title: A novel program to improve patient safety by integrating peer review into the emergency medicine residency curriculum.
abstract: BACKGROUND
  Evaluating the quality of care as part of a quality improvement process is required in many clinical environments by accrediting bodies. It produces metrics used to evaluate department and individual provider performance, provides outcomes-based feedback to clinicians, and identifies ways to reduce error.
  
  
  CONCLUSIONS
  To improve patient safety and train our residents to perform peer review, we expanded our quality assurance program from a narrow, administrative process carried out by a small number of attendings to an educationally focused activity of much greater scope incorporating all residents on a monthly basis. We developed an explicit system by which residents analyze sets of high-risk cases and record their impressions onto structured databases, which are reviewed by faculty. At monthly meetings, results from the month's case reviews are presented, learning points discussed, and corrective actions are proposed.
  
  
  CONCLUSIONS
  By integrating Clinical Quality Review (CQR) as a core, continuous component of the residency curriculum, we increased the number of cases reviewed more than 10-fold and implemented a variety of clinical process improvements. An anonymous survey conducted after 2 years of resident-led CQR indicated that residents value their exposure to the peer review process and feel it benefits them as clinicians, but also that the program requires a significant investment of time that can be burdensome.
authors.affiliation: Department of Emergency Medicine, Mt. Sinai School of Medicine, New York, New York.
authors.forename: Reuben J
authors.initials: RJ
authors.lastname: Strayer
authors.affiliation: Department of Emergency Medicine, Mt. Sinai School of Medicine, New York, New York.
authors.forename: Bradley D
authors.initials: BD
authors.lastname: Shy
authors.affiliation: Department of Emergency Medicine, Mt. Sinai School of Medicine, New York, New York.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Shearer
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration / Q000592:standards; D061214:Patient Safety; D010380:Peer Review; D011785:Quality Assurance, Health Care / Q000379:methods; D058996:Quality Improvement
keywords: administration; continued quality improvement; education; error; medical error; patient safety; peer review; quality; quality assurance; quality improvement; resident education