Clinical Competency Committees
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Transcript Clinical Competency Committees
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Clinical Competency
Committees
What Faculty need to know
Academic Affairs Committee
ACEP,JMTF, CORD
WHAT…are Clinical Competency
Committees (CCC’S)?
A group of faculty members tasked with
Assessing resident performance and progress based on multisource data
Determining individual resident’s level on Milestones
Making formal recommendations to the PD regarding
remediation, promotion and graduation
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WHAT...are the (EM) Milestones?
23 (core) SKILLS, KNOWLEDGE AREAS, ATTITUDES
Specific to the 6 CORE COMPETENCIES FOR EM
(PC, MK, PROF, ICS, PBLI, SBP)
Organized in developmental framework of levels 1-5
1—entry level
2-3 mid level resident advancing appropriately
4 target for graduation
5 expert level
Descriptors of levels
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EM MILESTONES
1. (pc-1) Resuscitation
8. (pc-8) Multi-tasking
2. (pc-2) H&P
9. (pc-9) Procedures
3. (pc-3) Labs/Studies
10. (pc-10) Airway
4. (pc-4) DDx
11. (pc-11) Pain
management/sedation
5. (pc-5) Pharmacotherapy
6. (pc-6) Reassessment, F/U
7. (pc-7) Disposition
12. (pc-12) ED Ultrasound
13. (pc-13) Wound manage
14. (pc-14) Vascular Access
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EM Milestones continued…
15. (mk-1) Medical knowledge
16. (prof-1) Compassion,
Integrity, Respect, Ethics
17. (prof-2) Accountability to
society, patients, profession
and self.
18. (ics-1) Patient centered
communication
19. (ics-10) Team Managment
20. (pbli-1) Follow up, CQI,
EBM
21. (sbp-1) Patient safety—
SBAR, handoffs, checklists…
22. (sbp-2) Efficiency, flow
23. (sbp-3) Technology (EMR),
data and information access
WHY… is my program initiating
CCC’s?
ACGME mandate: ALL programs must have CCC’s up and
running by July 2013 as part of the Next Accreditation
System (NAS).
All programs begin reporting aggregate data on
residents’ milestone achievement by December 2013.
In NAS, CCC’s are integral in the process of interpreting
data and assigning milestone levels.
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WHAT FOR?
What purpose does the ACGME hope to accomplish by
requiring programs to establish CCC’s?
Increase the validity and accuracy of program assessment of
resident competence throughout training and at graduation.
Provide the benefit of “the insight and perspective of a group”
to the resident evaluation process.
Assure that programs detect resident deficiencies EARLY and
provide meaningful recommendations for remediation.
Ultimately assure the competence of graduates to practice
independently.
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WHO…comprises the CCC?
The ACGME allows programs flexibility.
Some parameters:
5-7 members
MUST include clinically active core faculty “dedicated to
resident education.”
MAY include non MD medical educators
Suggestions:
PD,APD, core faculty
Faculty who primarily supervise in clinical setting
Site directors
Involved nursing staff
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HOW will the CCC’s function?
Meet quarterly, biannually, or more frequently as
necessary to allow semi-annual evaluation of each
resident
Review multi-source data (previously compiled) for each
resident.
Come to consensus on resident’s achievement of
milestone level (possible milestone level 1-5).
Generate report with competency determination for
each resident with recommendation for advancement,
graduation or remediation.
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HOW…will CCC’s function?
CCC Chair (Ideally NOT PD) directs process
Members must maintain confidentiality of proceedings
Deliberations, decisions and reports may be protected
(not discoverable) under peer-review confidentiality
depending on state laws.
Ongoing evaluation of CCC process to allow
recommendations for continued improvement of process
regarding activities of CCC
WHAT…are examples of data CCC
may use in resident assessment?
In-Service Scores
Direct observation data
Rotation/shift evaluations
Self evaluations/reflection
Patient satisfaction data
Adverse information
(complaints, misconduct)
Procedure logs
360 evaluations
Scholarly work
Oral board performance
Administrative compliance
Structured chart review
Core measures
Provider Reports
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How will CCC’s compile data?
Programs are free to develop Assessment Tools for
compiled data or use one already made.
Consistency of approach will increase accuracy even for
un-validated assessment tools.
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WHAT…is the role of the PD?
Receives report/consensus determinations with
recommendations of CCC.
Includes report in resident record.
Carries responsibility of ultimate decision making with
regard to advancement, remediation, graduation.
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DATA Sources
FAQs ACGME Website:
www.acgme-nas.org/assets/pdf/NASFAQs.pdf
www.acgmenas.org/assets/pdf/Milestones/EmergencyMedicineMiles
tones.pdf