Transcript CITATION DATA BASE - Council of Emergency Medicine

Residency Review Committee for
Emergency Medicine
Report to CORD
Art Sanders, MD, Chairman
October 2004
RRC for Emergency Medicine
AMERICAN BOARD OF EMERGENCY MEDICINE
Dane Chapman, M.D.
Daniel Danzl, M.D., Vice-Chair
Rebecca Smith-Coggins, M.D.
MaryAnn Reinhart, Ph.D, Ex-officio
COUNCIL ON MEDICAL EDUCATION (AMA)
Louis S. Binder, M.D.
Charles K. Brown, M.D.
Arthur Sanders, M.D. , Chairman
AMERICAN COLLEGE OF EMERGENCY PHYSICIANS
Francis Counselman, M.D.
Sandra Schneider, M.D.
David Overton, M.D.
Marjorie Geist, Ph.D., Ex-officio
EMERGENCY MEDICINE RESIDENTS ASSOCIATION
Kelly Corrigan, M.D.
Review of Applications (9/2004)
Committee Action
September 2004
2nd Review of Program Application
Confirmed Withhold
01
1st Review of Program Applications
Proposed Withhold
Provisional Accreditation
02
02
• UMNDJ-New Jersey Medical School (Newark)
• University of Utah (Salt Lake City)
Status Decisions Accreditation Cycle
2 Provisional - 3 year cycles
2 Full Accreditation - 3 year cycle
6 Full Accreditation - 4 years/7 years pilot
6 Full Accreditation - 5 years/8 years pilot
RRC-EM Pilot Project
Extend max accreditation cycle from 5 to 8 yrs
Require yearly QI indicators of the program
Update of citations
Changes in program
Procedures, resuscitations of graduating
residents
ED volume, faculty supervision
Resident survey yearly
RESIDENT SURVEY
•3 year plan to survey 1/3 of residents each year for 3 years
•Year 1 had 85% compliance rate and over 25,000 respondents
•Survey programs with 5 residents or more
•Survey January through April
•Internet based – Average 9 minutes to complete
RESIDENT SURVEY
•Used by site visitors as additional data element to augment
resident interview and as early warning of non-compliance
indicator
•32 Questions pertaining to Duty Hours, Competencies,
Evaluation, and Supervision
•Ability for residents to enter comments and/or connect to
confidential resident complaint system
RESIDENT SURVEY
PDs and DIOs have access to aggregate reports if
compliance is 70% or higher
Plan to have every resident complete survey annually (5 or
more in program)
Plan to add Specialty specific questions to aid in program
review
RRC-EM Pilot Project
It is inappropriate to claim that
programs in the pilot with longer
accreditation cycles are better than
other programs.
New Program Requirements
Approved in June 2004
Effective January 2005
Competencies - Guidelines on Competencies
Yearly competency assessment, 3 procedures, 3
chief complaints, 1 resuscitation, 50% off service
Duty Hours
New PIF
Program Requirements Revision
Subspecialties
Toxicology
Pediatric Emergency Medicine
New PIF
Questions on Clinical Operations
ED volume and supervision ratio
Time to CT scan, blood, etc.
Throughput time for admitted and
discharged pts.
Ambulance diversion time
On call consultants
New PR - Clinical Operations
The hospital must assure that all clinical specialty
and subspecialty services are available in a timely
manner…If any clinical services are not available for
consultation or admission, the hospital must have a
written protocol for provision of these services
elsewhere. This may include written agreements for
the transfer of these patients to a designated
hospital that provides the needed clinical services.
(PR II.E.2)
Guideline - EM Faculty Qualifications
All EM faculty supervising EM residents on EM
rotations must be board certified by ABEM or have
appropriate qualifications in EM. Examples of
educational qualifications acceptable to the RRC:
Certification by the AOBEM
Certification by a subspecialty board of ABEM
Recent residency or fellowship graduates working
toward certification by the above Boards
Qualifications must be relative to the pt population
supervised
RRC-EM Outcomes Project
RWJ Grant to ACGME - Competency Project
To identify patient care quality measures that are
appropriate to use to assess the outcomes of
GME in EM
To link patient care quality measures in EM to the
quality and effectiveness of GME
Can accreditation decisions be outcome rather than
process based?
RRC Report to CORD
Questions???