On-Demand Learning Lab: Administrative Foundations of Practitioner Peer Review-Recording Administrative Foundations of Practitioner Peer Review

Video Transcription

Video Summary

NACU hosted a Live Learning Lab webinar on the “Administrative Foundations of Practitioner Peer Review,” presented by Nicole DeVries, Clinical Director for Hospital Quality Improvement at Inland Empire Health Plan and a former hospital quality leader. She positioned peer review as a medical staff function that supports patient safety, professionalism, and high reliability, while meeting regulatory expectations (often Joint Commission–driven). <br /><br />DeVries emphasized that a robust program must be grounded in a medical staff–approved policy and a consistent, bias-reducing process. She outlined three core components: (1) individual record peer review, using defined triggers, structured workflows, and clear provider notification; (2) Ongoing Professional Practice Evaluation (OPPE), a periodic competence evaluation using specialty-specific indicators often aligned to ACGME core competencies; and (3) Focused Professional Practice Evaluation (FPPE) “for-cause,” initiated by serious events or trends, with clear criteria, documentation, and legal safeguards.<br /><br />She recommended a phased approach to OPPE—start with validated, accessible metrics, then refine indicators to align with strategic priorities. DeVries also highlighted linking peer review/OPPE trends to broader quality improvement and value-based contracting (e.g., embedding performance requirements in physician group contracts). Q&A addressed review frequency, physician perceptions, external peer review to reduce bias, and standardizing FPPE across committees.

Keywords

practitioner peer review

medical staff policy

patient safety and professionalism

Joint Commission regulatory compliance

individual record peer review triggers

bias-reducing review process

Ongoing Professional Practice Evaluation (OPPE)

Focused Professional Practice Evaluation (FPPE) for-cause

quality improvement and value-based contracting