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OMC Peer Review Frequently Asked Questions

What is peer review?

Peer review is simply the evaluation of our work by others in the same field.  In midwifery peer review we prepare a clear outline of a case, share it with other midwives, and receive feedback and support from our colleagues.  Participation in peer review means both providing feedback to peer midwives AND presenting our own cases for review.

Besides sentinel events, what cases do I need to bring to peer review?

Apart from sentinel events there are no specific requirements about what cases you need to bring to peer review.  Peer review is a community learning opportunity and we all benefit from hearing a wide range of cases.  Here are some types of cases that are great for peer review: prenatal cases where you are seeking input before the birth; complex social situations; cases you learned something from; cases you want feedback on; cases involving co-care with MFM; cases with a complex care plan; cases where you found yourself in a gray area in relation to community standards or rules; cases involving challenges with hospital transfer or EMS; rare occurrences that other midwives might benefit from learning about; triumphant cases; gestational diabetes; hypertension/preeclampsia; inductions; post-dates; VBAC; breeches; and twins.  You can bring any case to peer review and we will all enjoy the learning!

I live far from any of the regular regional OMC peer review meetings, how can I participate in OMC peer review?

There are a few different ways to participate in OMC peer review beyond the in-person regional meetings:

  • Statewide online peer review (now offered at least 2 times a year)
  • Contact your OMC regional representative or the OMC president, vice president, or executive director to set up a special peer review meeting
  • Contact your OMC regional representative to find out if the region has any scheduled online peer review sessions. Some regions have both in-person and online meetings

I am a CNM in a birth center practice, am I welcome at OMC peer review? 

Yes!  All midwives who attend community births (home birth or birth center) and student midwives in apprenticeship are welcome at OMC peer review.  There are Certified Nurse Midwives, Naturopathic Midwives, Licensed Direct-Entry Midwives, Traditional Midwives, and Certified Professional Midwives in our community and all participate in OMC peer review.  Feel free to contact anyone in OMC leadership if you are planning to attend an OMC peer review meeting for the first time and have questions.

I don’t understand the peer review requirements in the LDM rule.  Can you explain them in plain language? 

  • LDMs must participate in peer review
  • Peer review should include recommendations for quality improvement and continuing education
  • There must be at least 2 LDM reviewers involved in each peer review. This doesn’t mean that CNMs, OBs, or other provider types can’t also be involved.
  • There must be at least one LDM reviewer outside of the practice involved in each peer review. Internal peer review, only with providers within a practice, doesn’t meet the requirement of the LDM rule.
  • LDMs must participate in at least 1 peer review each year that is with an organization, like OMC, that is focused on peer review and has at least 5 members and includes at least 2 LDM reviewers and at least one reviewer who is not in the midwife’s practice. Other organizations besides OMC could be created for this purpose but we are not currently aware of another organization.
  • The following sentinel events need to be reviewed with a peer review organization such as OMC within 90 days:
    • Maternal hospitalization for infection
    • Maternal hospitalization requiring blood transfusion
    • Uterine rupture
    • Maternal or neonatal death
    • Neonate admitted to Neonatal Intensive Care Unit within 72 hours (except for observation or anomaly)
    • Transfer care deemed emergent by the LDM.

You can find the full LDM rules here:  https://www.oregon.gov/oha/PH/HLO/Pages/Board-Direct-Entry-Midwifery-Laws-Rules.aspx

I had a sentinel event in my practice.  How do I set up a case review through OMC?

Contact your regional representative or the OMC president, vice president, or executive director to set up a case review for a sentinel event.  Any of these people can either set up a review for you or share a list of OMC-trained case reviewers who you can contact yourself to set up a review.  Here are the OMC guidelines for peer review and case review.

Can OMC require a midwife to participate in peer review?

No.  OMC is a voluntary organization that provides peer review meetings and case review for sentinel events as a service to community birth midwives.  Our community standard is that all midwives should participate in peer review but OMC cannot require a midwife to do anything.  OMC peer review does meet the requirements of the LDM peer review rules including the rules to review with an entity at least once a year and to review sentinel events with an entity.

I’m licensed in Washington as well as Oregon.  Do OMC peer review sessions meet my Washington license requirements?

No.  Licensed Midwives in Washington are required to participate in peer review with a Washington state approved Quality Management Program (QMP).  MAWS, WARM, and PMC are the organizations that currently meet this requirement.  Midwives who are licensed in both states could work with OMC to apply for OMC approval as a QMP in Washington if this is a priority for you.

What counts as an OMC peer review for the LDM rules?

Regional OMC peer review meetings, statewide OMC peer review meetings, special OMC peer review meetings organized at the request of a midwife, and OMC case reviews organized by an OMC advocacy council member or the OMC executive director all count as OMC peer review.  OMC case reviews must include an OMC trained case reviewer.  OMC needs to know about the review and be involved in the planning for it to count as an OMC review.

To set up an OMC peer review or case review meeting contact the OMC QI workgroup at omcpresident@ormidwifery.org or your OMC regional rep: https://oregonmidwiferycouncil.org/contact-omc/

OMC Peer Review FAQ (PDF)