Lower Lights Christian Health CenterColumbus, Ohio

A Faith based, Non Profit Community Health Center

MISSION OF LLCHC

LLCHC ministers the love of Christ as a model full service medical home, focused on whole person wellness, available to all in

Central Ohio who need it regardless of ability to pay

VISION STATEMENT

LLCHC transforms the overall health of Central Ohio, serving one individual and family at a time

Facts Services• 5 Sites• 2 Counties• 9,774 Users/Patients• 45,000 Annual Visits• 25% of Patients with adepression diagnosis receive counseling at LLCHC• >70% of Patients at LLCHC have a Comorbid Mental Health or Substance Abuse diagnosis

• Primary Care• Prenatal Care• Behavioral Health• Enabling• Dental• Vision• Pharmacy• Spiritual Care• Nutrition

Peer Review Frequency

• We have 20 Medical Providers (~ 13.58 FTE’s) who all participate in Peer Review

• Currently, there are 4 types of reviews done (1 per month, 3 times per year) and a check on coding for billing purposes – General Review– Diabetes Patients– Hypertensive Patients– Patients with HyperlipidemiaNote: – Coding accuracy is added to one of the reviews above 2x per year– If you are just starting Peer Review, start with something basic and

work into other areas that you want to focus on

Basis for Each Peer Review

• There are care guidelines documented for each Peer Review type

• The guidelines tie in to UDS measures where applicable

• Each Provider is looking at the patient’s encounters and documentation to ensure that we are meeting our guidelines for Diagnosis, Treatment Goals and Medical Management

Process Overview

Peer Review Packets are passed out at

the Monthly Provider Meeting

As each Provider completes their assignment, the

packets are returned to the Quality Dept

Returned Peer Review is scored

individually and as a Practice

Medical Director reviews the Peer

Review results and writes comments for

the Provider

Previous Peer Review with comments and the new Peer

Review assignments are passed out at the Provider

Meeting.

Practice results are reviewed in our

monthly CQI Meeting

Peer Review Preparation

• Each month Peer Review is prepared, monitored and tracked in our Quality Department by our Clinical Care Coordinator

• Our Medical Director reviews the peer review guidelines and questions periodically to make sure that we are covering the information that we think is most important

• In our monthly Provider meetings, our Medical Director reviews, with the staff, the guidelines and instructions for the Peer Review taking place that particular month

Peer Review Packets

• Each provider receives the following information each month in our Provider Meeting:– The Patient and Encounter numbers of up to 4 patients to

review– A sheet with the care guidelines related to the type of Peer

Review– Directions to complete that particular Peer Review– A scoring sheet with questions to be answered for each

patient reviewed– Feedback/results from their previous month’s Peer Review

– with comments from our Medical Director

Oversight

• Each month, Peer Review is reviewed in our CQI Meeting– We review the practice results over time from the peer

review “type” that was just completed– If there are concerns about any results, they would be

discussed in this group with the Medical Director and any additional actions would come from this meeting

– The CQI meeting includes members of our Board of Directors as well as representatives from all areas of the Health Center

– If there was determined to be a significant issue, it would go to the full Board of Directors

Additional Information

• Peer Review is mandatory in our facility – Providers cannot “opt out” - it is punitive if you do not participate

• Peer Review results are a part of the Provider’s annual review• For FQHC’s, Peer Review needs to be monitored by your

Medical Director and not only tied to performance but, to re-appointment to staff. This should be a documented process in your facility

• HRSA views Peer Review as a way of holding people accountable

• No peer review should be kept in patient charts or Provider files. It should be kept separate as Peer Review to keep it legally protected.

Future Plans for Peer Review

• We would like to use Peer Review as a form of process improvement and develop new reviews around UDS measures that would allow us to put an added focus on a particular measure

Questions??