Question: We have been working long and hard on our peer review process at the hospital and are pretty proud of the process we have established.   Then, we realized that as more care is provided on an outpatient basis, there is no peer review of that care.  Can we piggyback on our inpatient peer review process for care provided on an outpatient basis?

Answer:  As hospitals and health care systems mature, many are reaching the same realization – that it would be helpful to have some kind of peer review for care provided on an outpatient basis.  Assuming you are happy with the peer review process at the hospital, we think it is a great idea to start with that as a framework.  You will want to build on the principles of fairness, confidentiality, and collegiality that are part of the existing peer review process.

You may even involve some of the same individuals in the process.  That will help reduce the learning curve.

Obviously, the biggest difference will be the indicators that will trigger a review and the standards or benchmarks you use.   Don’t think you have to start from scratch.   There are a number of organizations that have already established indicators.

One thing to keep in mind is that while peer review information receives substantial protection under most state laws, some statutes limit the protection to peer review conducted in a hospital or other licensed entity.  You will want to know in advance if the documents you create for your outpatient peer review process will be protected from discovery and if the participants in that process will be entitled to immunity.

And don’t think the idea of outpatient peer review is limited to hospital-affiliated groups.  The same rationale for engaging in peer review applies for any group practice.

For more information about peer review for outpatient settings, join Susan Lapenta and Phil Zarone for the audio conference “Safety and Quality Across the Continuum” on March 5, 2013.