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Title: Reciprocal peer review for quality improvement: an ethnographic case study of the Improving Lung Cancer Outcomes Project.
Authors: Aveling, Emma-Louise
Martin, Graham
Jiménez García, Senai
Martin, Lisa
Herbert, Georgia
Armstrong, Natalie
Dixon-Woods, Mary
Woolhouse, Ian
First Published: 9-Aug-2012
Publisher: BMJ Publishing Group
Citation: BMJ Quality and Safety, 2012, 21 (12), pp. 1034-1041.
Abstract: BACKGROUND: Peer review offers a promising way of promoting improvement in health systems, but the optimal model is not yet clear. We aimed to describe a specific peer review model-reciprocal peer-to-peer review (RP2PR)-to identify the features that appeared to support optimal functioning. METHODS: We conducted an ethnographic study involving observations, interviews and documentary analysis of the Improving Lung Cancer Outcomes Project, which involved 30 paired multidisciplinary lung cancer teams participating in facilitated reciprocal site visits. Analysis was based on the constant comparative method. RESULTS: Fundamental features of the model include multidisciplinary participation, a focus on discussion and observation of teams in action, rather than paperwork; facilitated reflection and discussion on data and observations; support to develop focused improvement plans. Five key features were identified as important in optimising this model: peers and pairing methods; minimising logistic burden; structure of visits; independent facilitation; and credibility of the process. Facilitated RP2PR was generally a positive experience for participants, but implementing improvement plans was challenging and required substantial support. RP2PR appears to be optimised when it is well organised; a safe environment for learning is created; credibility is maximised; implementation and impact are supported. DISCUSSION: RP2PR is seen as credible and legitimate by lung cancer teams and can act as a powerful stimulus to produce focused quality improvement plans and to support implementation. Our findings have identified how RP2PR functioned and may be optimised to provide a constructive, open space for identifying opportunities for improvement and solutions.
DOI Link: 10.1136/bmjqs-2012-000944
ISSN: 2044-5415
eISSN: 2044-5423
Version: Post print
Status: Peer reviewed
Type: Journal Article
Rights: Copyright © 2012 by BMJ Publishing Group Ltd and the Health Foundation. Deposited with reference to the publisher's archiving policy available on the SHERPA/RoMEO website.
Appears in Collections:Published Articles, Dept. of Health Sciences

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