Featured in the March/April 2019 Colorado Medicine.
Since becoming COPIC’s CEO, I’ve had several humbling learning experiences. Certain issues I thought I knew well have more depth and complexity when viewed through the lens of my new role. Professional review is one of these issues. As a practicing physician, I participated in professional review with my peers and there was a shared understanding about the value of it. Now, my conversations often look at this process from regulatory and legal angles and involve people who aren’t physicians.
Luckily, I am surrounded by experts who know how to frame the issue in a broader perspective. And through my interactions with them, I’ve developed a few “talking points” to explain why everyone should support professional review.
The Colorado Department of Regulatory Agencies (DORA) has already recommended the reauthorization of professional review.
The Colorado Professional Review Act (CPRA), which governs the professional review process, is up for review this year. The first step was an initial review by DORA and it recommended the full reauthorization of CPRA. This recommendation reinforces that professional review laws are necessary to protect patient safety, and that medical professionals are in the best position to monitor themselves because of the necessary knowledge needed to perform these complex reviews. The next step involves a review of CPRA by the Colorado General Assembly during the 2019 legislative session.
Professional review doesn’t just relate to physicians in a hospital setting.
In Colorado, professional review applies to those licensed under the Medical Practice Act – physicians, physician assistants and anesthesiologist assistants, as well as advanced practice nurses. In addition, CPRA allows medical practices to utilize professional review as long as certain requirements are met. This is supported by the federal Health Care Quality Improvement Act, which states that a “health care entity” includes group medical practices that follow a formal peer review process for the purpose of furthering quality health care.
Professional review doesn’t just examine adverse outcomes.
Within the medical community, professional review is recognized as a supportive process that encourages performance improvement. This means reviews are triggered not just when an adverse outcome occurs, but also when care could be improved to avert possible issues. Professional review benefits most from a multi-disciplinary team approach where everyone can understand and embrace the changes that may emerge and make a positive difference for patients.
Professional review is a key aspect of the lifelong learning physicians embark on.
We participate in professional review to learn and ensure that all patients receive the best outcomes possible. I have seen first-hand the impact professional review has on quality improvement, the value of in-depth, open discussions that occur, and how those involved recognize the responsibility associated with this process.
The ultimate goal of professional review is to ensure that qualified health care professionals are providing safe and appropriate patient care.
As physicians, we need to educate those outside of health care about professional review. It promotes evaluating, learning and improving care delivery as an ongoing process. CPRA enables physicians and medical professionals to share information without fear of retribution from colleagues who are under review. Without these protections, important information would likely not be shared, and patients could be at increased risk of system failures or near misses. It is also important to point out that CPRA only affords protections if certain standards (e.g., registration, compliance and reporting) are met by participants.
As the American Medical Association notes, “The peer review process is intended to balance physicians’ right to exercise medical judgment freely with the obligation to do so wisely and temperately.” COPIC strongly supports the value and role of professional review and I hope that we all voice how important this process is to health care.