The Genesis of a Professional Peer Review Council

Pictured below are the members of the original Professional Peer Review Council: (left to right) Lillian Hilles, FNP, MSN, Concordia University; Jean Benthien, CRNP, MSN, Point Loma Nazarene College; Joanne Christner, BS, RN, Chapman University; Judy Hotchkiss, RN,C, Marymount College Palos Verdes; and Marsha Schreiber, MSN, CNS, RN, Biola University.

For many years, my friend and colleague Jean Benthien and I had discussed the joys and pitfalls of being student health center directors at small colleges. One challenge of the position was determining how to maintain the high standard of practice that we had set for ourselves. We believed that we gave good service to our students, however, we had no one to review our work. Due to many factors, having our health centers accredited by the Joint Commission was not feasible. Our dilemma always remained the same: How do we hold ourselves accountable?

Finally deciding we must do something about our quandary, we sent out a message to similar schools for volunteers to help us set up a peer review process. After selecting three other directors of small colleges/universities, we met and discussed why there would be a need for a review mechanism. We all agreed we could profit from such a process, committed to a time frame for the work to be completed, named our group, and selected a mission. We became the Professional Peer Review Council (PPRC) and committed to as long as it took to establish a credible review tool. We determined the mission of the PPRC to be the development, implementation, and ongoing evaluation of professional standards and practices for small college student health services.

We agreed the value of such a review process to be:

• Networking - Sharing of like experiences and aspirations. We could be an extension of abilities and knowledge to each other.

• Updating pertinent information - Sharing campus fads and health related trends and medical information, becoming more aware of rules, regulations, and current styles in higher education.

• Maintenance of set standards - Working towards accreditation and holding peers and institutions accountable for high standards.

• Affirmation - Sharing each other's creativity and new ideas realizing that critiques can be of value to all.

We met once a month, selecting standards and working on a process of reviewing a health center. Between each meeting there was work to be completed by each individual that was discussed at length the next time we met. All of our institutions were supportive of our endeavor and allowed time for us to meet.

After meeting for approximately two years, we felt that we finally had an assessment tool and were able to start the review process of one of the schools of the PPRC. After the initial review, assessment, and report, we realized that although we were pleased with the result, our work would always be an unfinished product as we would constantly be updating and revising the questionnaire (assessment tool).

Selected areas of review and categories of standards to be assessed included the following:

• RIGHTS OF PATIENTS
  • Dignity
  • Privacy
  • Confidentiality
  • Responsibilities
  • Respect
• MEDICAL RECORDS
  • Organization
  • Prematriculation Issues
  • Documentation
  • Confidentiality
• GOVERNANCE/ADMINISTRATION
  • Functional Relationship
  • Policies
  • Procedures
  • Protocols
  • Goals
  • Objectives
• QUALITY OF CARE
  • Staff Training
  • Ration of Staff to Patient
  • Communication Patterns
  • Cost Containment
  • Student Insurance
  • Liability Coverage
• PROFESSIONAL IMPROVEMENT
  • Professional Improvement Allotment
  • Staffing
  • Computer Access
  • Library Type Resources
  • Ties to Other Disciplines
  • Professional Organization Ties
• FACILITIES
  • Physical Plant
  • OSHA Compliance
  • Universal Precautions
  • Safety
• QUALITY MANAGEMENT

  Peer Based Organization

  A governing body made up of professional and administrative staff to participate in programs of quality management to determine acceptable or unacceptable outcomes on which to base changes.

  Quality Improvement Plan

  Activities determined by the governing body in which concerns of service, standards, and performance of practice are established, evaluated and documented.

  Risk Management

  Committee activities that oversee liabilities and risks to the organization in areas of record keeping, education, insurance, and government regulations.

Utilizing a peer review process is a viable way for the small health service to approach quality assurance and quality improvement. We realize that our quality can be improved, look for system improvements (85% of problems), employ a positive, proactive approach, measure conformance to standards, then plan improvements. This is a refreshing contrast to the old approach of "If it ain't broke, don't fix it, looking for bad apples, a punitive or reactive approach, and following up only on complaints and bad events. The peer review process has empowered us to move beyond the old approach.

At the present time, our original group of five has now become three. We continue to work hard on the peer review process and to be pleased with the work we have completed. We all have benefited a great deal from this process, becoming much more aware of our important role in each of our respective institutions. After presenting our work at several professional meetings, we are gratified with the support we have received from our colleagues.

Members of the current Professional Peer Review Council (PPRC):

Judith A. Hotchkiss, RN,C
Director Student Health Center.
Marymount College Palos Verdes.
30800 Palos Verdes Dr. East.
Rancho Palos Verdes, CA 90275.
310-377-5501 x 244.
FAX 310-265-9231.
jhotchkiss@marymountpv.edu

Jean Benthien, CRNP, MSN
Director of Health Services.
Point Loma Nazarene College.
3900 Lomaland Dr. .
San Diego, CA 92106.
619-849-2280.
FAX 619-849-7014.
jbenthien@ptloma.edu

Marsha Schreiber, MSN, CNS, RN
Director of Student Health.
Biola University.
13800 Biola Ave.
LaMirada, CA 90639.
562-903-4841.
FAX 562-906-4512.
marsha_schreiber@peter.biola.edu

Other original PPRC participants:

Joanne Christner, BS, RN
Director, Wellness Center.
Chapman University.
Orange, CA 92666.

Lillian Hilles, FNP, MSN
Director of Student Health.
Concordia University.
Irvine, CA 92612.

Return to Summer 1998 CQ Menu
Return to Connections Quarterly Main Menu