Background and Goal of Study: Audits, checklists, guidelines, and practice advisories considerably improved safety in the perioperative setting. Yet, given the reality of multi-generational and multi-cultural workforces and discoveries in management sciences, the community is only just about to recognise the importance of peer review in perioperative medicine. While the concept of feedback has been institutionalized across various settings over the past decades, peer reviews take place on a different level in organizational hierarchy and depends heavily on individual and departmental culture. We aimed to shed light on this crucial activity to prevent, manage, and learn from catastrophic complications.
Materials and Methods: We searched PubMed, Embase and EBSCO, Web of Science, JSTOR and WISO and reviewed current evidence considering peer review, i.e. the performance assessment by someone of the same status and ability, from both management science and medicine to define, build, and adjust a department’s mission, vision, and culture.
Results and Discussion: While respective evidence is sparse in medicine, such deriving from management sciences is overwhelming. The latter suggests peer review being integrated in every department’s mission and vision to evolve from a peer review-adverse culture towards an open and supportive peer review environment since not only the fear of performance review, but also the lack of it generate dysfunctional
work environments. Further, professional performance, compliance with epartmental strategy, and personality traits can be addressed preventively, retrospectively, and acutely, and can be benchmarked with the departmental mission, vision, and values, defined in the strategy.
Conclusions: Aiming at reducing perioperative morbidity and mortality, peer review provides a valuable leadership tool to improve in the face of ever increasing complex workplace settings and a key element towards preventing, managing, and learning from catastrophic perioperative complications. Both leadership and peers in perioperative medicine have to be aware that change is not an event but rather a process that requires time, has to follow specific steps, and has to be planned strategically.

01 / Peer review to prevent, manage and learn from catastrophic complications in perioperative medicine