smcs cme program cme accreditation standards smcs cme approval process bary siegel, m.d. education...
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SMCS CME Program
CME Accreditation StandardsSMCS CME Approval Process
Bary Siegel, M.D. Education Team Chair June 23, 2011
Postgraduate Medical Education
Postgraduate Medical Education
HistoryDefinition of CMEThe criteria needed for an activity to qualify for CME
1904 AMA formed the Council on Medical Education
1910 Carnegie Foundation Bulletin Number 4
1940-50s Council on Medical Education increased it’s focus on postgraduate medical education (PGME)
1955 One third of physicians reported no formal PGME in the last 5 years
1960s AMA House of Delegates established the Advisory Committee on Continuing Medical Education
1981 Accreditation Council for Continuing Medical Education (ACCME)
History of Postgraduate Medical Education
Accreditation Council for Continuing Medical Education(ACCME)
• AMA• American Board of Medical Specialties• American Hospital Association• Association for Hospital Medical Education• Association of American Medical Colleges• Council of Medical Specialty Societies• Federation of State Medical Boards
AMA PRA CATEGORY 1 CREDIT™
Or EquivalentAmerican Osteopath Association
American Academy of Family PracticeAmerican College of Obstetricians and Gynecologists
January 1996, the California Medical Association launched a new not-for-profit subsidiary, the Institute for Medical Quality (IMQ) to help improve the quality
of care delivered to patients in California
The IMQ Accredits Our Program
In order for us to award CME we must meet all of the IMQ’s criteria which also meet all of the
criteria of the ACCME for awarding AMA PRA CATEGORY 1 CREDIT™
What is Postgraduate Medical Education?
If We Create a High Quality Educational Program
• Do Physicians learn anything?• Does patient care improve?
What is CME?
The California Legislature defines Category 1 continuing medical education as follows: Continuing medical education activities that serve to maintain, develop or increase the knowledge, skills, and professional performance that a physician or surgeon uses to provide care, or improve the quality of care provided for patients, including, but not limited to, educational activities that meet any of the following criteria: – 1. Have a scientific or clinical content with a direct bearing on
the quality or cost-effective provision of patient care, community or public health, or preventive medicine
– 2. Concern quality assurance or improvement, risk management, health facility standards, or the legal aspects of clinical medicine
– 3. Concern bioethics, professional ethics – 4. Designed to improve the physician/patient relationship 2011 IMQ/CMA CME Accreditation Standards Manual
The definition expressly excludes:
Educational activities that are not directed toward the practice of medicine, or are directed toward the business aspects of medical practice, including, but not limited to, medical office management, billing and coding, and marketing.
2011 IMQ/CMA CME Accreditation Standards Manual
What do we really want to accomplish?
Improve the Quality of CareThus
Improve Patient Outcomes
Where Do We Start?
NEEDS ASSESSMENT
If there is no need for improvement there is no
need for CME
• Needs Assessment• Then call us
The Gap
The Gap
The difference between where we are today and
where we want to be
Interventions to close the gap should address the basic physician core competencies
Medical Knowledge
This is the ability to use medical knowledge for clinical problem solving and medical decision making.
Competency
The provision of timely, effective, appropriate, and compassionate
patient care.
Practice-Based Learning and Improvement
Understands patient care practices and assimilates necessary components for improvement. This entails the use of evidence based treatment to treat a patient’s health problems. This also encompasses the ability to critically interpret medical literature and use this to improve patient care.
Systems-Based Practice
This is the ability to understand, access, and effectively utilize the resources of a health care system in order to provide optimal patient care.
Interpersonal and Communication Skills
The ability to effectively discuss and exchange information with patients, their families, medical colleagues, and the health care professionals and other staff members.
Professionalism
Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to diverse patient populations.
Closing the Gap
Expected OutcomesAnd
How Will You Measure Them?
Expected OutcomesAnd
How Will You Measure Them?
If you don’t know where you are going how are you going to know if you get
there?
Measuring Outcomes
Knowledge
• Pre Test/Post Test
Competency
Intent to ChangeApplication of skills (ACLS, simulations, etc)
Post course survey
Performance• Self Report• Utilization and Review• Objective Change in Practice• Expert Opinion (not the strongest but useful)
Patient Outcomes• Chart Review• Quality Indicators• Survival• Decreased Complication rate
Bridging the Gap
Cultural and Linguistic Competency
CALIFORNIA AB 1195 California requires continuing medical education
activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect July 1, 2006, to encourage physicians and surgeons, CME providers in the State of California, and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development.
Cultural and Linguistic Competency
• Linguistic Accommodations• Cultural and Ethnicity data re diagnosis,
incidence, treatment, clinical care• Religion, faith, spirituality• Nationality, Race, Ethnicity• Age groups• Sex, Gender, Sexual Orientation• etc
Why Cultural and Linguistic Competency?
We want to improve patient outcomes
Sepsis
Needs Assessment
• Our current mortality rate for patients presenting to the ER in sepsis is X%
• We are in the top 10% Nationally• We want to be in the top 5%
GAP
We are in the top 10% and we want to be in the top 5%
Intervention
• Analyze the problem and decide how you can effect change• How can you improve performance and outcomes by
addressing physician core competencies?• Education
– Conference and lectures– Mailings to the House Staff on the early recognition and treatment
of sepsis– PostersLarger ER
Analysis
• Mortality prior to intervention and after intervention
• Are you where you want to be or is there still room for improvement?
How to Improve Patient Care
NeedsAssessment
Outcome Program
Gap
Regularly Scheduled Series
Regularly Scheduled Series
• Needs assessment• Gap• Intervention• Cultural and Linguistic Competency• Evaluation
How to Improve Patient Care
NeedsAssessment
Outcome Program
Gap
References
• http://www.amaassn.org/resources/doc/cme/pra-booklet.pdf
• http://www.imq.org/wpcontent/uploads/2011/05/April-2011-CME-Standards.pdf
