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Peer Reviewer and Lead Reviewer Training
House Keeping
Overview
Introduction to CCQI
Introducing the peer-review process
Differentiating between peer-reviewer and lead reviewer
Roles and responsibilities
Structure of peer-review visits
Report writing and products of the visit
Troubleshooting
Royal College of Psychiatrists’ Centre for Quality Improvement (CCQI)
c20 projects
Manages quality improvement national initiatives
Over 90% of mental health services in the UK participate
Supports services to take responsibility for improving local mental health provision
Engages directly with clinicians, managers, front line staff and service users
Engages with outside agencies, e.g. NHS England, DH, CQC and the RCN
Introduction to CofC
Project Team:
Sarah Paget, Programme Manager
Francesca Coll, Deputy Programme Manager
Arun Das, Project Worker
Katie Plummer, Project Worker
Membership 2016-2017
80 members
65 scheduled visits (accreditation and peer-review)
Community of Communities
Agree
Standards
Self-Review
Peer-Review
Local ReportAction
Planning
National
Report
Annual
Forum
Annual Cycle
Members
Total Members
CYP ADTC ADD HMP
Learning Outcomes
Be able to explain:
The peer-review process
The lead-reviewer role
The peer-reviewer role
Practise key components of the role
Think about scoring and peer-review visit outcomes
Think about what you would do in difficult situations
Peer-Review Process
Encourages reflections
Engage staff and service users in the process of service development
Recognises local achievement and identifies areas for improvement
Validate and measure service improvement
Focused action plans for development
Promote change and growth by giving the whole community responsibility to create change
Support the host TC in continually improving their services in a supportive and constructive way
Service Standards and Criteria
Standards reflect underlying principles and values
Criteria expand the standard
Agreed best practice by expert consensus
Parameters to measure ‘TC-ness’
A benchmark for measuring improvement
Allows services to demonstrate quality
Standards and Criteria - Layout
This is the Standard
These are the criterion.
Lead reviewer
Facilitator
Timekeeping/maintaining the structure of the timetable
Peer reviewers (3-5 staff/Community members of different disciplines from different TCs)
Engage the community in discussions
Share examples of best practice
Encourages honest reflection
A TC Specialist will attend on Accreditation visits
Review Team
Lead Reviewer Role
To ensure all parties are prepared for the review
Maintain structure of the day i.e. timing etc.
Support, assist and guide review team and host community
Ensure all parties remain focused on task
Ensure enough evidence is gathered for the standards being covered
Facilitate feeding back to the host community
Write the report
Peer-Reviewer Role 1
Introduce yourself to the Community – help the Community
to relax
Engage in reflective discussions with the host community
about their practice against the standards and criteria
Review the community’s performance against the standards
and not against the practice of your own Community
Highlight areas of achievement and support TC to think
about areas for improvement
Peer-Reviewer Role 2
Share examples of best practice and what works well
Enquire and comment on improvements from previous
cycles
Contribute to the written record of the visit
Review and comment on the accuracy and clarity of the
draft local report during the consultation stage
Preparing for and Managing the peer-review day
Preparing for the review
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Before the Day
Prepare yourself
• Check travel arrangements with own service or CofC• Understand the TC by reading the below review pack sent
by email:
2015-2016 Final Report Host TC and Peer-review team contact details Peer-review workbook, including timetable Guidance Notes/Handbook
Document preparation Areas of Achievement and best practice Areas for Development Areas of interest Make Notes
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Lead Reviewer Preparation
Peer-review team
• Phone call 1 week before the review
• Explain role and purpose of the day
• Explain documents received
• Check preparations
Host community
• Phone call 1 week before the review
• Explain the purpose of the day
• Check the timetable
Reassure
Support
Encourage
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Exercise 1 – Pre-visit preparation
Read last year’s report Note action points
Read this year’s self-review Identify criteria not met or partly met Think of some questions for how you would engage a
struggling host community to discuss CS1, CS2 and CS3 – You’ll need these later on!
Identify Areas of Achievement and best practice Identify areas of interest and any questions you may
have
After reading the material and making notes, discuss your findings with the person next to you
Preparing for and Managing the peer-review day
Peer- Reviewer Training
Video
https://youtu.be/Ch2TEkH2Px0
Preparing for and Managing the peer-review day
What happens on the review day
Lead Reviewer Focus
Process facilitation
Support and guidance
Evidence gathering
Report writing
Act as a scribe?
Evidence TriangulationObservationTestimonyRecords
ObservationTestimony
Records
What you read
?
Triangulate the Information
Evidence Collecting Sessions
Introduction
Action plan update
Formal Meetings
Informal time
Lunch
Tour
Observation
Evidence review
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Remember: Take Notes Focus Discussion Standards and Criteria
Introductions
Introductions with the review team:
Process and purpose of the review
Lead reviewer role
Peer reviewer role
Run through timetable and allocate peer reviewers as session Chairs for meetings
Introductions with the whole community:
Process and purpose of the review
Lead reviewer role
Peer reviewer role
Community to provide an update of past 12 months
Informal questions between host community and reviewers
Run through timetable
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Exercise 2 – Briefings at the beginning of the day
In pairs Using the example documents you have received practice the following:
1) Briefing the review team on the day1 person take the role of the lead reviewer and chair the review team briefing at the beginning of the day. Other person take the role of a peer-reviewer
SWAP over
2) Introductions with the whole community 1 person take the role of the lead reviewer and rehearse how you would chair the introduction meeting with the whole community. Other person take the role of host community.
Hint: see the checklist in your lead reviewer handbook
Formal Meetings
Focused on section of standards
Use criteria to open up discussions
Ensure the standards are fully understood
Last 5 minutes to summarise any action points identified
Remember: Take Notes Focus Discussion Action Points
Observation
Host community plan observation with CofC
Awareness of the standards
Remember:
Do not contribute to the discussions
Do not take notes during the observation
Discuss as a review team afterwards
Evidence Portfolio Review
Host community prepare documents to evidence standards and criteria – noting which standards documents refer to
Host community available to talk through documents
All review team to read documents provided
Discuss the documents in relation to relevant standards and criteria
Remember: Take Notes Focus Discussion Action Points
Review team meetings
Time to collectively think about the evidence you have seen on the review day
Think about progress made during the year
Important to note important discussions, no need to minute take
Highlights any areas that need to be asked again or where more information is needed for clarification
Share thoughts about the visit
Writing the report
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Exercise 3 – Facilitating discussions in formal meetings
In small groups
1) Formal meeting reviewing the standards1 person take the role of the lead reviewer, 1 person the role of a peer-reviewer chairing the meeting and 2 people take on roles as the host community.
• Using the extract in the exercise handout, the peer-reviewer should chair the meeting, asking the host community questions based on the criteria and comments in the self-review. • The lead reviewer should keep track of time, answer any questions, intervene if it is going off track and help facilitate difficulties. • Other members – being difficult is allowed to help the lead reviewer practice!
Preparing for and Managing the peer-review day
Scoring Standards and Report Writing
Scoring the Standards
Criteria discussed on the review must be scored
Discuss the evidence as a team
Review scores for the criteria
?
Scores2 = Met1 = Partly met0 = Not met 9 = Not applicable (Rarely used)N = Standard not covered
Evidence Triangulation
Report Writing
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Lead Reviewer is responsible for writing the
report
Peer-Review Team is responsible for compiling content
• Evidence from the day used to score the standards
• Commentary provided to validate scores
• Contribute thoughts on standards
• Suggest scores for standards
• Suggest areas of achievement
• Suggest areas of development
Remember: Take Notes Focus Discussion Recommendations
What the report will look like
Combination of all team members comments from the review day
The evidence and commentary will match the score
Presentation of identified areas of good practice or where previous recommendations have been met
Presentation of identified areas of improvement
Benchmarking from previous year
Peer-review team and host community feedback
Appendices with service information
Areas for Development and Recommendations
Scores of 0 or 1, must always have an identified area of development and recommendation
Met standards can also include areas of further development and recommendation
Recommendations should be realistic; clearly explained; and designed in collaboration
Ensure recommendations are fed back where possible on the day
Example 1: Validating a score
There is a written record of attendance for all therapeutic sessions in the timetable
2
Written records of attendance for all therapeutic sessions are kept, an example was provided to the review team. Case notes indicate individual attendance. There is a signing in and out book for all staff and service users.
How could this report writing example be improved?
Example 2: Suggested areas for development
Staff and service user provide written material about the community which is informative for prospective service users, referrers and other related professionals
1
There is an old welcome booklet for the community but this contains some out of date information. There is little information included about the therapeutic process.
Area for development:To review and update the written material for the community including information about the therapeutic process. The community suggested a working party is set up to work on this.
How else could a recommendation be made?
Exercise 4 – Report writing session
In Small groups
1 person take the role of the lead reviewer, other
members take the role of peer-reviewers.
The lead reviewer should take a lead in scoring and
collecting comments against criteria discussed in
exercise 3.
Feedback with the whole community
Lead reviewer chairs meeting
Review team feedback experience of the day
Review team feedback 1 key areas of achievement and 1 area for development each (if appropriate)
Host service feedback experience of the day
Outline the report timeline
Draft report sent to the community within 28 days of the review
Community and PRT consultation period lasting 14 days
Final report sent to the community
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Feedback forms
Lead reviewer should collect feedback forms:
Host Community
Peer-review team members
Included in reports
Follow up with CofC if necessary
PRT welcome to contact CofC with feedback
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Lead-Reviewer: After the review
Type comments in the Excel workbook
Send completed peer-review day workbook to CofC within 3 days of the review
Be available to CofC to follow up queries re: experiences of the day; scoring; areas of concern
Complete feedback form about the review day
Preparing for and Managing the peer-review dayTroubleshooting
What would you do in the below situations?
You are at a peer-review day and one or more of your peer-review team have not arrived.
The host community seem nervous and defensive.
You are scoring a standard and are struggling to come to a unanimous agreement with the peer-review team.
There are no service users around on the day of the peer-review.
The host community do not seem to be engaging with the day.
The team is unable to justify their score based on the evidence throughout the visit.
Contact Details
Sarah Paget
C of C Programme Manager
020 3701 2675
Francesca Coll
C of C Deputy ProgrammeManager
020 3701 2679
Arun Das
C of C Project Worker
020 3701 2676
Katherine Plummer
C of C Project Worker
020 3701 2678
Thank you and
please complete a
feedback form!