Case Review has historically and continues to be a main stay of performance evaluation. By its nature of individuals rating other individual's performance, it has always carried the burden of a degree of subjectivity. This has lead, in many cases, to a system described as punitive and unfair. In extreme cases, there are accusations of sham peer review that often fall into litigation. This talk will be composed of two parts.
The first and major section will discuss best practice steps in establishing a fair and effective case review process. These steps include case identification, triaging, summary of issues, initial review, response of involved practitioner and case adjudication. This will also go into roles and responsibilities of the various participants including reporting methods.
The second area will talk about the successful implementation of case review and some of the common pitfalls that may be avoided.
Why should you attend: Hospital and Medical Staff leaders who oversee, conduct and/or support individual case review as part of the peer review process for evaluating practitioner performance. This also includes any Managed Care groups, Medical groups, Insurance Companies or other Payers that have established practitioner case review as part of their processes.
Areas Covered in the Session: