360o PEER REVIEW GUIDELINES for QLP

“ The peer review process is designed to foster individual accountability for professional
development and practice, as well as group accountability for overall quality of professional
practice” (Toward Clinical Excellence, 2002).

Peer reviewer’s responsibilities:

• Accurate reporting is a professional responsibility. Modifying feedback to avoid
damaging or enhancing egos place consumer’s safety and professional credibility at
risk.
• Comments should be precise, objective and factual, using non-judgmental language.
• Give your opinion only; do not discuss the review with others.
• Excellence in one area does not mean the person is excellent in all areas. Comment
on both areas of excellence and areas needing improvement.
• Comments at either end of the scale must be supported by specific examples.
• Consider the person’s performance over the whole time under review. It is important
to avoid being swayed by one incident.

__________________________________________________

Each midwife will require 3 peer reviews and the process for distribution is as follows:

1. The Midwife will select one of their peers to compete the form
2. The Manager will select a midwife to complete the form
3. The Team leader will complete one of the peer review form

The application form for the domains need to be signed by your manager and this will provide
an opportunity to distribute your peer reviews.

Reference:
Ministry of Health. (2002). Toward Clinical Excellence. An introduction to clinical audit, peer
review and other clinical practice Improvement activities. Wellington: New Zealand.
This document is available on the M.O.H. website: http://www.moh.govt.nz

Acknowledgement of Waitemata DHB for 360o Peer Review

Review Dec 2006
QLP
Confident Domain
360° Clinical and Situational Leadership Peer Review
This questionnaire is designed to help midwives seeking to achieve or maintain the
“Confident” domain demonstrate their “confidence in handling complex clinical situations
and situational leadership skills.” Feedback is required from midwifery peers that have been
selected by the midwife, manager and team leader Your honest feedback will help the
midwife assess performance and develop skills.
It is important that you complete this feedback within ten working days

Name of midwife requesting feedback:

_____________________________________________

Name of midwife providing feedback:

______________________________________________

Giving examples or suggestions will improve

Please circle the most appropriate response the quality of the feedback and assist the
assessor.
Has the midwife developed the broad range of
skills necessary to function effectively in a
secondary maternity facility?

What is the midwife’s usual response in an

emergency situation?

How would you describe the midwife’s response to

a challenging situation?

Does this midwife take the opportunity to care for

women with complex medical, social or cultural
needs?

Is this midwife able to manage her workload

effectively and delegate appropriately?

Does the midwife individualise care and seek ways

to make the system work for the woman?

Acknowledgement of Waitemata DHB for 360o Peer Review

Review Dec 2006
QLP
Please add any additional comments or suggestions that you feel would help your colleague
develop her practice.

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

______________________________

Signature of reviewer: ______________________________

Date review completed: ______________________________

Acknowledgement of Waitemata DHB for 360o Peer Review

Review Dec 2006
QLP
 360o PEER REVIEW GUIDELINES for QLP

“ The peer review process is designed to foster individual accountability for professional
development and practice, as well as group accountability for overall quality of professional
practice” (Toward Clinical Excellence, 2002).

Peer reviewer’s responsibilities:

• Accurate reporting is a professional responsibility. Modifying feedback to avoid
damaging or enhancing egos place consumer’s safety and professional credibility at
risk.
• Comments should be precise, objective and factual, using non-judgmental language.
• Give your opinion only; do not discuss the review with others.
• Excellence in one area does not mean the person is excellent in all areas. Comment
on both areas of excellence and areas needing improvement.
• Comments at either end of the scale must be supported by specific examples.
• Consider the person’s performance over the whole time under review. It is important
to avoid being swayed by one incident.

__________________________________________________

Each midwife will require 3 peer reviews and the process for distribution is as follows:

4. The Midwife will select one of their peers to compete the form
5. The Manager will select a midwife to complete the form
6. The Team leader will complete one of the peer review form

The application form for the domains need to be signed by your manager and this will provide
an opportunity to distribute your peer reviews.

Reference:
Ministry of Health. (2002). Toward Clinical Excellence. An introduction to clinical audit, peer
review and other clinical practice Improvement activities. Wellington: New Zealand.
This document is available on the M.O.H. website: http://www.moh.govt.nz

Acknowledgement of Waitemata DHB for 360o Peer Review

Review Dec 2006
QLP
Leadership Domain

360° Midwifery Leadership Qualities Review

This questionnaire is designed to help midwives seeking to achieve or maintain the
“leadership” domain understand the qualities required of a successful leader. Feedback is
required from a midwifery peer that has been selected by the midwife, manager and team
leader. This is to ensure that a variety of perspectives are provided. Your honest feedback
will help the midwife identify strengths and areas that need improvement so that the midwife
is able to develop into the role model we expect for our service and profession. It is important
that you complete this feedback within ten working days.

Name of midwife requesting feedback:

_____________________________________________

Name of midwife providing feedback:

______________________________________________

Leadership Giving examples or suggestions will

Please circle the most appropriate
Characteristic improve the quality of the feedback
response
and assist the assessor.
How does this midwife lead by
Modelling the
example, role-model partnership with
way
women and support midwifery
colleagues?

How does this midwife provide

leadership, create an atmosphere of
calm and manage difficult situations
with confidence?

How does this midwife make a

Inspire a
positive difference to the midwifery
shared vision
care provided in the unit?

Has this midwife encouraged you to

improve your practice, and if so how?

Acknowledgement of Waitemata DHB for 360o Peer Review

Review Dec 2006
QLP
 Please give an example of how this
Challenging
midwife looks for innovative solutions
the process
to problems?

How does this midwife demonstrate

that she is able to acknowledge and
accept mistakes and use them as
learning opportunities?

Does this midwife engage well with

Enabling
colleagues using a co-operative,
others to act
collaborative approach?

How does this midwife demonstrate

that she is respectful of colleagues
and clients supporting a culture of zero
tolerance to violence?

Does this midwife recognize and

Encouraging
encourage the achievements of
the heart
others?
If so how ?

How does this midwife celebrate the

successes and accomplishments of
this maternity service?

Signature of reviewer: ______________________________ … Core Midwife

… Team leader

… Manager
Date review completed: ______________________________

Acknowledgement of Waitemata DHB for 360o Peer Review

Review Dec 2006
QLP