A Case Review analyzes a physician’s performance based upon the medical records selected by the hospital. Depending on the needs of the hospital, NPRC can perform a more comprehensive Case Review that assesses a physician’s overall practice patterns or a more limited Case Review of one or more cases that, upon initial review by the hospital, appear to indicate some cause for concern.

A highly qualified NPRC peer reviewer, board certified in the same specialty as the provider, reviews each case to determine if there are deviations from comparative data, benchmarks and accepted standards of care. Variations from expected outcomes or practice patterns are analyzed for their actual and/or potential effects on patient care and outcomes.

A Case Review can serve as the basis for the hospital to determine appropriate peer review action or as an indicator that a more comprehensive review of the physician is required.

In general, the NPRC Reports for Case Reviews include the following components:

• an Executive Summary that concisely encapsulates the findings of the Report
• an abstract of the medical records for each case
• answers to pertinent clinical questions within the expertise of the peer reviewer, while eliminating extraneous issues
• clear and concise findings and conclusions regarding the medical management of the cases, including the degree of concern (e.g., was it a deviation from the accepted standard of care or an issue requiring additional review or monitoring) and the impact, or potential impact, on patient care
• references to current medical literature and comparative data, benchmarks and accepted standards of care
• the curriculum vitae of the peer reviewer performing the review

NPRC peer reviewers and other consultants are available, at the request of the hospital, for on-site consultation and/or attendance at a hearing or committee meeting.

See also:

Hospital Peer Review Guide II: An Effective Peer Review Report