Peer Review Model Paper

Peer-Review Process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

One of the most critical factors which contribute to the number of preventable cases of healthcare harm is the culture of silence surrounding these cases. The fear of medical providers to report incidences is related to the possibility of punishment and liability due to a medical error (Discovery, 2010). The criminalization of some acts of medical error has resulted in job dismissal, criminal charges and jail time for some healthcare workers. This is despite the fact that the system they are working in helped to create the situation which led to the error in the first place. Human error, due to fatigue and system errors can result in deadly consequences, but by criminalizing the error it effectively shuts down the ability to correct the root problem. Healthcare workers, working at all levels within the medical system, can provide valuable input on how to improve the processes and prevent harm from occurring (Discovery, 2010).

Once an area of evidence-based practice has been chosen for investigation, the reviewer must locate current evidence sources and, using a structured approach, assess each for applicability to the issue being investigated. The aim of this paper is to use a Rapid Critical Appraisal Checklist (Melnyk and Fineout-Overholt, 2011) to support these sources of evidence into a review that discusses the importance of daily, high-level, multidisciplinary communication and patient safety. The summaries of these evaluations will be provided as an appraisal of each study.

Safe Harbor Peer Review (SHPR), this is a type of nursing peer review that may be initiated by a nurse (LVN, RN, APRN) before accepting or participating in an assignment they deem would place a patient at risk of harm which would then cause the nurse to violate his/her duty to their patients.

In many ways, the hospital system in America is set up mirroring our government. They are similar in the way that checks and balances have been set in place to ensure the best possible care is delivered to patients. With these checks and balances there are three main bodies; the governing board, medical staff, and executive management (Showalter, 2017). The duties and responsibilities of each body many times is to oversee and continually check the others. A prime example of this system can be seen through the case of Moore v. The Board of Trustees of Carson-Tahoe Hospital, which took place in Nevada and was heard before the Supreme Court of the state in 1972 (Moore v. Board of Trustees of Carson-Tahoe Hospital, 1972). Specifically, in this case, the duty of the governing board to “exercise reasonable care in selecting and retaining medical staff” is questioned in contrast with the right of the physician to have “due process… when disciplinary action is taken” (Showalter, 2017). In hopes of changing a decision by the governing board, and attempting to reverse the decision of a lower court, the appellant, Dr. Moore, brought the case against Carson-Tahoe Hospital (Moore v. Board of Trustees of Carson-Tahoe Hospital, 1972).

A peer review is a process of subjecting research methods and findings to the study of others who are experts in the same field. The purpose is designed to prevent dissemination of irrelevant findings, unwarranted claims, unacceptable interpretations, and personal views. It relies on colleagues that review one another’s work and make an informed decision about whether it is legitimate, and adds to the large dialogue or findings in the field.

Throughout my research, a challenge I encountered was the fact that some of the articles I encountered seemed to included biases within them especially with the primary view of

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

Take the point of view of Brendtro, Mitchell, & Doncaster (2011) and analyze the article(s) you selected in #3. Using these authors’ arguments from their “Practice-Based Evidence: Back to the Future” article, what would be their evaluation of the article(s) you selected?

In a similar case where a hospital was required to provide a timely peer review hearing before suspending a physician’s medical staff privileges, the results were not in favor of the plaintiff. The Encino Tarzana Regional Medical Center (ETRMC) was allegedly charged with abusing the peer review process. An obstetrician/gynecologist had his medical privileges suspended without prior notice and became involved in a surplus of disputes with the hospital. Under California law, the hospital has the right to suspend a physician’s staff privileges without a hearing if it finds the doctor as a danger to a patient’s health or safety. Dr. Mileikowsky’s reputation has presented a listing of complaints dated back 10 years so they hospital made a decision

This essay will be a critical review on the study conducted by Majid et al (2011). The article which is titled ‘Adopting evidence-based practice in clinical decision making:

“The definition of a health professional is a person who works to protect and improve people’s health by the diagnosis and treatment of illness to bring about a complete recovery from mental, physical and social perspectives, either directly or indirectly (Kurban, 2010, pg. 760).” Nurses in the community today have acquired an increasing responsibility to intervene with medical decisions. In the past, there were clear differences between nurses and doctors. It was more common for a nurse to be supervised directly under the physician. They are not just performing Doctor’s orders anymore. The nurse role in patient care has been widely expanded. Allegations against someone can be one of the most stressful moments of their careers. Negligence

Reviewing the article in its entirety, we are aware that the article focuses in the American Medical Association, but the same circumstances or situations that are highlighted within the context of the article could be an issue with any MCO Board of Directors that has willing participants from a wide-range of organizations that are members of the board. We acknowledge that there will or should be guidelines, principles, by-laws, Code of Conduct and Code of Ethics, but as with the health care environment we are dealing with individual human beings and human nature.

Another less formal option would consist of a peer review of an employee’s concerns to address

Today, peer review is performed in a variety of settings, such as part of the quality