Transcript Dr Alan Smith DIO - University of Utah

2014-2015 House Staff Orientation
Alan J. Smith, PhD, MEd
Assistant Dean for GME
Director, GME Office
ACGME Designated Institutional Official (DIO)
Sign-in/out Times Today …
1. 7:30-8:00 AM: Registration & morning session
2. Mandatory Sleep Deprivation session (1:00-1:30)
No one may leave during this session.
3. 3:00 PM: At completion of the day: turn in
paperwork and pick up your ID badge.
Sign in/out sheets will be in the lobby/hallway outside this
room. The Sleep Deprivation sheet will be passed around
during the presentation.
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Can You Start?
If You Are NOT CLEARED To
Start Working . . .
 Breanna will call you out of
this meeting
 You cannot begin your
program until your
credentialing is complete
 Breanna must clear you for
hire
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University of Utah GME
• 72 ACGME accredited programs
• 26 Residency programs with 558 residents
• 47 Fellowship programs with 157 fellows
• 34 GMEC approved (non-accredited) fellowship
programs with 32 fellows
• 10 Dental Residents
• Total of 757 residents and fellows for 2014-2015
• 256 new residents and fellows for 2014-15
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GME Growth
Match Numbers
70.0%
60.0%
100.0%
60.0%
93.0%
80.0%
50.0%
70.0%
44.6%
40.0%
95.5%
90.0%
60.0%
55.4%
40.0%
96.2%
40.0%
US Medical
School
60.0%
Male
Female
30.0%
50.0%
Foreign
Medical
School
40.0%
30.0%
20.0%
20.0%
10.0%
10.0%
0.0%
3.0%
4.5%
7.0%
0.0%
2012
2013
2014
2012
2013
2014
GME Organization
Senior VP for Health Sciences,
Dean, School of Medicine
Vivian Lee, MD, PhD, MBA
Chief Medical Officer
Thomas L. Miller MD
Assistant Dean & Director,
GME & DIO
Alan J. Smith, PhD, MEd
Administrative Manager
Chris Springman
Credentials
Coordinator
Breanna Stoll, MBA
Project Coordinator
Melanie Powell
Staff Development Educator
Anne Vinsel, MFA
Information
Coordinator
Kyle Wheeler
Financial Manager
Sharee Bracken
Administrative
Coordinator
(E*Value)
Renn Butterfield
Accreditation
Coordinator
Ronnie Koon
GME Contact Information
Location
• School of Medicine Building, Level 1
Southeast Corner (1C412)
Webpage
• http://medicine.utah.edu/gme
Email
• [email protected]
Phone
• 801-581-2401
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A few of the services
provided by the GME Office
• Maintains your permanent training record
• Issues your annual contract
• Ensures that you receive your contracted
salary and benefits
• Processes your loan deferments and
forbearances
• Assists with your License Applications
• Issues your graduation certificate
• Provides Notary service
Resident Resources
• Resident representatives on Hospital,
School of Medicine, and Department
committees
• Resident members of the GME
Committee
• Resident Interdisciplinary Council
representatives
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Email
• You are expected to read your email
regularly
• To access email electronically from off
campus: www.umail.utah.edu
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Policies and Procedures
• House staff Policies and Procedures
Manual available on GME website
http://www.medicine.utah.edu/gme/
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ACGME Requirements
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Duty Hours
• The ACGME requires Sponsoring
Institutions to track duty hours across all
accredited programs
• You will be required to enter your duty
hours in the GME E*Value system.
(more about this later today)
Duty Hour Requirements
• Limited to 80 hours per week averaged
over a 4-week period, including all
approved moonlighting (PGY-1
residents may not moonlight).
• All trainees must have one day off in 7
over a 4-week period; at-home call may
not be assigned on your free day.
Duty Hour Requirements
• Maximum duty period length:
 PGY-1 must not exceed 16 hours in duration
 PGY-2 and above may be scheduled a
maximum of 24 hours of continuous duty plus
4 hours for transitions of care.
• Minimum time off between duty periods:
 PGY-1 should have 10 hours, must have 8.
 PGY-2 and above should have 10 hours,
must have 8, but may be shortened in
selected circumstances.
Levels of Supervision
•
Direct Supervision
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Supervising physician physically present with resident and
patient (PGY-1)
Indirect Supervision

Direct supervision immediately available – Supervising
physician physically within site of patient care, and
immediately available to provide direct supervision (PGY-1)

Direct supervision available – Supervising physician not
physically present within site of patient care but immediately
available via phone, and available to provide Direct
Supervision (Intermediate level)
Oversight

Supervising physician available to review
procedures/encounters with feedback provided after care is
delivered
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Professionalism, Personal
Responsibility and Patient Safety
•
Understand your personal responsibility to:
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Appear for duty appropriately rested and fit to provide
the services required of your patients
Actively participate in interdisciplinary clinical quality
improvement and patient safety programs
Assure the safety and welfare of patients entrusted to
your care
Manage your time before, during & after clinical
assignments
Recognize impairment, including illness and fatigue in
yourself and your peers
Honestly and accurately report duty hours, patient
outcomes, and clinical experience data (e.g., logs)
Comply with the Social Media Policy
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Professionalism
• Professional Conduct Policy (GME 8.4)
• Social Media Policy (GME 9.7)
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Transitions of Care
• Develop competence in communicating with
team members in the hand-over process
• Inform all members of the health care team
of current responsibilities for each patient’s
care
Alertness Management and Fatigue
Mitigation
• Learn to recognize signs of fatigue and sleep
deprivation
• Transfer care when unable to perform clinical
duties
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Teamwork
• Work as a member of effective
interprofessional teams that are appropriate
to the delivery of care in your specialty
ACGME Resident/Fellow
Survey
• Core specialty programs (regardless of size)
and subspecialty programs (with 4 or more
fellows) surveyed annually between January
and June
• Survey data used in decisions affecting your
program’s accreditation status
• ACGME sends link directly to resident
• Takes about 10-20 minutes to complete
Resident/Fellow Survey
Areas
•
Duty hours (areas in which rules violated)
•
Faculty supervision and teaching
•
Evaluations (access to & opportunity to
evaluate faculty and program; confidentiality)
•
Educational content (goals & objectives;
fatigue management; scholarly activities;
education/service balance)
Resident/Fellow Survey
Areas
•
Resources (access to reference materials;
use of EMR)
•
Patient safety (pts informed of resident &
faculty roles; culture reinforces pt safety;
participate in QI activities; process to address
concerns)
•
Teamwork (work in interprofessional teams)
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Overall evaluation of program
Survey Report to Program
ACGME Next
Accreditation System
(NAS)
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NAS
• In July 2013, the ACGME began a
phased implementation of the Next
Accreditation System (NAS)
• All ACGME institutional and program
accreditation will fall under NAS by July
2015
What is the NAS?
• Accreditation system based on
continuous oversight rather than
episodic sampling
• Program site visits at ~ 10 year intervals
• Emphasis on program effectiveness as
evidenced by resident advancement
through the Milestones
What is the NAS?
• Program status updated annually based on
key performance indicators:
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Board certification exam results(rolling pass
rates)
Program attrition (residents, faculty, PD, chair)
Resident survey results (annual)
Faculty survey results (annual)
Resident performance on Milestones
Case logs (annual)
Scholarly activity (resident and faculty)
Milestones
• Specific benchmarks of skills, knowledge,
and behaviors that each resident is expected
to achieve at identified stages of residency
training.
• Milestones are associated with each of the
six ACGME general competency areas:
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Medical Knowledge
Patient Care
Professionalism
Communication and Interpersonal Skills
Systems-based Practice
Practice-based Learning and Improvement
Milestones
• Designed to allow tracking of discrete and
measurable educational outcomes
• Progress of each resident to be assessed by
program’s Clinical Competency Committee
(CCC)
• CCC members = Key Faculty + Program
Director
Neurological
Surgery
Milestones
Milestones Example (Neurosurgery)
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Level 1 Milestone?
“Whoa! Watch where that thing lands –
We’ll probably need it.”
Questions?
Thank You and Welcome!