Outpatient Care: A Conceptual Framework and a Form for Structured Implicit Review

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This report describes a structured implicit review form designed for use in the outpatient setting. The form was developed as part of a broader Medicare beneficiary complaints process to improve physician peer review reliability. It was designed specifically for evaluating care that occurs in the outpatient setting and is intended to be used after a formal training session.

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Product Details

  • ISBN-13: 9780833030849
  • Publisher: RAND Corporation
  • Publication date: 3/28/2002
  • Pages: 58
  • Product dimensions: 8.30 (w) x 10.80 (h) x 0.20 (d)

Read an Excerpt

This monograph describes the development of a structured implicit review tool that physicians can use to evaluate the quality of care in the outpatient setting, where most care is now provided. Structured implicit review specifies the key aspects of care and data sources for review while preserving individual reviewer judgments about quality. The work is part of a broader effort to improve the process of Medicare peer review.
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Table of Contents

Introduction 1
Adapting SIR For Outpatient Use 2
Theoretical Framework for Outpatient Care 4
Expert Panel 6
SIR Form Development 7
Reviewer Training 8
Form Reliability and Resource Use 10
Guidelines for Outpatient Implicit Review 12
Outpatient Implicit Review Form 21
App. A Outpatient Care Conceptual Framework 35
App. B: Rating Form 38
App. C Expert Panelist Background Form 53
App. D Outpatient Complaint Review Expert Panel 54
References 55
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