rrc surgery what is new
DESCRIPTION
Surgical Education Week March 19-24, 2012 San D iego, California James C. Hebert, MD, FACS Chair , Surgery RRC. RRC Surgery What is New. Disclosures. None. James C. Hebert, MD, Chair John H. Armstrong, MD Paris Butler, MD, Resident Timothy R. Billiar, MD Ronald Dalman, MD - PowerPoint PPT PresentationTRANSCRIPT
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Surgical Education WeekMarch 19-24, 2012
San Diego, California
James C. Hebert, MD, FACSChair, Surgery RRC
RRC Surgery What is New
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Disclosures
• None
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RRC—Surgery Members• James C. Hebert, MD, Chair
• John H. Armstrong, MD
• Paris Butler, MD, Resident
• Timothy R. Billiar, MD
• Ronald Dalman, MD
• Peter J. Fabri, MD
• Linda M. Harris, MD
• G. Whit Holcomb, MD
• Peggy Simpson, EdD – Executive Director
• John J. Ricotta, MD
• Marshall Z. Schwartz, MD
• Steven Stain, MD
• Charles W. Van Way III, MD, Vice Chair
• Marc K. Wallack, MD
• Frank Lewis, MD, Ex-Officio ABS
• Patrice Blair, MPH, Ex-Officio ACS
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RRC Meeting Activity
• 253 programs were surveyed– 164 post-site visit reviews– 89 administrative requests at meetings
• 391administrative interim decisions
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Surgery PR Changes ( 7/1/12)
• New expectations for simulation learning• Removal of the distinction between
“designated preliminary” (DP) and “non-designated preliminary” positions– 300% limit on Preliminary Positions
• Clarification of transplant surgery experience• Flexibility for required chief year
– 4 to 6 month maximum.
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Program Requirements- Simulation
II.D.2. Resources must include simulation
and skills laboratories. These
facilities must address acquisition
and maintenance of skills with a
competency – based method of
evaluation
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RRC Review- Simulation
• Review Simulation G & O’s• Review Evaluation Methods and Tools• Encourage Best Practices (such as ASC-
AEI)• FAQs
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Preliminary Residents
• III.B.1. Residency positions must be allocated to one of two groups: categorical or preliminary positions.
• III.B.1.b) Preliminary (P) residents are accepted into the program for one or two years before continuing their education.
• III.B.1.b).(1) The number of preliminary positions in the PG1 and PG2 years combined must not exceed 300% of the number of approved categorical chief resident positions.
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Transplant Experience
• IV.A.5.a).(3).(d) A formal transplant experience is required. It must include patient management and cover knowledge of the principles of immunology, immunosuppression, and the management of general surgical conditions arising in transplant patients. Clearly documented goals and objectives must be presented for this experience;
• Formal rotation may be easiest
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Chief Year Clinical Rotations
• IV.A.5.a).(3).(f).(iv): Clinical assignments during the chief year must be in the essential content areas of general surgery. No more than six months of the chief year may be devoted exclusively to only one essential content area;
• Aligns with current ABS requirements; (requires ABS approval)
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Goals of The “Next Accreditation System”
• To begin the realization of the promise of Outcomes• To free good programs to innovate• To assist poor programs to improve• To reduce the burden of accreditation• To provide accountability for outcomes (in tandem with
ABMS) to the Public
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Challenges/Opportunities
• Culture Change and Faculty Development
• Program Directors, Designated Institutional Officials
• Faculty
• Review Committee Members
• “Retooling” of ACGME Infrastructure and Personnel
• The “Community of Educators” in each specialty must come together and agree on:
• core elements of the competencies
• levels of performance
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New Administrative Structure
• John R. Potts, III, MDSenior Vice President, Surgical Accreditation
• Louis J. Ling, MDSenior Vice President, Hospital-Based Accreditation
• Mary Lieh-Lai, MDSenior Vice President, Medical Accreditation
• Kevin B. Weiss, MD, MPHSenior Vice President, Institutional Accreditation
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Surgical Accreditation
• John R. Potts, III, MDSenior Vice President, Surgical Accreditation
• Peggy Simpson, EdDExecutive Director, RRCs for Plastic Surgery, Surgery, Thoracic Surgery
• Pamela L. Derstine, PhD, MHPEExecutive Director, RRCs for Colon and Rectal Surgery, Neurological Surgery, Orthopaedic Surgery, Otolaryngology
• Patricia Levenberg, PhDExecutive Director, RRCs for Obstetrics & Gynecology, Ophthalmology, Urology
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The “Next Accreditation System” in a Nutshell
• Continuous Accreditation Model – annually updated• Based on annual data submitted, other data requested, and
program trends
• Scheduled Site Visits replaced by 10 year Self Study Visit
• Standards revised every 10 years• Standards Organized by
• Structure• Resources• Core Processes• Detailed Processes• Outcomes
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The Conceptual ChangeFrom…
The Current Accreditation System
Rules
Corresponding Questions
“Correct or Incorrect” Answer
Citations and Accreditation Decision
Rules
Corresponding Questions
“Correct or Incorrect” Answer
Citation andAccreditation Decision
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The Conceptual ChangeTo…
“Continuous”
Observations
Assure that the Program Number of Potential Fixed the Problem Related “Rules” Problems
Promote
Innovation
Diagnose
the Problem
If there is one!
The “Next Accreditation System”
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Conceptual Model of Standards Implementation Across the Continuum of Programs in a Specialty
STANDARDS
StructureResources
Core ProcessDetailed Process
Outcomes
InitialAccreditation
New Programs
StructureResourcesCore ProcessDetailed ProcessOutcomes
Withhold AccreditationWithdrawal of Accreditation
2-4% 15% 75%
6-8%
Accreditation with Warning
New Programs,Accredited Programs with Major Concerns
Probationary Accreditation
StructureResourcesCore ProcessDetailed ProcessOutcomes
Maintenance ofAccreditation
Accredited Programs without Major Concerns
Maintenance of Accreditation with
Commendation
StructureCore ProcessResourcesDetailed ProcessOutcomes
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Next Accreditation System
• Seven specialties/RRC’s begin training 7/2012• Pediatrics• Internal Medicine• Diagnostic Radiology• Emergency Medicine• Orthopedic Surgery• Neurological Surgery• Urological Surgery
• Sponsor Visit Program begins 9/2012• The “Next Accreditation System” begins 7/2013• These seven specialties “go live” 7/2013• The remaining specialties begin training 7/2013• All specialties/RRC’s using the “Next Accreditation System” 7/2014• Visits to IRC and all 7 RRC’s this Spring
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Thank You
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