What's New @ RHQN

RHQN Monthly Newsletter February 2010

Expanding External Peer Review Services
One of the Rural Healthcare Quality Network’s (RHQN) keystone functions is the provision of an external peer review service. This service is a tool for satisfying several of the Centers for Medicare and Medicaid Services (CMS) conditions of participation for critical access hospital status. We are very proud of this unique service offered to Washington State’s rural hospitals for several reasons. First, we are the only peer review service in the country that collects information from local facility clinical quality improvement trends and issues and uses this information to shape a statewide clinical quality improvement program. These observations and trends are the foundation of the RHQN’s annual strategic plan.

Second, the RHQN external peer review physician team looks at approximately 9,000 patient charts each year. Not all charts receive an in depth review. But, all are part of a targeted process that evaluates patient care quality based on criteria established in the RHQN strategic initiatives, the facility’s medical staff and quality improvement processes, and the Joint Commission and Department of Health standards of care. Every other state program I have looked at review somewhere between 250 and 500 charts a year. The depth and breadth of information gathered and the importance of it toward shaping a statewide clinical quality improvement program for rural hospitals cannot be understated.

The third reason the RHQN’s external peer review program is so valuable is the quality and accessibility of our physicians. No other state employs and sends external peer review physicians to their rural hospitals. The external peer physicians’ responsibilities include:

1. Conducting on-site chart review using an established set of criteria,
2. Assisting and advising the medical staff on credentialing and certification issues,
3. Reviewing the medical staff bylaws (also a requirement for critical access hospital status),
4. Providing continuing medical education (on-site and through monthly newsletters), and
5. Supporting and advising the clinical quality improvement committee and their functions in the facility.

Each member facility receives four external peer review physician visits per year as part of their dues and can contract for more visits at a set fee.

At the current time, the RHQN’s external peer review process is handled by two physicians, Dr. Myron Bloom and Dr. Bruce Stevenson. Dr. Bloom provides peer review services for the eastern two thirds of Washington State and Dr. Stevenson provides services for the western third. About a year ago, Dr. Bloom asked for a reduction in his workload as he edges closer to retirement and has experienced some personal health issues. Since then, we have been evaluating how we do external peer review and how to enhance the process, wherever possible. With that in mind, the Rural Healthcare Quality Network is very pleased to announce the addition of three external peer review physicians to our team. These physicians, Dr. Tom Tobin, Dr. Darrol Hval, and Dr. Scott Edminster, are all board certified in emergency medicine, have many years of hospital based experience (most recently with Deaconess Medical Center in Spokane), and they are great educators and mentors. They have worked extensively with, and are well known to, many rural physicians in eastern Washington. Drs. Tobin, Hval, and Edminster will begin their orientation with Dr. Bloom March 19th and will assume their external peer review responsibilities on April 1.

Initially, each of the new peer review physicians will have three hospitals assigned to them. A final decision about which hospitals each will be assigned has not been finalized. Letters will be sent out to those facilities when the decisions are made. Please join me in welcoming our new peer review physicians. If you have questions about external peer review, need to contact the physicians, or need a consultation about the process, please feel free to contact Randy Benson, RHQN Executive Director at randyb@wsha.org or (206) 577-1821.

Subspecialty Peer Review
We wanted to remind everyone that the RHQN provides subspecialty peer review assistance in several areas. Subspecialty peer review services are available in general surgery, orthopedic surgery, radiology, sleep lab, internal medicine, and nephrology. Please contact Lori Martinez, RHQN Executive Assistant, at lorim@wsha.org or (206) 216-2550 for details.

Upcoming Member Conference Calls
Bev McCullough, RHQN QI Manager, and I have split the Members Conference Call topic list for 2010. We will be doing calls every month. If you have topic suggestions, please call or e-mail Randy Benson, RHQN Executive Director, at randyb@wsha.org or at (206) 577-1821.

• March 9, 10:30 a.m. - “Applying Excellence: A Primer on Facilitating Change - Part II” presented by Randy Benson, RHQN Executive Director
• April 13, 10:30 a.m. - Clinical Best Practices and Lessons Learned, facilitated by Bev McCullough, RHQN Quality Improvement Manager
• May 11, 10:30 a.m. - “DOH Survey Update: What's New In the Environment of Care” presented by Randy Benson, RHQN Executive Director

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