Peer review in a shared governance model

Improving unit performance with a staff-driven peer review process

PURPOSE

A staff-driven peer review process was developed and implemented to determine if it would improve the perception of the quality of nursing care delivered and unit performance.

CONCLUSIONS

Perceived quality of care, as measured on the National Database of Nursing Quality Indicators Survey, improved by the second year after all nurses had completed the process. The unit performance improvement indicators showed improvement in the first year after implementation, with further improvements noted the second year.

PRACTICE IMPLICATION

This project demonstrated that staff nurses could and would autonomously improve practice and unit performance based on unit data.

Implementing peer review: guidelines for managers and staff

The performance appraisal process is a key component of professional nursing practice. The peer review process is referred to frequently in Magnet Nursing Standards as a key element in professional nursing. The peer review process allows professionals from common practice areas to systematically assess, monitor, make judgments, and provide feedback to peers by comparing actual practice to established standards. Peer review can engage a multigenerational workforce and lead to more satisfied, engaged employees. As a component of the annual performance appraisal, peer review can create positive relationships, foster a better work environment, and allow peers to increase individual and group accountability. Peer review has many common elements that can be individualized to fit any type of unit or work culture. This article describes how to design, implement, and evaluate a unit-based peer review program. The content and steps outlined are intended to support nurse managers in implementing unit-specific peer review programs by focusing on existing expertise and best practices. The implementation steps are divided into 5 phases describing the introduction of concepts and getting nurses engaged, implementation guidelines, piloting the process, staff education, and ongoing evaluation. Staff involvement is the key to a successful unit-based peer review process.