A Novel Program to Improve Patient Safety by Integrating Peer Review into the Emergency Medicine Residency Curriculum

Abstract Background Evaluating the quality of care as part of a quality improvement process is required in many clinical environments by accrediting bodies. It produces metrics used to evaluate department and individual provider performance, provides outcomes-based feedback to clinicians, and identi...

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Bibliographic Details
Published in:The Journal of emergency medicine 2014-12, Vol.47 (6), p.696-701.e2
Main Authors: Strayer, Reuben J., MD, Shy, Bradley D., MD, Shearer, Peter L., MD
Format: Article
Language:English
Subjects:
Clinical Competence
Curriculum
Education, Medical, Graduate - methods
Emergency
Emergency Medicine - education
Humans
Internship and Residency - organization & administration
Internship and Residency - standards
Patient Safety
Peer Review
Quality Assurance, Health Care - methods
Quality Improvement
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Summary:Abstract Background Evaluating the quality of care as part of a quality improvement process is required in many clinical environments by accrediting bodies. It produces metrics used to evaluate department and individual provider performance, provides outcomes-based feedback to clinicians, and identifies ways to reduce error. Discussion To improve patient safety and train our residents to perform peer review, we expanded our quality assurance program from a narrow, administrative process carried out by a small number of attendings to an educationally focused activity of much greater scope incorporating all residents on a monthly basis. We developed an explicit system by which residents analyze sets of high-risk cases and record their impressions onto structured databases, which are reviewed by faculty. At monthly meetings, results from the month's case reviews are presented, learning points discussed, and corrective actions are proposed. Conclusion By integrating Clinical Quality Review (CQR) as a core, continuous component of the residency curriculum, we increased the number of cases reviewed more than 10-fold and implemented a variety of clinical process improvements. An anonymous survey conducted after 2 years of resident-led CQR indicated that residents value their exposure to the peer review process and feel it benefits them as clinicians, but also that the program requires a significant investment of time that can be burdensome.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2014.07.035