Purpose: Peer review for outreach facilities is a valuable safety and quality tool. We describe an approach utilized to overcome the challenge of converging an outreach community practice with an affiliated academic clinic for a consistent level of excellence.
Methods: The RO outreach practice developed a robust program to provide peer learning that promotes CQI in treatment practices. Prospective and retrospective processes are implemented through two primary mechanism, case-oriented and practice-oriented peer review.
Results: Case-Oriented Peer ReviewProspective peer review is performed with a four-layer peer review system on all patients’ treatment courses for curative and palliative cases. Three days a week the outreach facility team participate in an affiliated academic center’s dedicated 90 minute time slots for disease site groups. Pretreatment chart rounds include planned cases where indications, volumes, dose/fractionation and beam arrangements are considered. Review is recorded in a patient specific chart round task within RIS. Academic input facilitates an open discussion with all department staff represented. These prospective peer reviews are cascaded to the outreach facility chart rounds in an additional once/week time slot. A Chart Rounds widget enables electronic attendance records and patient specified tasks. Case–oriented peer reviews are performed subsequently by dosimetry, physicist and therapists prior to treatment initiation. Multidisciplinary level review is performed at the academic center and outreach facility tumor boards.Practice-oriented Peer Review The outreach staff participate in numerous Standing Committees. This peer review also includes a prospective, concurrent or retrospective case for educational purposes, professional feedback and future learning. Staff teach and review their CEU’s.
Conclusion: This peer review implementation helps establish a closer working relationship with the academic center and the process improves patient care and consistency. Scheduling complications between the groups are addressed. A successful comprehensive peer review program has been implemented, which can be applied to networked facilities.