Cases

Incident-Based Peer Reviews

 

Cases are performed when a concern is reported or an adverse indicator is present. They are used to identify issues and assess the severity of those problems.

  • Review clinical visits or procedures
  • Primary physicians can submit initial statements and final responses
  • Assign actions based on final assessment
 

Case Workflow

  1. Create

    Hospital admin enters case details and uploads files.
  2. Assign

    Hospital admin assigns case to internal review committee or submits it to the Exchange.
  3. Request Statement

    The subject physician is given the opportunity to submit a statement.
  4. Review

    Either a hospital committee or exchange physician(s) complete the review process and submits findings with our easy-to-use online software.
  5. Prescribe Action

    Hospital admin or committee prescribes action based on review findings.
  6. Request Response

    The subject physician is given the opportunity to respond to the review findings.
  7. Archive

    The findings and prescribed actions of finalized cases are archived. Aggregated performance data for departments and individual physicians can then be monitored by select hospital admin and supervising physicians to help identify opportunities for performance improvement.

Hospital admins can track the status of open cases from the admin dashboard.

Case Ratings

  • No issues identified level 0
  • Minor issue with no effect on patient level 1
  • Issue with potential for adverse effect on patient level 2
  • Disease or symptoms were caused, exacerbated or allowed to progress level 3
  • Longevity and/or functional quality of life shortened or adversely effected level 4
  • Issue attributable to death level 5

Issues may include problems with process, documentation, acts of omission or commission, quality of care, treatment or services provided.