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Peer review--it's not just for doctors anymore

Accreditation Connection, January 20, 2005

Not unlike the peer review processes for physicians, peer review for nurses is prone to manmade flaws, such as biased evaluators, lack of constructive feedback, and tardy entry of evaluations to management. To combat these problems, employees at Saint Joseph's Hospital (SJH) in Atlanta implemented peer review councils (PRC).

During the American Nurses Credentialing Center's Eighth Annual Magnet conference held in Sacramento, CA, Anne Pedersen, RN, MSN, the nursing director of cardiology at SJH, and Patricia Crabtree, RNc, MS, the nurse manager at St. Joseph's, relayed the fruits of their PRC efforts to the audience. Such successes include an 85% reduction of late evaluations, improved quality of feedback, and a more professional working environment. So how did they do it? Crabtree and Pedersen explained the necessary steps to the audience.

Once staff and management began to express interest in forming PRCs, Pedersen and her team took the following steps to implement the new evaluation process:

They developed a draft to formally define the make-up and purpose of PRCs. This includes defining and discussing the following: the councils' philosophy, values, and functions; the responsibilities of those involved (e.g., unit managers, peer-review chairs and members, and staff members); the importance of confidentiality, constructive feedback, and impartiality

They obtained human resources' (HR) and nursing leaders' support. To gain backing from HR and unit managers, Pedersen ran the first draft by them for review. The second draft was then discussed with the chief executive officer. Finally, Pedersen and her peers wrote the third and final draft, which they shared with the executive council (i.e., chairs from each council, the director of shared governance, and the chair of the nursing staff) for approval.

They performed a unit vote for implementation of PRCs. After confirming the PRCs' purpose and format with all necessary parties, Pedersen presented the final draft to the staff for discussion and approval. The PRC concept was voted in with a unanimous yes, she said.

They identified and appointed PRC chairs and members.

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