing it as a collaborative effort rather than the responsibility of a single department or role.

It is indeed a journey, one that requires time, patience, and unwavering commitment. However, the reward - a more collaborative, communicative, and patient-centered healthcare environment - is well worth the effort.??

As you embark on this journey towards a multidisciplinary approach in your organization, I invite you to share your insights, challenges, and triumphs. How are you facilitating this transformative shift in your peer review process? What obstacles have you encountered, and how have you overcome them? Your experiences will no doubt serve as valuable lessons for us all.

?? Your journey towards embracing a multidisciplinary approach in your organization doesn't have to be navigated alone.

We're here to lend our expertise, offer guidance, and provide practical solutions tailored to your unique challenges and goals.

Ready to take the next step? Send me a message:?

??210.854.2312?

?? https://hwhealthcaresolutions.com

?? [email protected]

I'm excited to explore how I can assist you in enhancing your peer review process, fostering greater collaboration, and driving significant improvements in patient car.??

About Herman Williams

Over the last 25+ years as an MD with an MBA and MPH, I have worked with 3 Multi-Million dollar Hospital organizations serving as VPMA and CMO saving millions of dollars and improving quality. I went on to serve as Chief Physician Executive for BDO USA, the fifth-largest professional services firm in the United States.?

The key to my clients' success has been my proprietary ???????????? ??????????????????????.?

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Today, I run my own organization helping hospital executives solve their “Burning Issues”.