Why we need Clinical peer review

Monday, January 14, 2019

Peer review is the professional assessment of a healthcare organisation’s standards which encompasses their processes and quality of work.

But why do we need it?

Peer review provides a healthy means for obtaining feedback from experienced colleagues and partners. It’s a powerful tool to improve quality and ensures that optimum clinical results are achieved by diminishing the inter and intra observer variability. It reinforces protocols and provides consistence across the board. It is an intrinsic component of clinical governance and can be easily initiated and implemented on a departmental level. As a by-product, peer review also promotes team engagement, reduces discrepancies, is an easy way to teach and learn, is intrinsically relevant and cost effective and at the bedrock is a base for professional requirements.

How does this work in echocardiography?

The BSE process of departmental accreditation represents the most closely relevant process of quality assessment.

The ability to competently perform an echocardiogram or to deliver a quality echocardiography service presupposes the existence of a safe, organised and constructive ‘echo environment’. An echocardiographer can only perform as well as this environment allows. On this basis the British Society of Echocardiography (BSE) have promoted a departmental accreditation which in the UK is voluntary. To achieve departmental accreditation, echocardiography departments must meet optimum standards regarding; staffing, training, organisational standards, equipment, standards of scanning and reporting on studies. Further, they must also demonstrate a willingness to engage in quality assurance.

A BSE article; Issue 96, Jan 2017 outlined this approach. Echo: The Journal of The British Society of Echocardiography; The Echocardiography Quality Framework pages 5 to 10.

True clinical excellence is only achieved by adopting a multi-angle approach to quality assurance

The reassessment of the quality of echocardiographic studies could be considered a conventional and compulsory starting point for an echo Quality Assessment (QA) program. Nevertheless, it can prove to be difficult due to the subjective nature of the “image quality”. This fact emphasises the need for quality control and for inter and intra observer variability assessment. Sharing information, knowledge and personal experience should play an important role to improve standards, however only an organised structured process will allow you to measure progression and assure the best possible care.

Peer review is one of the most important actions to provide the delivery of a proper Quality Control Programme.

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Eduardo Lima
National Echocardiography Lead

Source: Barry McCormick, Director of the Centre for Health Service Economics and Organisation, the Health Foundation Pathway Peer Review to improve quality, thought paper November 2012