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Most workplace experts agree, the best predictor of future behavior is past behavior. Therefore, one of the most critical aspects of recruiting and credentialing new physicians and advanced practitioners is collecting peer references.

Organizations rely heavily on the feedback of medical professionals who worked alongside of the physicians they are looking to hire to determine whether their performance will be of quality. Yet, the peer reference questionnaires that are commonly used by medical services departments don’t always enable hospitals to receive quality feedback. Oftentimes responses are returned, with simple yes or no answers and provide little insight into potential areas that may be of concern.

There are a few ways to access higher quality peer reference feedback. To get started, ask yourself a couple questions:

– Is your questionnaire competency-based?
– How easy or difficult is it for peers to provide responses?

Competency-Based Peer Referencing

In the recent blog post, Patient Experience and Practitioners: Perfect Together?, experienced physician leader and hospital executive, Dr. William Cors, states, “Practitioner performance is more than just the technical quality of care or the degree of medical knowledge possessed. It is necessary to determine what aspects or dimensions of practitioner performance are important to your organization.” Many organizations look to a commonly adopted framework of physician performance competencies by the Joint Commission.

The Joint Commission’s recommended six core competencies:

  1. Patient Care
  2. Medical Knowledge
  3. Practice-based Learning and Improvement
  4. Systems-Based Practice
  5. Professionalism
  6. Interpersonal & Communication Skills

Applying these six competencies to your peer reference questionnaire will help your facility to receive feedback on critical areas of the provider’s practice as well as their soft skills, or the intangible skills that often determine cultural fit at an organization.

Linda Van Winkle, CPMSM, CPCS, an industry veteran with over 30 years of experience in medical staff services and current credentialing consultant for SkillSurvey, suggests, “Consider including one question pertaining to each competency to ensure you are receiving information on each area – if you don’t ask, you will not receive information that may be critical. You will find that competency-based peer referencing allows you to gain more insight than requesting a more general, overall recommendation.”

Apply Behavioral Science

Adding questions pertaining to the six physician performance competencies into your peer reference questionnaire will help you to receive more specific feedback, but it is also important to evaluate how each question is constructed to ensure the questionnaire is clear and consistently interpreted by references so the responses being provided are reliable.

SkillSurvey’s analytics team examined over 25 peer reference forms currently being used by hospitals across the nation to develop a standard peer reference form, available to SkillSurvey Credential OnDemandTM clients. This team researched industry and legal guidelines, and incorporated their deep knowledge gained through developing a library of 130 job-specific surveys for healthcare roles used in SkillSurvey Reference’s patented Pre-Hire 360® online reference process.

Here are a few guidelines our analytics team followed when developing our standard form which are good to consider when evaluating your own questionnaire:

Write questions so they are subjectively viewed as relevant.
Does a peer reference think it makes sense they are being asked to respond to these questions about the applicant? This increases a reference’s perception of fairness and, therefore, their willingness to respond.

Use competency-based questions.
This helps you to evaluate the skills and behaviors relevant to the specific role the applicant is applying for and better predict future behaviors related to their practice. Include questions pertaining to all the facets of the six core competencies that make up the standards of the Joint Commission for measuring practitioner competence. Clearly define each competency being measured so that all peer references respond in a consistent manner on observable behaviors

Use a 5-point scale response format.
A 5-point scale is better for predictive validity and other correlational studies as it provides more response variability. Also, include “not observed” as a response option, which has been shown to reduce measurement error.

Automate the process so it is completely paperless for both you and peer references.

Take a look at how you are currently conducting peer referencing. Are you mailing or faxing paper questionnaires to peer references? Are you emailing the questionnaire as a PDF attachment? Even if the process is paperless for your office, it isn’t paperless for the providers responding if they have to complete and sign it by hand, then scan or fax the hard copy document back to your office.

Cloud-based technology, as used in the SkillSurvey Credential OnDemand Peer Referencing and Affiliation Verification module, makes it possible to automate the entire process for both credentialing teams and peer references. Your existing reference questionnaire, or using our standard reference form, is digitized and sent to references via a secured link in an email. The reference conveniently accesses the digital questionnaire via a link in their email, completes the form on any smartphone, tablet or computer, signs it electronically using DocuSign®, and simply clicks submit. The completed form is made available to your office immediately via an online dashboard.

Save your seat for a live demonstration of SkillSurvey Credential OnDemand to see how your organization might benefit from faster, smarter credentialing. >>

The advantages to this process?

Increase response rate and speed:
The ability to conveniently provide immediate input online improves the rate of response and reduces the time it takes to receive completed responses to just three days. Better yet, the need to conduct individual follow up with non-responsive references is virtually eliminated with automated reminders that deploy if references haven’t responded in a specified amount of time.

Improve quality of feedback:
Never see reference questionnaire returned with a line down the middle of the page again. Eliminating the need to complete a reference questionnaire by hand promotes references to provide more detailed feedback. Providers can easily elaborate on potential issues or concerns with an applicant by typing responses directly into the online questionnaire.

Avoid common roadblocks:
Required fields built into forms ensure you are getting answers to each question asked and additional clarification on any answers that might require more information. These hard stops prevent the submission of incomplete or unsigned questionnaires, eliminating unnecessary back and forth after the form is initially returned. And with digital responses, there’s no need to worry about deciphering providers’ infamously bad handwriting.

The Key to Improving the Quality of Peer Reference Feedback

Whether a peer reference notes that they would allow an applicant to treat their own family members or if they alert you of a potentially disqualifying issue, their input is a crucial part of the credentialing and privileging processes and key in determining whether an applicant is qualified to join your medical staff. It’s important that the feedback peer references provide allows every decision to be well-informed.

To ensure you are receiving clear, specific and reliable peer reference feedback, review your existing peer reference questionnaire and your process for requesting references. Look to the Joint Commission’s six recommended competencies for physician performance and consider a standard reference form such as the one developed by SkillSurvey’s analytics team. Moreover, do your best to eliminate paper from the process, especially for the responding peer references. Technology that automates the entire process, like SkillSurvey Credential OnDemand, can improve the quality of the feedback you’re receiving and the speed and rate in which you receive it.

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