Much Change—Little Demonstrable Improvement: Will the Trend Continue?

10/5/2015 - Dr. Marc Edwards of QA to QI Patient Safety Organization announced the launch of his fourth national study of clinical peer review practices since 2007. The current study is designed to assess best practices and trends among 470 hospitals that participated in his prior studies. Dr. Edwards observed that "Four years ago, I found a persistently high rate of program change, with little sign that practices associated with greater impact on quality and safety were being incorporated. Four out of five hospitals had substantial room for improvement in peer review program structure, process and/or governance. Given that peer review is the dominant method by defects in patient care are assessed with a view to improvement, the finding was most troubling."

The results of his 2011 study appeared in the Journal of Healthcare Management, which is published by the American College of Healthcare Executives—the premier professional organization for senior hospital leaders. That put the information in front of the right audience to take the needed action.

"Considering that each year about 20% of hospital medical staffs make big changes to their peer review program, it should be easy to tell whether they are paying attention to the best practice QI model or whether they are simply churning the out-moded, dysfunctional QA model that has dominated practice and poisoned efforts to improve safety for more than 30 years."

Data collection is expected to take four to six months.

Marc T. Edwards

Marc T. Edwards, MD, MBA is President and CEO of QA to QI LLC. He operates a Patient Safety Organization, conducts research in healthcare operations improvement, markets clinical peer review program management software, and assists clients to make improvements in quality, safety and resource use. For additional information, visit or contact him directly:; 860.521.8484.

QA to QI Patient Safety Organization (West Hartford, CT; specializes in the development of evidence-based tools for healthcare improvement through operations research.