What are the key elements of an Ongoing Professional Practice Evaluation (OPPE)?
An OPPE is an ongoing professional practice evaluation. Medical Staff views and evaluates a practitioner in terms of a variety of performance criteria. It is a standard assessment which need not be triggered by a complaint or concern. As an Ongoing Professional Practice Evaluation (OPPE) is both routine and continuous it needs to have a structure that makes it both repeatable, consistent and reliable. The OPPE generally takes place twice every 12 months but it can be more frequent if necessary. It is a peer review process. Properly done the review is performed by physicians in the same area of practice. The evaluation should be done by persons familiar with the actual work of the subject physician.
There is some fuzziness in the use of the phrase OPPE to evaluations that are triggered by complaint. They may be better phrased as an FPPE (Focused Professional Performance Evaluation) even if the trigger does not initially put the physician at risk for discipline or MEC action.
According to the Joint Commission:
“OPPE identifies professional practice trends that may impact the quality and safety of care and applies to all practitioners granted privileges via the Medical Staff chapter requirements. A well-designed process supports early detection and response to performance issues that could negatively impact patient outcomes.”
The Joint Commission focuses on Qualitative Data which they say includes but is not limited to:
• Description of procedures performed
• Periodic Chart Review
quality/accuracy of documentation
appropriateness of tests ordered / procedures performed
• Types of patient complaints
• Code of conduct breaches
• Peer recommendations
• Discussion with other individuals involved in the care of patient(s), e.g. consultants, surgical assistants, nursing, administration, etc.
Issues arise in terms of sharing this data within Medical Staff. Best practices requires that these assessments be shared during the periodic review of privileges and when additional privileges are sought. Many hospitals and entities segregate and restrict their OPPE’s which ultimately interferes with medical staff’s overarching obligation to fully evaluate medical staff qualifications to protect patient safety.