Transcript AMA PRA CATEGORY 1 CREDIT™

SMCS CME Program
CME Accreditation Standards
SMCS CME Approval Process
Bary Siegel, M.D.
Education Team Chair
June 23, 2011
Postgraduate Medical Education
Postgraduate Medical Education
History
Definition of CME
The criteria needed for an activity to
qualify for CME
History of Postgraduate Medical Education
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)
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 Equivalent
American Osteopath Association
American Academy of Family Practice
American 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 Care
Thus
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 Outcomes
And
How Will You Measure Them?
Expected Outcomes
And
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 Change
Application 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
– Posters
Larger 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
Gap
Needs
Assessment
Program
Outcome
Regularly Scheduled Series
Regularly Scheduled Series
•
•
•
•
•
Needs assessment
Gap
Intervention
Cultural and Linguistic Competency
Evaluation
How to Improve Patient Care
Gap
Needs
Assessment
Program
Outcome
References
• http://www.amaassn.org/resources/doc/cme/
pra-booklet.pdf
• http://www.imq.org/wpcontent/uploads/201
1/05/April-2011-CME-Standards.pdf