Independent medical examiner: Quality Assurance Program (QAP)

Improving through QAP

WorkSafe has changed its quality assurance processes for IME reports.

The changes, introduced in 2022, encourage collaboration and make it easier for you to meet your obligations under the IME Agreement and Service Standards.

The main changes are as follows.

• The IME QAP process was previously anonymous. The new model identifies the peer who reviewed your report. This will encourage collaboration between you and your peer.
• In the past your report was given a specific rating. Now the focus is on working together to maximise report quality. It improves the process beyond a pass/fail outcome.
• The agent referral is now part of the QAP review. This acknowledges the impact of referral quality on report quality.

IME QAP remains an important part of how WorkSafe works with you to improve outcomes for Victorians injured at work.

Consultative peer review

All peers who complete IME QAP assessments are themselves experienced examiners. They have a comprehensive understanding of WorkSafe’s current reporting expectations.

They are specialists in their field and are available to support you to produce high quality IME reports.

All peers are recruited from WorkSafe’s pool of examiners. All examiners in the relevant specialty are welcome to apply for available roles when advertised.

How your peer will contact you

After your report has been reviewed you will receive an email from WorkSafe’s IME QAP team.

This email will include:

• the name of the peer who reviewed your report
• the peer’s summary of feedback
• confirmation if a discussion with the peer is required or optional.

Peer consultation can be optional or required

Most of the time the QAP report will determine peer consultation is optional.

For some reports, consultation is required.

Reasons for this can include, but are not limited to, the following.

• The examiner is new to the scheme.
• Report content does not meet WorkSafe’s current expectations for IME reports.
• A significant error in the report has been detected.
• The report does not contain evidence to support findings.
• The peer needs to discuss improvements following previous feedback.

How often your reports will be reviewed

How often your IME reports are reviewed depends on the number of reports you produce.

An examiner completing a high volume of reports can be reviewed multiple times in a month.

A specialist not often accessed by WorkSafe may be reviewed only once or twice in their 3-year tenure.

Matched consultation

WorkSafe will match your report with a peer who is experienced in the relevant examination type. Sometimes this peer will not be from the same speciality.

When a peer of a different speciality reviews your report, their feedback will focus on WorkSafe’s reporting requirements. These don’t significantly vary across specialities.

How reports are selected for review

The IME QAP program focuses on randomly selected IME reports.

However, WorkSafe will sometimes select a specific report for review to:

• follow-up progress after previous feedback
• address a concern raised by the WorkSafe clinical panel
• make sure all new examiners receive feedback.

There may also be other reasons why an IME report is selected for review.

QAP is not performance management

The IME QAP is designed to help IMEs meet their obligations and WorkSafe’s expectations.

Peers are available to support and mentor you but will not lead performance management activity.

The IME service standards require IMEs to participate and cooperate with WorkSafe in the IME QAP process.

You must cooperate and comply with WorkSafe in the peer review of your reports. You must work to improve identified areas for development.

WorkSafe wants to support you outside of a performance management framework.

However, examiners who don’t take a constructive approach to the support offered by peers, or who do not improve based on the feedback from the QA process, may be subject to performance management in accordance with the IME Agreement and Service Standards.

This would be coordinated by WorkSafe, not a peer.

Identified improvements

The IME QAP process has shown the following areas are critical to the quality of IME reports.

• A clear, comprehensive history that allows all readers to understand the basis of the examiner’s opinion.
• Clear identification of where all aspects of the patient history were sourced.
• Providing the reader with a comprehensive understanding of the examination undertaken. This should be justified by research, evidence and best practice standards.
• Findings clearly linked to the examination undertaken and best practice recommendations.
• Clear evidence to support findings. Especially if the opinion deviates from treater or from accepted guidelines.

All of these aspects have shown significant improvement through the IME QAP process.

If you have any questions about the IME QAP process, email [email protected].