Contest entry: Practitioner quality summary form

Happy Free Form Friday!

A reader sent in this form to help streamline the peer review process.

Kathy J. Szary, medical staff services coordinator and executive assistant at Grinnell (IA) Regional Medical Center, shared her story and tool for the The Greeley Medical Staff Institute Symposium contest. She said,

I work in a one-person office in a rural hospital in Iowa. I was fortunate enough several years ago to be able to purchase a credentialing software program to help with the credentialing process.

My dilemma was how to get my arms around the peer review process. I had written a proposal for a quality software program to compliment my credentialing software program in 2007 for the 2008 budget, but it was not approved due to limited financial resources available.

My solution was to develop an Excel spreadsheet to track this information and print reports as needed for reappointment and CMS surveys.

After each peer review committee meeting (medicine case review committee, OB committee, and surgical case review committee, and medical staff executive committee, as needed), I collect the review forms, organize them by practitioner, and then input the information from the review form into the Excel spreadsheet database. I am then able to hide rows that I do not need to print a report for a specific practitioner that accompanies their recredentialing application, or as requested during a CMS survey. The review forms are then placed in the practitioner’s peer review file.

The key for the Excel spreadsheet includes the following:
status: MS (medical staff) or AHP (allied health professional)
type: MCR (medicine case review)
SCR (surgical case review)
OB (OB committee)
Rdm (random)
Oth (Other)

Our peer review policy states that there will be a minimum of ten charts selected at random and reviewed prior to the reappointment process, hence, the “random” classification. I use “other” classification for such things as events taken to the MSEC and then document in the “action/follow-up” column what action was taken.

Thanks for sharing! You can download the Practitioner Quality Summary Here (Excel) .

That concludes The Greeley Medical Staff Institute Symposium contest.

Thanks so much to all the participants, and congratulations to the winners! You can find a listing of all the forms, tools, and tips here.