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The standards for peer review are outlined in Chapter Five, Clinical Staffing and Chapter Ten, Quality Improvement/Assurance of the Health Resources and Services Administration (HRSA) Health Center Program Compliance Manual (Chapter Five, Chapter Ten). Chapter Five addresses the need to consider the results of peer review/performance improvement activities in the reappointment process for credentialing and privileging, while Chapter Ten addresses the need for the completion of quarterly Quality Improvement/Assurance assessments. Likewise, Chapter Ten discusses the need for Quality Improvement/Quality Assurance assessments to be conducted a minimum of quarterly by Physicians or other licensed health care professionals, such as nurse practitioners, registered nurses, or other qualified individuals.
Although HRSA provides minimal guidance regarding the topics of peer review and medical record review, there is a notable difference between the two.
High performing health centers complete both peer review and medical record review and report results on a quarterly basis. Both reviews identify opportunities for improvement, facilitate the delivery of high-quality care and mitigate risk on the part of the health center. Resources for Peer Review and Medical Record Review can be found at ECRI (ECRI | Trusted Voice in Healthcare).
Community Health Centers (CHCs) serve all patients, regardless of race, ethnicity, gender or even ability to pay. As such, some CHCs receive special population funding which focuses on certain populations such as homeless, Migrant and Seasonal Agricultural Workers (MSAW) and residents of public housing. If a health center receives this special funding OR additional funding that supplements their regular CHC funding (Section 330 e), it is a requirement that there is representation on the Board of Directors of these specific special populations. Chapter 20: Board Composition outlines those requirements. Receiving input from special population representatives provides a valuable resource in the successful oversight of the health center program in various key areas. For example:
Input from special populations patients is extremely important. Without input from, e.g. homeless patients / those identified as homeless, or MSAW, a health center does not know if extended hours or changes in care delivery are needed.
Input from special populations can be completed through focus groups, patient satisfaction surveys or methods that are culturally and linguistically appropriate. Health centers should document this feedback along with discussion within the board of director’s meeting minutes.