 Watch Your Language! Likely every reviewer has at least once been presented with a case and related questions that seem so straightforward that there isn’t much to say. A hospital may want an explanation for a bad outcome after a routine procedure. There may not be an obvious answer. A physician can do everything correctly, but something still goes wrong. In such cases, it may be tempting to answer the question, “What caused this outcome?” with "pure, dumb, bad luck".  Likewise, there often are cases for which it seems a yes/no answer is all that is needed in response to the client’s questions. Especially when the answer is “yes.”
While that may be true, it isn’t enough for a CIMRO review. There’s a reason the hospital is asking that question about that case, and we owe the client complete, clear, well-supported, educational answers. It begins with a case summary that paints a picture. Who is the patient, clinically? What was the procedure? The indications? What techniques were used? What was the outcome, and how was the case resolved? For example: A patient undergoes a successful hysterectomy without complications. All the correct protocols were followed, including use of the appropriate perioperative antibiotics. The patient is discharged, but returns with a wound infection requiring readmission. Why? The peer reviewer (PR) could say the patient was just unlucky. Postoperative infections happen, even when everything was done correctly. That’s not untrue. Or, if all the client asks is, “Was the standard of care met?” the answer may just be “yes.” However, the client needs the PR to dig deeper. Perhaps the patient has diabetes. There may be a history of wound infections or chronic steroid use. If there’s a nugget of useful information, the reviewer needs to find it and bring it to the surface. Also, ask “are other concerns identified?” Perhaps the client did ask a yes/no question, but perhaps you have an idea of what they really are asking. Use that space to share your thoughts. When in doubt, or if you have a suggestion for helping identify the information they really need, let us know. The nurses are glad to help, and the clients will appreciate the effort that goes beyond their expectations. How long should it take to complete a review? The time needed to complete a review varies. As a general guideline, if your review is taking significantly longer than the estimated review times reflected below, please contact our review team at [email protected]. Can I complete my review using a dictation service? Peer reviewers can only use a dictation service if they have a direct contract in place. Our Business Associate Agreement, Section 4(e) states, “Business Associate may not re-disclose Patient Identifying Information to a third party unless that third party is a contract agent of the Business Associate.” Please let us know if this affects your ability to perform reviews. |
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