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首页> 外文期刊>American Journal of Obstetrics and Gynecology >Peer review of medical practices: missed opportunities to learn
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Peer review of medical practices: missed opportunities to learn

机译：同行医疗实践回顾：错过的学习机会

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摘要

Appropriately conducted peer review of medical practices provides the greatest opportunity for health care professionals to learn from their mistakes and improve the quality and safety of health care. But in practice, peer review has not been an effective learning tool because it is subjective and irreproducible. Physicians reviewing the same cases disagree over the cause(s) of adverse outcomes and the quality and appropriateness of care, and agreement is not improved by training, use of objective review criteria, or having the reviewers discuss the cases. The underlying reason is a general lack of understanding and an oversimplified view of the causes of medical errors in complex, high-risk organization and a preoccupation with attributing medical errors to particular individuals. This approach leads to judgments, not understanding, and creates a culture of blame that stops learning and undermines the potential for improvement. For peer review to have an impact on the quality of care and patient safety, it must be standardized to remove cognitive biases and subjectivity from the process.
机译：适当地对医疗实践进行同行评审，为医疗保健专业人员提供了最大的机会，可以从他们的错误中吸取教训，并提高医疗保健的质量和安全性。但是实际上，同行评议不是一种有效的学习工具，因为它是主观的且不可复制的。审阅同一病例的医生不同意不良结局的原因以及护理的质量和适当性，并且通过培训，使用客观的审阅标准或让审阅者讨论病例，协议不会得到改善。根本原因是，对复杂，高风险组织中医疗错误的原因普遍缺乏理解，并且过分简化了看法，并且全神贯注于将医疗错误归因于特定的个人。这种方法导致了判断而不是理解，并造成了一种责备文化，这种文化停止了学习并破坏了改进的潜力。为了使同行评审对护理质量和患者安全产生影响，必须进行标准化以消除过程中的认知偏见和主观性。

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