The webinar will begin shortly. Please take a moment to answer the poll questions below. How many people are participating in this webinar at your location today? 1 2 3 4 5 6 7 8 or more Are you accredited through the ACCME system? Nationally Intrastate Non Accredited Commercial Supporter email us at acme@commpartners.com 1 The 2006 ACCME Updated Accreditation Criteria Presented by: Murray Kopelow, MD 2 e-mail us at acme@commpartners.com 1
Why? Why now? 3 Started with people reading Widely used CME delivery methods such as conferences have little direct impact on improving professional practice. From D. A. Davis, et. al. JAMA 274 (9), Sept. 6, 1995 4 e-mail us at acme@commpartners.com 2
Followed by we must conclude that where performance change is the immediate goal of a CME activity, the exclusively didactic CME modality has little or no role to play. From D. A. Davis, et. al. JAMA 282 (9), Sept. 6, 1999 5 Turned into We all know traditional CME is ineffective... JAMA 282 (9), Sept 6 1999 6 e-mail us at acme@commpartners.com 3
Was applied in the system as the majority of [CME] activities offered to physicians employ learning methods that have been shown not to have a positive effect on the quality of care physicians provide to their patients. A Vision for Medical Education in the United States Association of American Medical Colleges July 2004 7 While the only meta synthesis in the literature actually said Continuing education is effective in assisting professionals to modify and improve their practice Umble and Cervero, 1996 Robertson, Umble, Cervero, 2003 8 e-mail us at acme@commpartners.com 4
At the same time, messages from Maintenance of Certification Maintenance of Licensure Quality and Safety Hospital credentialing about what they needed from CME 9 CME has the potential to be a viable tool for use in ensuring ongoing physician competence if it is part of a system of continuous professional development that includes self-assessment, remediation, and reassessment. Johnson, Austin and Thompson in Role of State Medical Boards in Continuing Medical Education JCEHP September 10 2005 e-mail us at acme@commpartners.com 5
All adults in the United States are at risk for receiving poor health care, no matter where they live; why, where, and from whom they seek care; or what their race, gender, or financial status is. Rand 2006 Ideal Performance Performance Quality gap The difference between health care processes or outcomes observed in practice, and those potentially achievable on the basis of current professional knowledge. 11 AHRQ 2006 Joint Commission 2007 Medical Staff Standards (Pre-publication) All licensed independent practitioners and other practitioners privileged through the medical staff process participate in continuing education. Rationale Continuing education is an adjunct to maintaining clinical skills and current competence. JCAHO Elements of Performance Hospital-Based Education: Hospital-sponsored educational activities are offered prioritized by the organized medical staff. These activities relate, at least in part, to the type and nature of care, treatment, and services offered by the hospital. The organized medical staff helps prioritize hospitalsponsored continuing education. Education is based on the findings of performance improvement activities. Individual-Based Education: Each individual's participation in continuing education is documented. Participation in continuing education is considered in decisions about reappointment to membership on the medical staff or renewal or revision of individual clinical privileges. 12 e-mail us at acme@commpartners.com 6
So, it is Mission Critical that CME must, Contribute to patient safety and practice improvement Be based on valid content Be independent of commercial interests 13 Sept 2006 Change in Emphasis Focus on rewarding providers for changing and improving their practice of CME. 14 e-mail us at acme@commpartners.com 7
Mission Planning Needs Objectives Activity Impact Program Structure Program Impact Standards for Commercial Support 15 Planning Needs Objectives Activity Impact Program Structure Standards for Commercial Support Mission Competence Performance Patient Outcomes Interventions Program Impact Competence Performance Patient Outcomes 16 e-mail us at acme@commpartners.com 8
Program Structure Mission Competence Performance Patient Outcomes Interventions Needs Planning Objectives Standards for Commercial Support Program Impact Competence Performance Patient Outcomes Activity Impact 17 Aligns Learner and Provider Mission Competence Performance Patient Outcomes Interventions Needs Planning Objectives Standards for Commercial Support Program Impact Competence Performance Patient Outcomes Activity Impact Program Improvement 18 e-mail us at acme@commpartners.com 9
Starting Point: The Professional Practice Gap --- the Questions in Practice? Do Know Ability 19 1.1 Have a written statement of its CME mission, which includes the CME purpose, content areas, target audience, type of activities provided, and expected results of the program. C Has a mission statement that includes all of the basic components. EC Has a mission statement that includes all of the basic components with a strong emphasis on assessment of results. 20 e-mail us at acme@commpartners.com 10
1.1 Have a written statement of its CME mission, which includes the CME purpose, content areas, target audience, type of activities provided, and expected results of the program. Has a mission statement that includes all of the basic components. Has a mission statement that includes all of the basic components with a strong emphasis on assessment of results. Evolved to, 1.... all of the basic components (CME purpose, content areas, target audience, type of activities, expected results) with expected results articulated in terms of changes in competence, performance, or patient outcomes that will be the result of the program. 21 1.1 Have a written statement of its CME mission, which includes the CME purpose, content areas, target audience, type of activities provided, and expected results of the program. Has a mission statement that includes all of the basic components. Has a mission statement that includes all of the basic components with a strong emphasis on assessment of results. Evolved to, 1.... all of the basic components (CME purpose, content areas, target audience, type of activities, expected results) with expected results articulated in terms of changes in competence, performance, or patient outcomes that will be the result of the program. 22 e-mail us at acme@commpartners.com 11
2.1 Use a planning process(es) that links identified educational needs with a desired result in its provision of all CME activities. 2.2 Use needs assessment data to plan CME activities. 2.3 The provider must communicate the purpose or objectives of the activity so the learner is informed before participating in the activity. 2.1 C Planning process(es) used consistently that link(s) identified educational needs and desired result. EC Innovative and creative planning process(es).documentation that identified educational needs contribute to appropriate methodology and desired results for the offered activities. 2.2 C Needs assessment data are consistently used. EC from multiple sources are consistently used to plan and evaluate activities. 2.3 C Purpose or objectives of the activity are consistently communicated to the learner. EC Purpose or objectives of the activity describe learning outcomes in terms of physician performance or patient health and are consistently communicated to the learner. 23 2.1 Use a planning process(es) that links identified educational needs with a desired result in its provision of all CME activities. 2.2 Use needs assessment data to plan CME activities. 2.3 The provider must communicate the purpose or objectives of the activity so the learner is informed before participating in the activity. Planning process(es) used consistently that link(s) identified educational needs and desired result. Innovative and creative planning process(es). documentation that identified educational needs contribute to appropriate methodology and desired results for the offered activities. Needs assessment data are consistently used.. from multiple sources are consistently used to plan and evaluate activities. Purpose or objectives of the activity are consistently communicated to the learner. Purpose or objectives of the activity describe learning outcomes in terms of physician performance or patient health and are consistently communicated to the learner. Evolved to, 2. The provider incorporates into CME activities the educational needs (knowledge, competence, or performance) that underlie the professional practice gaps of their own learners. 3. The provider generates activities/educational interventions that are designed to change competence, performance, or patient outcomes as described in its mission statement. 4. The provider generates activities/educational interventions around content that matches the learners current or potential scope of professional activities. 5. The provider chooses educational formats for activities/interventions that are appropriate for the setting, objectives and desired results of the activity. 6. The provider develops activities/educational interventions in the context of desirable physician attributes (e.g., IOM competencies, ACGME Competencies). 24 e-mail us at acme@commpartners.com 12
2.1 Use a planning process(es) that links identified educational needs with a desired result in its provision of all CME activities. 2.2 Use needs assessment data to plan CME activities. 2.3 The provider must communicate the purpose or objectives of the activity so the learner is informed before participating in the activity. Planning process(es) used consistently that link(s) identified educational needs and desired result. Innovative and creative planning process(es). documentation that identified educational needs contribute to appropriate methodology and desired results for the offered activities. Needs assessment data are consistently used.. from multiple sources are consistently used to plan and evaluate activities. Purpose or objectives of the activity are consistently communicated to the learner. Purpose or objectives of the activity describe learning outcomes in terms of physician performance or patient health and are consistently communicated to the learner. Evolved to, 2. The provider incorporates into CME activities the educational needs (knowledge, competence, or performance) that underlie the professional practice gaps of their own learners. 3. The provider generates activities/educational interventions that are designed to change competence, performance, or patient outcomes as described in its mission statement. 4. The provider generates activities/educational interventions around content that matches the learners current or potential scope of professional activities. 5. The provider chooses educational formats for activities/interventions that are appropriate for the setting, objectives and desired results of the activity. 6. The provider develops activities/educational interventions in the context of desirable physician attributes (e.g., IOM competencies, ACGME Competencies). 25 Planning @ Level 2 Yes No Gap identified? Gap of own learners? K,C,P need incorporated? Designed to C, P, PO? Implementation @ Level 2 Yes No Content matches scope? Formats appropriate to setting? Formats appropriate to objectives? Formats appropriate to desired result? 26 e-mail us at acme@commpartners.com 13
3.3 The provider must present CME activities in compliance with ACCME s policies for disclosure and commercial support. C Provider consistently in control of content; discloses required information and relationships; demonstrates appropriate management of funds from commercial supporters. ensures that promotion and education are separate; 27 3.3 The provider must present CME activities in compliance with ACCME s policies for disclosure and commercial support. C Provider consistently in control of content; discloses required information and relationships; demonstrates appropriate management of funds from commercial supporters. ensures that promotion and education are separate; Evolved to, 7. The provider develops activities/educational interventions independent of commercial interests (SCS 1, 2 and 6). 8. The provider appropriately manages commercial support (SCS3). 9. The provider maintains a separation of promotion from education (SCS 4). 10. The provider actively promotes improvements in health care and NOT proprietary interests of a commercial interest (SCS 5). 28 e-mail us at acme@commpartners.com 14
3.3 The provider must present CME activities in compliance with ACCME s policies for disclosure and commercial support. C Provider consistently in control of content; discloses required information and relationships; demonstrates appropriate management of funds from commercial supporters. ensures that promotion and education are separate; Evolved to, 7. The provider develops activities/educational interventions independent of commercial interests (SCS 1, 2 and 6). 8. The provider appropriately manages commercial support (SCS3) 9. The provider maintains a separation of promotion from education (SCS 4). 10. The provider actively promotes improvements in health care and NOT proprietary interests of a commercial interest (SCS 5). 29 2.4 The provider must evaluate the effectiveness of its CME activities in meeting identified educational needs. C Educational activities are evaluated consistently for effectiveness in meeting identified educational needs, as measured by satisfaction, knowledge, or skills. EC Educational activities are evaluated consistently for effectiveness in meeting identified educational needs, as measured by practice application and/or health status improvement. 30 e-mail us at acme@commpartners.com 15
2.4 The provider must evaluate the effectiveness of its CME activities in meeting identified educational needs. C Educational activities are evaluated consistently for effectiveness in meeting identified educational needs, as measured by satisfaction, knowledge, or skills. EC Educational activities are evaluated consistently for effectiveness in meeting identified educational needs, as measured by practice application and/or health status improvement. Evolved to, 11. The provider analyzes changes in learners (competence, performance, or patient outcomes) achieved as a result of the overall program s activities/educational interventions. 31 2.4 The provider must evaluate the effectiveness of its CME activities in meeting identified educational needs. C Educational activities are evaluated consistently for effectiveness in meeting identified educational needs, as measured by satisfaction, knowledge, or skills. EC Educational activities are evaluated consistently for effectiveness in meeting identified educational needs, as measured by practice application and/or health status improvement. Evolved to, 11. The provider analyzes changes in learners (competence, performance, or patient outcomes) achieved as a result of the overall program s activities/educational interventions. 32 e-mail us at acme@commpartners.com 16
2.5 The provider must evaluate the effectiveness of its overall CME program and make improvements to the program. Mechanism in place to measure the effectiveness of the program.. PC but no documentation exists that the mechanism has been used or any changes have resulted from the process C with evidence that improvements have been made. EC Innovative and creative mechanism(s).. improvements being made on a regular basis. 33 2.5 The provider must evaluate the effectiveness of its overall CME program and make improvements to the program Mechanism in place to measure the effectiveness of the program PC but no documentation exists that the mechanism has been used or any changes have resulted from the process C with evidence that improvements have been made. EC.Innovative and creative mechanism(s).. improvements being made on a regular basis. Evolved to, 12. The provider gathers data or information and conducts a program-based analysis on the degree to which the CME mission of the provider has been met through the conduct of CME activities/educational interventions. 13. The provider identifies, plans and implements the needed or desired changes in the overall program (e.g., planners, teachers, infrastructure, methods, resources, facilities, interventions) that are required to improve on ability to meet the CME mission. 14. The provider demonstrates that identified program changes or improvements, that are required to improve on the provider s ability to meet the CME mission, are underway or completed. 15. The provider demonstrates that the impacts of program improvements, that are required to improve on the provider s ability to meet the CME mission, are measured. 34 e-mail us at acme@commpartners.com 17
2.5 The provider must evaluate the effectiveness of its overall CME program and make improvements to the program. Mechanism in place to measure the effectiveness of the program.. PC but no documentation exists that the mechanism has been used or any changes have resulted from the process C with evidence that improvements have been made. EC..Innovative and creative mechanism(s).. improvements being made on a regular basis. Evolved to, 12. The provider gathers data or information and conducts a program-based analysis on the degree to which the CME mission of the provider has been met through the conduct of CME activities/educational interventions. 13. The provider identifies, plans and implements the needed or desired changes in the overall program (e.g., planners, teachers, infrastructure, methods, resources, facilities, interventions) that are required to improve on ability to meet the CME mission. 14. The provider demonstrates that identified program changes or improvements, that are required to improve on the provider s ability to meet the CME mission, are underway or completed. 15. The provider demonstrates that the impacts of program improvements, that are required to improve on the provider s ability to meet the CME mission, are measured. 35 Level 3: Accreditation with Commendation 2.1 EC... Innovative and creative planning process(es) used consistently, with documentation that identified educational needs contribute to appropriate methodology and desired results for the offered activities. 2.4 EC... Educational activities are evaluated consistently for effectiveness in meeting identified educational needs, as measured by practice application and/or health status improvement. 3.1 EC... Organizational framework for the CME unit exists, all components of the Element (resources and support) are present including a process to review and continually improve the organizational framework. 2.5 EC... Innovative and creative mechanism(s) in place to measure the effectiveness of the program with evidence of improvements being made on a regular basis. 36 e-mail us at acme@commpartners.com 18
Level 3: Accreditation with Commendation 2.1 EC... Innovative and creative planning process(es) used consistently, with documentation that identified educational needs contribute to appropriate methodology and desired results for the offered activities. 2.4 EC... Educational activities are evaluated consistently for effectiveness in meeting identified educational needs, as measured by practice application and/or health status improvement. 3.1 EC... Organizational framework for the CME unit exists, all components of the Element (resources and support) are present including a process to review and continually improve the organizational framework. 2.5 EC... Innovative and creative mechanism(s) in place to measure the effectiveness of the program with evidence of improvements being made on a regular basis. Evolved to, 16. The provider operates in a manner that integrates CME into the process for improving professional practice. 17. The provider utilizes non-education strategies to enhance change as an adjunct to its activities/educational interventions (e.g., reminders, patient feedback). 18. The provider identifies factors outside the provider s control that impact on patient outcomes. 19. The provider implements educational strategies to remove, overcome or address barriers to physician change. 20. The provider builds bridges with other stakeholders through collaboration and cooperation. 21. The provider participates within an institutional or system framework for quality improvement. 22. The provider is positioned to influence the scope and content of activities/educational interventions. 37 38 e-mail us at acme@commpartners.com 19
Timeline for Implementation 39 Timeline for Implementation % Enterprise / Programs / Activities in Compliance 100 x x x x x 06 08 08 10 10 12 x x 0 x x Time 40 e-mail us at acme@commpartners.com 20
Questions & Answers Type your question into the chat box on the lower left hand side of your screen. Be sure to click the send button to submit your questions and comments. 41 Thank you. 42 e-mail us at acme@commpartners.com 21
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