All figures for the named indicators are published by QMI for all participating hospitals to ensure transparency. If results are significantly above or below the relevant benchmark, QMI will initiate a peer review procedure that investigates the treatment cases that led to the conspicuous results.
The peer review procedure is divided into four steps:
- The responsible doctor carries out a self-review together with his team.
- The doctor’s peers offer a constructive critique of the same treatment cases, visiting the hospital for this purpose. The clearly defined procedure for analysing relevant medical records is based on uniform criteria.
- This is followed by what is actually the key part of the review: an eye-level discussion between the peers and the responsible doctor. If the peers have identified quality-related problems, suggestions for solving them are included in the discussion. These frequently relate to standards, guidelines, documentation, processes or interdisciplinary interfaces.
- The resultant findings are then presented to the hospital management. The doctor involved is responsible for putting any ideas for improvement into practice. He is assisted in this process by the hospital management, which, in turn, monitors implementation.
More and more hospitals in Switzerland are joining the Quality Medicine Initiative (QMI). In view of this, the H+ hospital association has initiated a project to adapt the peer review procedure to Swiss requirements. There are two specific objectives in this regard: first, that of drawing up the procedure in the additional national languages of French and Italian to enable participation among hospitals in Western Switzerland and Ticino; second, that of integrating nursing staff into the procedure – which will be contingent on nursing staff also being trained up as peers besides doctors. The project is funded by an alliance between the H+ hospital association, the Swiss Medical Association and the Swiss Nurse Leaders Association. On account of its interprofessional approach, the “Swissification” of the peer review procedure is being followed with great interest in Germany.