Lots of Change, Little Improvement

3/15/2018 - Dr. Marc Edwards of QA to QI Patient Safety Organization announced that two manuscripts reporting findings from the Longitudinal Clinical Peer Review Outcomes Study have been accepted for publication. In Pursuit of Quality and Safety: an Eight-Year Study of Clinical Peer Review Best Practices in U.S. Hospitals will appear in the International Journal for Quality in Health Care published by Oxford University Press. An Assessment of the Impact of Just Culture on Quality and Safety in U.S. Hospitals will appear in the American Journal of Medical Quality.

"I'm grateful to the editors at AJMQ who patiently delayed publication following acceptance on October 3, 2017 while the scientific peer review process at IJQHC played out. This way, the two manuscripts can properly cross-reference each other," said Dr. Edwards.

He indicated that the study confirmed the trend identified in 2011: hospital medical staffs frequently make major clinical peer review program changes without attention to the evidence-based factors that would enhance effectiveness. Nevertheless, it did confirm that those whose peer review programs first and foremost aim at improving the quality and safety of care are more likely to have a better process. It also uncovered additional best practices associated with greater likelihood of significant ongoing impact on the quality and safety of care. Dr. Edwards used the data to update the Clinical Peer Review Program Self-Assessment Inventory.

What is more, the study identified that over 70% of hospitals have implemented Just Culture programs. While they are generally positive about the effect, there is no objective evidence that Just Culture has improved quality or safety of care.

Article abstracts are available on the QA to QI website: https://qatoqi.com/research.htm.

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 https://qatoqi.com/bio.htm or contact him directly: marc@QAtoQI.com; 860.521.8484.

QA to QI Patient Safety Organization (Raleigh, NC; www.QAtoQI.com) specializes in the development of evidence-based tools for healthcare improvement through operations research.