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Informing Policy. Advancing Health.

Ensuring Patient Safety with an Updated Professional Review Process

HB 12-1300, sponsored by Representative Bob Gardner (R) and Senator Irene Aguilar (D), would continue and improve the Colorado Professional Review Act (CPRA), which governs the process that physicians use to review the quality of patient care provided by other physicians.  The medical professional review, also known as peer review, is an important process to address and learn from medical errors and improve patient safety.

The role of a medical professional review committee is to evaluate the conduct of a provider to determine whether the physician is competent and safe to practice. The evaluation of a physician can be triggered by a complaint or an adverse event such as an unexpected death. After thorough review and due process, a review committee may decide the physician met the standard of care; if not, the committee may require the physician to obtain additional training or restrict the physician’s privileges to practice at that facility. Professional review committees are organized by medical staffs of hospitals, ambulatory surgery centers and medical societies.

CPRA ensures the professional review process remains confidential and provides immunity to individuals and groups that conduct professional reviews as long as they comply with the due process provisions of CPRA.  The confidentiality and immunity protection is important to encourage staff to report providers that are suspected of unsafe practices.  It also encourages other practitioners to participate in the review process by protecting their identities.

Under the sunset review process HB 12-1300 continues CPRA until September 1, 2019. The legislation incorporates additional measures recommended by the Department of Regulatory Agencies’ (DORA). Those measures would:

  • Authorize professional review of physician assistants (PAs) and advanced practice nurses (APNs) to reflect the presence of PAs and APNs providing front-line care in hospitals and clinics.
  • Allow sharing of professional review information with other hospitals where the provider practices.  It also allows information to be shared with the Colorado Department of Public Health and Environment.
  • Require entities that conduct professional review to report their activities to the Colorado Medical Board (CMB) and the Colorado Nursing Board (CNB).   The CMB and CNB are to publish summary data without individually identifiable information.   The purpose of reporting is to have a more accurate description of the level, frequency and effectiveness of professional review in Colorado.

Professional review is required by The Joint Commission, the organization that accredits over 19,000 health care organizations around the nation. It is also required by the Centers for Centers for Medicare and Medicaid Services.

HB 12-1300 has passed the House and has been assigned to the Senate Health and Human Services Committee.