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Peer review

Peer reviews identify opportunities for practice improvement, supported by a peer assessor.

Peer reviews help nurse practitioners (NPs) identify practice improvement opportunities), supported by a peer assessor. All nurse practitioners licensed to practice in British Columbia will complete a peer review. NPs that prescribe controlled drugs and substances may be re-selected at any time based on BCCNM review of Pharmanet data. 

Peer reviews are completed virtually unless circumstances require the review to be completed onsite. During the review, the peer assessor will review: 

  • Client documentation 
  • Prescribing practices
  • Controlled drugs and substances prescribing (if applicable)​

Before your review

If you are selected for a peer review, a member of the Quality Assurance team will notify you by email and provide next steps. The following items should be completed before your review date.​
1. Complete the pre-visit questionnaire
In the email informing you that you’ve been selected for a peer review, you’ll be asked to complete a pre-visit questionnaire. Your answers will help the Quality Assurance team plan and schedule your review, and your peer assessor better understand your practice.
2. Assessor access to client charts
  • Most peer reviews take place virtually. You will need to work with your employer (and IT department if applicable) to provide your assessor with remote “read only” access to selected client charts. Please ensure you follow your organization’s health record, information management, privacy, and/or security policies and procedures. We recommend starting this process as soon as possible once your review date is set to avoid delays related to security or system access.
  • If a virtual review is not possible (e.g. you have paper client charts only), an onsite review will be scheduled.
3. Prepare client charts
You will need to have 30 complete and randomly selected charts pulled for clients you’ve seen and cared for in the last three months. If you have fewer than 30 charts, don’t worry; just pull all the charts you have. How you do this will depend on the charting method (see below).

Note: If you are prescribing controlled drugs a​nd substances – including opioid agonist therapy – you must provide at least three charts where you have prescribed this type of prescription.

Charting method
Instructions
Electronic medical records (EMR)
 Provide a list of 30 client charts, including client age, gender, and presenting complaint. Ensure the peer assessor has "read only" access. 
Paper charts Arrange for 30 charts to be randomly selected and available on review day. 
EMR and paper charts Provide the EMR and paper charts for each client. 
4. Identify a space for the chart review (on-site review only)
If your review will be on-site, the assessor will need a quiet location to review your charts. Prior to the review date, please identify an appropriate working space.

Day of review

​​While you may be able to schedule some patients on the day of your review, we request that you keep your schedule flexible to accommodate the morning and end-of-day meetings with your assessor. We ask that you do not schedule patients after 2 p.m. to allow for flexibility in the timing of your afternoon session. An approximate review schedule and detail on each step is outlined below.

1. Assessor meet + greet (45-60 mins)
You will give the assessor a brief introduction to the nature of your practice and an orientation to your charts (e.g., charting approaches in the practice setting, navigating the EMR to follow the client’s journey). The assessor will review the expected schedule for the day.

Virtual review details
  • Virtual reviews will take place on WebEx, BCCNM’s video conference platform.
  • If you can remotely access your electronic record management system, you do not need to be at your physical work location during the review.
  • The review can be scheduled on a workday or a day off.
Onsite review details
  • The assessor will meet you at your workplace in a predetermined location.
​​2. Chart review (4-6 hours)
The assessor will review ten of the 30 patient records you provide. The assessor will try to select records that represent the breadth of your practice, such as age, gender, chronic disease, episodic care or wellness care. The charts will be reviewed using Chart Review Guidelines based on BCCNM Practice Standards, Professional Standards, NP Scope of Practice and Entry-level competencies for NPs in Canada.

You may arrange to see clients during the chart review period; the assessor completes the review independently. The amount of time needed for the assessor to complete the chart review will depend on the charts selected. We ask that you do not schedule patients after 2 p.m. to allow for flexibility in the timing of your afternoon session.

Virtual review details
  • Ensure that the assessor has contact information so they can reach you when they have completed their chart review.
Onsite review details
  • Please ensure that there is a quiet location where the assessor can review your charts
  • Ensure that the assessor has a way to contact you should they need to.
​​​3. Review findings discussion (1-1.5 hours)
Following the chart review, the assessor will meet with you to go over their findings and work with you collaboratively to identify opportunities for practice improvement. If specific areas for improvement are identified, you can discuss strategies to enhance your practice in these areas. Please make sure to budget sufficient time for this process, as it’s a key part of the review.

Virtual review details
  • The assessor will meet with you again via WebEx in the afternoon.
Onsite review details
  • Please ensure a quiet location to meet with the assessor.

After your review

Post-review questionnaire
After your review, you will receive an email asking you to complete an evaluation form. All responses are confidential and anonymous to your assessor and BCCNM employees. If you have any additional feedback to share, you can contact us directly np-review@bccnm.ca.
Review assessor report and feedback letter
You will be able to access the assessor’s chart review findings immediately after your review by logging into the Peer Review website​​. You will also receive a feedback letter 6-8 weeks after your review that outlines your strengths and recommendations for practice improvement. The letter may also include details about a follow-up review if required.
How to use the review data and feedback
The results of your peer review can be used to inform your ongoing professional development, based on your discussion and the strategies identified with the peer assessor on the day of your review.

Questions?

Check the frequently asked questions page. Still can't find the information you need? Email np-review@bccnm.ca or call 604.742.6540 (Toll-free in Canada only 1.866.880.7101 ext. 6540). ​


900 – 200 Granville St
Vancouver, BC  V6C 1S4
Canada

info@bccnm​.ca
604.742.6200​
​Toll-free 1.866.880.7101 (within Canada only) ​


We acknowledge the rights and title of the First Nations on whose collective unceded territories encompass the land base colonially known as British Columbia. We give specific thanks to the hən̓q̓əmin̓əm̓ speaking peoples the xʷməθkʷəy̓əm (Musqueam) and sel̓íl̓witulh (Tsleil-Waututh) Nations and the Sḵwx̱wú7mesh-ulh Sníchim speaking Peoples the Sḵwx̱wú7mesh Úxwumixw (Squamish Nation), on whose unceded territories BCCNM’s office is located. We also give thanks for the medicines of these territories and recognize that laws, governance, and health systems tied to these lands and waters have existed here for over 9000 years.

We also acknowledge the unique and distinct rights, including rights to health and wellness, of First Nations, Métis, and Inuit peoples from elsewhere in Canada who now live in British Columbia. As leaders in the settler health system, we acknowledge our responsibilities to these rights under international, national, and provincial law.​