6/11/2010 – Dr. Dennis Ehrich, Vice President for Medical Affairs of St. Joseph’s Hospital Health Center, Syracuse, NY, announced the initiation of an ambitious project to reform clinical peer review practice with support from the medical staff leadership using the My PREPTM toolkit supplemented with a measured amount of onsite facilitation by Marc T. Edwards, MD, MBA of QA to QI Consulting. The medical staff will fund half the cost of the project.
Says Dr. Ehrich, "We have very good staff resources for quality improvement and a strong IT department. Our preference is to do it ourselves. Once we made the commitment to fix peer review, however, the My PREPTM toolkit was the logical choice. Nothing else was out there to help us transition to the QI Model. It wasn’t worth investing in the necessary development work to try to customize our otherwise robust MIDAS system for the task. We doubted that we could create a home-grown method for clinical performance measurement without a lot of pain."
Dr. Ehrich, who has a 6-Sigma Green Belt, is changing his role at the hospital to that of Chief Quality Officer so that he can focus exclusively on quality improvement activities. "When I came across Dr. Edwards’ 2009 articles in the Physician Executive Journal, they struck a resonant chord for me. He showed a way to revitalize peer review as a core support for quality improvement activity. Sad to say, our peer review program deteriorated over the past decade. We abandoned our traditional departmental reviews and transitioned to a process in which physicians conducted their reviews in isolation and submitted them to a centralized committee for discussion and disposition. This approach to review, taken in the context of New York State’s heavily regulated healthcare environment raised the anxiety level of our medical staff, negatively impacting their willingness to participate."
"After speaking with Dr. Edwards, I decided to bring him in to meet with our physician leadership. I wanted to see if that group could commit to the improvement. Dr. Edwards spent a day and a half with us. At the end of the first day, Marc was armed with a good understanding of the organization and was able to engage our physician leaders for 2½ hours in a dialogue about where we’d been and where we could go. When the evening was over, clearly, there was enthusiasm for change. Some physician leaders did require a one-one-one explanation of the new process, after which they saw the value of making the change."
"At the Medical Executive Committee meeting the next morning, we won a “thumbs up” to proceed with the project. A month later, with proposal in hand, the group committed to cost-share with the hospital."