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Tip of the week: Train physician reviewers to do effective case reviews

Medical Staff Leader Connection, November 4, 2009

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Physicians have reviewed case charts from their first days of medical school, but they are rarely taught to do so formally. What should they be looking for when they are handed a folder filled with a patient’s medical records? To help physicians answer this question, it is best practice for a medical staff to create a training program to improve the inter-rater reliability of new committee members and keep current members on track.

There are three components to reviewer training. First, reviewers must have a common understanding of the procedures and tools. This is best achieved through an orientation session. During this session, the trainer needs to explain the case review process and define the expectations of reviewers in terms of review time frames and scoring form completion.

Second, the reviewers should have some practical guidance during the review. Provide a well designed review form and some questions for the reviewer to keep in mind.

Third, the reviewers need a method to calibrate their performance to the group norm. This can be accomplished by having reviewers score the same case independently and discuss the results. Medical staffs can do this when a new committee is started, when new members join the committee, and annually with the entire committee.

This week’s tip is excerpted from Peer Review Best Practices: Case Studies and Lessons Learned by Robert J. Marder, MD, CMSL and Jonathan H. Burroughs, MD, FACPE, CPE, FACEP, CMSL.

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