INTEGRATING NURSING PEER REVIEW INTO A UNIT SHARED GOVERNANCE MODEL

Purpose:
The purpose of the project was to develop a nursing peer review system that was staff driven and improve the quality of care delivered.

Significance:
Accountability is at the root of the shared governance-peer review model. This model transfers the responsibility of the quality care delivered back to the staff to determine if quality of care meets standards and what type of improvements may be needed.

Strategy and Implementation:
Once the medical record audit and peer review tool was completed, the information was tracked for unit performance improvement (PI) issues and for the nurse's own professional growth. The unit shared governance council (USGC) was responsible for prioritizing tracked PI issues and developing a plan for improvement with the nursing staff. The focus of this process was to return the ownership of improving nursing care to the nursing staff who actually delivers the care. The National Database of Nursing Quality Indicators (NDNQI) RN Survey with Practice Environment Scales was utilized to measure the percent difference in perception of quality of care delivered once peer review had been piloted over a two year period. Unit performance improvement indicators were also tracked for changes on an annual basis over a two year period.

Evaluation:
Perceived quality of care improved on both units by the second year. Further, during both years, numerous unit performance improvement indicators improved. The unit performance improvement indicators that were improved during the first year were maintained or further improved.

Implications for Practice:
The USGC members became aware of trends in the unit's performance. Once prioritized, the staff nurses provided solutions to their unit's performance issues. This allowed for ownership and engagement in continuing evaluation of the quality of care delivered on each unit.