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Collaborative Rural Nurse Peer Review: A Quality Improvement Project.

Stephanie D Drobny1, Amy Snell, Lisa Morris

  • 1Banner Fort Collins, Colorado (Ms Drobny); Page Hospital, Page, Arizona (Ms Snell); Fay W. Whitney School of Nursing, University of Wyoming, Laramie (Dr Fischer); Sanford Health, Fargo, North Dakota (Ms Morris); Banner Lassen, Susanville, California (Ms Harshbarger); and Banner Health, Loveland, Colorado (Ms Village).

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Summary

Implementing nursing practice peer review in rural hospitals is achievable through collaboration. A rural collaborative council successfully developed effective processes, overcoming unique challenges in small facilities.

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Area of Science:

  • Nursing Practice
  • Healthcare Management
  • Quality Improvement

Background:

  • Peer review is fundamental to professional nursing.
  • Implementing peer review presents challenges, particularly in small and rural hospitals.
  • Limited nurse reviewers and potential bias are key barriers in these settings.

Purpose of the Study:

  • To address challenges in implementing nursing practice peer review in small, rural hospitals.
  • To develop recommendations for effective peer review processes in resource-limited settings.
  • To create a sustainable model for rural nursing peer review.

Main Methods:

  • A collaborative council with representation from rural and critical access hospitals was formed.
  • Nursing leaders and staff nurses collaborated to identify barriers and propose solutions.
  • Processes for case referral, review, investigation, and scoring were developed based on Just Culture principles.

Main Results:

  • A collaborative rural nursing practice peer review council was established with multi-facility representation.
  • Effective processes for case referral, reviewer assignment, investigation, and scoring were created.
  • High satisfaction was reported among staff nurses, reviewers, and Chief Nursing Officers.

Conclusions:

  • Collaborative approaches can mitigate barriers to nursing peer review in rural hospitals.
  • This model demonstrates efficient and effective peer review processes for small, rural facilities.
  • The collaborative council provides a successful framework for quality improvement in geographically distinct hospitals.