Quarterly Quality of Care Peer Review Chart Audit

Quarterly physician peer review template for chart-based quality of care audits aligned to HRSA QI/QA expectations for health centers.

Review Scope and Chart Identification

• Review quarter and year documented
• Patient chart identifier recorded
• Reviewer name and credentials recorded
• Encounter date range reviewed matches quarterly sample

Clinical Documentation Completeness

• Chief complaint or reason for visit clearly documented
• History, exam, and assessment are sufficient to support the plan
• Problem list, diagnoses, and active conditions are current
• Medication list reconciled and consistent with documented care
• Allergies and adverse reactions documented and visible

Clinical Quality and Standard of Care

• Assessment and plan are clinically coherent and supported by the record
• Ordered tests, referrals, or treatments are appropriate for the documented condition
• Preventive care, screening, or counseling opportunities were addressed when applicable
• Follow-up interval and return precautions are documented
• Any deviation from standard practice is explained in the chart

Safety, Risk, and Escalation

• Red-flag symptoms or abnormal results were recognized and addressed
• Medication safety concerns, contraindications, or interactions were considered
• Escalation, consultation, or referral was initiated when indicated
• Patient instructions and warning signs were documented clearly

HRSA QI/QA Follow-Up and Peer Review Outcome

• Overall peer review determination
• Corrective action plan documented if deficiencies were identified
• Follow-up owner assigned
• Target completion date recorded
• Reviewer signature