Notice: Out-Dated Version

This inventory was retired when the results of the Longitudinal Clinical Peer Review Effectiveness Study completed in March 2016 were accepted for publication in the International Journal of Quality in Health Care, published by Oxford University Press. Please see https:/ for the current version.

The associated methodological notes were simultaneously updated and can be found at:

Archived Version

This brief questionnaire returns a QI Model Score measuring the extent to which your clinical peer review program conforms to evidence-based best practices.

For technical background on the Self-Evaluation Tool see: Clinical Peer Review Program Self-Evaluation Tool Overview

Answer the following questions as they apply to the entire peer review program at your hospital, not just within a single department. Your score will display after you submit your responses.

If you wish to receive a copy of the results and analysis, please be sure to enter your correct email address. All information entered will be kept confidential. We do not sell or share our contact lists.

Identifying Information (Optional)

First Name
Last Name
Organization Name
Mailing Address
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Standardization of Process


Clinical Performance Measurement During Case Review (see examples below)

Example A: Commonly Used Overall Rating Method

This assessment, limited to an overall score, classifies the review decision, but does not measure clinical performance.

It has 10 options, but only captures 3 levels of management quality (Appropriate - Varied from Standard - Unacceptable).

Example B: Sample Methodology and Rating Scale for Measuring Clinical Performance

Multiple elements of clinical performance are rated on a 5 point scale from Best to Worst. Page one of several.

cf: Rubin HR et al. Guidelines for Structured Implicit Review of Diverse Medical and Surgical Conditions. RAND; 1989 N-30066-HCFA.

Common overall unstructured rating method Sample structured rating scale


Recognition of Excellence


Governance of Process


Rating Scales for Case Review (see examples above)


Reviewer Participation

Which statement best describes the level of participation by Reviewers in the Peer Review process?


Relationship to Performance Improvement Activity


Improvement Opportunities


Board Involvement


Performance Feedback


Case Review Volume


Documents Examined During Case Review


Adverse Events



Medical staff members frequently report adverse events, near misses and/or hazardous conditions affecting their own patients for peer review.


Committee Discussion of Case Reviews

What proportion of case reviews are presented and discussed in a committee prior to final decision-making?


Quality of Case Review

Rate the general quality of case review activity on the following scale:
Submit responses to see your QI Model Score security phrase