Peer Review Print

kid_docCommitted To High Quality Care

With a strong commitment to excellence in patient-focused care in local communities, the South East Rural Physician Alliance (SERPA) developed and implemented the Peer Review program in 2000. Largely a result of a proactive stance in meeting federal guidelines and regulations, and a firm belief in the importance of cost-effective, high quality care, SERPA’s Peer Review program is educational rather than punitive in nature. It is designed specifically for use in hospitals and is now used successfully by more than 18 hospitals in rural Nebraska.

Reviews By Rural Physicians

Physicians with an understanding about the operation of rural hospitals and healthcare delivery systems are in the best position to review other rural physicians. That’s why the SERPA Peer Reviewers are rural physicians thoroughly familiar with peer review methodology and techniques.

Confidential

SERPA peer reviews are confidential. Charts are double-blinded and confidentiality of communications, medical records, and peer review opinions is maintained at all times. Double-blinding also helps to ensure an accurate and unbiased review. Release of the protected healthcare information has been accepted under the new HIPPA regulations, if the information is used for providing peer review only.

peercoverFocused On Specific Criteria

Quality assurance staff from rural hospitals identified the criteria for SERPA Peer Reviews. If no charts meet the specific criteria, other charts may be selected for general review.

Charts selected are reviewed for:

  • Appropriateness of admission
  • Presumptive diagnosis supported in the history and physical
  • Discharge diagnosis appropriate and substantiated in medical record
  • Appropriate medication therapy ordered and administered
  • Appropriate procedures and diagnostic studies ordered
  • Appropriate management of abnormal diagnostic studies
  • Appropriate patient instruction documented
  • Appropriate consultation and referrals clinically indicated
  • Adequate documentation

Additional questions include:

  • Did the care the patient receive result in any adverse outcomes? If so, could the outcomes have been prevented?
  • Was the length of stay appropriate?
  • Was the level of care in this case appropriate?

Equivalent Entity Status

SERPA peer review information was submitted to the HCFA Region VII for review to see if SERPA could be accepted as an “equivalent entity” under the 42CFR 485.641(b)(4)(ii) . The response was affirmative as of December 2000 on the State of Nebraska letterhead.
42 CFR 485.641(b)(4)(ii)  states a third party review must come from “(1) one hospital that is a member of the network, when applicable; or (2) one QIO or equivalent entity; or (3) one other appropriate and qualified entity identified in the State Rural Health Care Plan.”

For more information on the SERPA Peer Review program, contact us today.

Service fees will vary based on your needs. We will put together a review program specifically for your organization. To discuss your needs and receive a customized proposal and estimate, please call us toll free at 888-917-3772 or contact us by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .