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TRS Healthcare: Peer Review

Learn the types of peer reviews conducted and their standards and guidelines.
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TRS Healthcare endorses peer review as an essential component of patient care. Peer Review is the evaluation of performance by other people in the same field in order to maintain or enhance the quality of the work or performance in that field. Any professional liability actions, credentials failures, civil and criminal actions violating laws and regulations, or violations of TRS policy will result in investigation and documentation of any and all issues. TRS uses the Peer Review process to examine healthcare service, to determine why things happen and to improve care and service in the future. Peer Review provides TRS a procedure to examine health care service, including adverse events and injuries as part of an effort to  determine why things happen and to improve care and service in the future. Peer Review also provides assistance to healthcare professionals and protection to patients. In addition, the Peer Review process provides an outlet for grievances and complaints. You must respond in writing to the Peer Review Committee for your views to be presented. Final decisions regarding recommendations for sanction activity shall be made only after a thorough review of each individual case by the Peer Review Committee. A Root Cause Analysis (RCA) will be performed to define the issue, identify issues and root causes that contributed to the problem, develop/implement a solution recommendation, and observe the recommended solutions to ensure effectiveness. RCA can reduce or minimize errors. Through RCA, TRS ensures clinical staff competency and promotes patient advocacy. Health Care Professionals will be educated for the following: professional competence, conflict management skills, communication skills (such as listening to patients and establishing trust, managing confrontation, disclosing medical mistakes), and risk reduction awareness and techniques. Supportive measures will be taken to promote professional development and counseling will be facilitated if needed. If aberrant or illegal behavior has been identified through the RCA and Peer Review Process, TRS will report these issues to the appropriate professional boards and/or law enforcement agencies.

TRS Conducts Two Types of Peer Reviews:

• Applicant Peer Reviews are performed on all healthcare professionals with detrimental criteria that may affect quality assurance, patient care and credentialing protocols outcomes during the application and re application process. Any professional liability actions, credentials failures, civil and criminal actions violating laws and regulations, or violations of TRS policy including disruptive behavior will result in investigation and documentation of all issues.
• Default Peer Reviews are also performed on all clinical, professional or personal incidents that may result in an early termination of assignment by the client, the healthcare professional or TRS.

Peer Review Must Conform to the Following Standards:

• The process must ensure patient confidentiality;
• The review process should be well-documented and should yield clear recommendations.
• Evidence of Health Care Provider performance concerns, as revealed through the quality improvement process, should be part of the appointment/re-appointment criteria.
• The peer review process must use consistent, fair and equitable guidelines, employing criteria that are well-defined and encompass all options.
• Decisions must be judged on generally accepted standards of care and that the medical care provided was necessary, reasonable, and appropriate given the available resources and the individual patient case situation in question.
• Should an assignment be shortened or canceled for any reason, all monies due at the end of the assignment will be paid within forty-five (45) days of completion and upon Company receiving the proper receipts, written documentation, and in accordance with State and Federal law.
• The Peer Review Process must use a standard evaluation form to ensure continued compliance with this policy.
• The Peer Review Committee will review the incident by reassessing previous issues, performance evaluations and written documentation from the facility and the healthcare worker. The Peer Review Committee will report the outcome and determine if the HCP is allowed to be assigned, re-assigned, terminated, suspended or placed in our monitoring system with classifications of medium or high-risk statuses. The Peer Review Committee may also stipulate additional counseling, educational in-services or other criteria to be met before a new assignment is granted to the healthcare professional.