Setting the Stage - Accreditation Council for Continuing ... · Setting the Stage An Overview of...

Newcomers’ Introduction to Accredited CMEPre-conference to CME as a Bridge to Quality™ Accreditation Workshop

April 13, 2016

Copyright 2016© – Accreditation Council for Continuing Medical Education – www.accme.orgFor non-commercial educational use only.

Setting the Stage

An Overview of CME

AMA

AHAABMS

ACCME

FSMB

AAMC

AHME

ARC

Decision

AAFP

AMA PRA Category 1 Credit™

Criteria

SCS

Provider

Conflict of Interest

Commercial Interest

Relevant Financial Relationship

Compliance

Sponsor CRR

MOC

Noncompliance

Prescribed

Recognition

Accreditation

CME CMSS

MOL Learner

Activity

Program

Engagement

Credit

System

QI

Collaboration

ACOG

CredentialingElective

Membership

OPPE/FPPE

AMA

AHAABMS

ACCME

FSMB

AAMC

AHME

ARC

Decision

AAFP


Criteria

SCS

Provider

Conflict of Interest

Commercial Interest

Relevant Financial Relationship

Compliance

Sponsor CRR

MOC

Noncompliance

Prescribed

Recognition

Accreditation

CME CMSS

MOL Learner

Activity

Program

Engagement

Credit

System

QI

Collaboration

ACOG

CredentialingElective

Membership

OPPE/FPPE This first session is about Setting the “CME Stage.”

We will discuss:

1. What continuing medical education (CME) is;

2. Why & When physicians need CME


April 13, 2016


Maintenance of Licensure

Maintenance of Certification

Continuing Medical Education• Provider Accreditation by ACCME; • Activity Accreditation by AAFP;

• Credit Systems by membership organizations (e.g. AMA, AAFP)

Achieving Licensure

Achieving Certification

Under‐GraduateMedicalEducation(LCME)

GraduateMedicalEducation(ACGME)

MedicalStudent

Resident Licensed Specialist Credentialed Practicing

Where and When is CME?

A Lifetime of Physician Professional Development

What is CME?

Definition:– educational activities

– maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services

– body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public.

What is CME?

Plan Do

StudyAct

We’re aware of a problem.We have come up with a

possible solution…

We’ve put our plan into action…

Did our plan work in addressing the problem?

We’re applying what we’ve learned, and we’re

starting again…

Based upon the work of Deming and Shewhart


April 13, 2016


What does CME look like?

From ACCME 2014 Annual Report, page 4

When… and How?

• Live (Synchronous) Activities:– In person courses– Small group discussions– Simulation & training– Committee work– Webcast & videoconference

• Non-live (Asynchronous) Activities: “Enduring…”– ‘On-demand’ Internet activities– Journal activities– Recorded video & audio– Case studies & narrative

What do you want to change?

Individual

Group

Live Enduring

Point of Care Performance Improvement

RSS, Annual Meetings

CommitteeLearning,

Journal Club

Internet Activities

JournalActivities


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Who is involved in planning?

1. The Accredited Provider

2. Accredited Provider + Nonaccredited Organization = Joint Providership the accredited provider is responsible for

compliance!

3. More than one Accredited Provider one provider must take responsibility for

compliance

Why do physiciansneed CME?

Maintenance of Licensure

Maintenance of Certification

Accredited CME

Achieving Licensure

Achieving Certification

Under‐GraduateMedicalEducation(LCME)

GraduateMedicalEducation(ACGME)

MedicalStudent

Resident Licensed Specialist Credentialed Practicing

Where and When is CME?

A Lifetime of Physician Professional Development


April 13, 2016


Next Up…

About the ACCME and Accreditation

• What does the ACCME do?• What is the value of ACCME

accreditation?

What does it mean to be Accredited

within the national CME system?

Why Accreditation?

Legislative Actions

1980’s ResponseStandards for CME

New innovations and knowledge Need for continuous learning

Quality Assurance


April 13, 2016


ACCME Mission“...the identification, development, and

promotion of standards for quality CME utilized by physicians in their maintenance of competence and incorporation of new knowledge to improve quality medical care for patients and their communities”

ACCME’s Primary Functions Serve as the body accrediting

institutions… offering CME in the US and internationally;

~700 national providers

ACCME Bylaws


April 13, 2016


NEVADA


institutions… offering CME in US and internationally;

Serve as the body recognizinginstitutions… offering CME accreditation;

41 Recognized State Accreditors

(State Medical Societies)

~1,200 local/regional providers

ACCME Bylaws




Develop criteria …for assuring compliance with these standards;

ACCME Bylaws





Develop… methods for measuring the effectiveness of CME and its accreditation, particularly in its relationship to supporting quality patient care and the continuum of medical education;

ACCME Bylaws


April 13, 2016






Develop… methods for measuring the effectiveness of CME and its accreditation, particularly in its relationship to supporting quality patient care and the continuum of medical education;

ACCME Bylaws

CME is effective

ACCME’s PrimaryFunctions

Recommend and initiate studies for improving the organization and processes of CME and its accreditation;

Review and assess developments in CME’s support of quality health; and

Review periodically its role in CME to ensure it remains responsive to public and professional needs.

ACCME Bylaws

Key Values“For the profession, by the profession”

As part of the system of medicine’s accountability, is it essential that CME be:

– Linked to quality and safety

– Effective in improving practice

– Independent of commercial interests

– Based on valid content

…our mission and work is a public trust.


April 13, 2016


How big is ourshared system?

Scope of the Enterprise

2014 Reporting Year

Physician Interactions

13,599,687

Other Learner Interactions

11,587,518

Activities 147,024

Hours of Instruction 1,033,615

Providers

SMS-Accredited 1,225

ACCME-Accredited 683

ACCME

Accreditation Review Committee 21 Members

700 providers with planning committees

700 X 8 = 5,600

1,225 providers withplanning committees

1,200 x 8 = 9,600

Volunteer-Supported

Accreditation Surveyors>100

State Accreditors (41)

Accreditation Review Committee

41 x 5 = 205 Members

Accreditation Surveyors41 x 10 = 410


April 13, 2016


Types of Activities in 2014Courses 71,047

Regularly scheduled series 23,427

Internet (live) 4,063

Test-item writing 87

Committee learning 575

Performance improvement 470

Internet searching and learning 82

Internet (enduring materials) 34,006

Enduring materials (other) 8,452

Learning from teaching 149

Journal CME 4,596

Manuscript review 70

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Competence Performance Patient Outcomes

Designed to Change

Analyzed for Change

CME Presented by Providers(ACCME System, 2014)

What’s on your mind, ACCME?


April 13, 2016



April 13, 2016


An Introduction to the ACCME’s

Accreditation Criteria

In our context, as educators…

Current PracticeCare

CompetencePerformance

Patient Outcomes

Optimal PracticeCare

CompetencePerformance

Patient Outcomes

ACCME to Provider...Provider to Learner...

Plan Do

StudyAct

We’re aware of a problem.We have come up with a

possible solution…

We’ve put our plan into action…

Did our plan work in addressing the problem?

We’re applying what we’ve learned, and we’re

starting again…

Based upon the work of Deming and Shewhart

How Do We Improve?


April 13, 2016


Criteria at a Glance

C1 Mission

C2-C6 Educational Planning

C7-C10 Ensuring Independence

C11-C13 Organizational Reflection & Improvement

C16-C22 Engagement with the Environment

Criterion 1: Mission

The provider has a CME mission statement that includes expected results articulated in terms of changes in competence, performance, or patient outcomes that will be the result of the program.

Mapping your impact• What do you want to achieve with CME?• How will you know if you are successful?

Using the Criteria as an algorithm for change…

Criteria 2-6:Educational Planning

How do you plan educational activities that address practice-based problems by facilitating change/improvement?


April 13, 2016


A Simple Approach

What is the practice-based problemwe want to address?

(and how are my learners involved?)

Why does the problem exist?

What do we want to change?

Were we effective in producing change?

Is the problem solved? If not, start again.

What is the practice-based problem we want to address?

(and how are my learners involved?)

Criterion 2: The provider incorporates into CME activities the educational needs (knowledge,

competence, or performance) that underlie the professional practice gaps of their own learners.

Where can we find problems to address?

• Newspapers and local media• Research literature• National benchmarks/guidelines• Local/regional/national healthcare data• Institutional/organizational data• Clinical data/measures• Surveys/opinion of health professionals• Patients

Criterion 2


April 13, 2016


Why does the problem exist?

Criterion 2: The provider incorporates into CME activities the educational needs (knowledge, competence, or performance) that underlie the professional practice gaps of their own

learners.

• delivery of care• diagnosis

• decision making• teaching• research

• administration• leadership

• communication• other?...

“Professional Practice”

Why does this problem exist?

Don’t know…

Don’t know how…

Don’t do…

Should stop doing…

Criterion 2


Criterion 3: The provider generates activities/educational interventions that are designed to change competence, performance, or patient

outcomes as described in its mission statement.


April 13, 2016



Knowledge (K)

Competence (C)

Performance (P)

Patient Outcomes(PO)

I don’t know I know.

I don’t know how I can. (I have a strategy to…)

I don’t do I do. (How often??)I am doing I’ll stop doing.

Current health/care… Better health/care

and/or

and/or

AC

CM

E E

xpec

ts

Format appropriate to what I want to change (C5)

Does your educational approach match the setting, objectives (goals), and desired results you have for the activity?

“Can you get there from here?”

Planned in the context of competencies (C6)

in support of… Certification and Licensure

Requirements Institutional Accreditation

Requirements Value-proposition to your

Organization

What approaches will help us to be most effective?

Criteria 7-10:Ensuring Independence

How do you ensure that your educational activities and your CME program are not influenced by commercial interests?

What is the practice-based problem we want to address?

Why does the problem exist?What do we want to change?Were we effective in producing

change?

How do we keep commercial bias out of education?

ACCME Standards for Commercial SupportSM:Standards to Ensure Independence in CME Activities


April 13, 2016


Were we effective in producing change?

Criterion 11: The provider analyzes changes in learners (competence, performance, or patient outcomes) achieved as a result of the overall

program’s activities/educational interventions.

Criteria 11-13:Organizational Self-Assessment & Improvement

Do your CME activities produce change in your learners and/or have an impact on patient care?

Are you meeting your mission?

What can you do to improve your CME program to better meet your mission?

Criteria 16-22:Engagement(For Commendation)

How do you facilitate improvement to maximize the impact of your program to improve practice and patient care? How do you

• ensure that your CME • program is the reason • for the success of others?


April 13, 2016


How could we be more effectivein producing change?

• ‘utilize patient-education materials’• ‘work with community-based organization to

improve cultural competency’• ‘quality improvement has data we can use’

• ‘engage the C-suite’

Accreditation withCommendation

Accreditation withCommendation

Criteria at a Glance

C1 Mission

C2-C6 Educational Planning

C7-C10 Ensuring Independence

C11-C13 Organizational Reflection & Improvement

C16-C22 Engagement with the EnvironmentACCME Criteria as an ALGORITHM

for change…

What questions about CME do you still have and would like for us to try to address during the second part of the Newcomers' Session?


April 13, 2016


The Value & Use of CME

“Accredited” vs “Credit”

Processes for Planning & Implementing CME in compliance with the

“ACCME Criteria”

“Credit”

Accredited Activity- can be designated

for AMA PRA Category 1 Credit™

ACCREDITED PROVIDER

“Accredited”

Learn more at Topic Breakout Sessionson Thursday and Friday!

Certified for “Credit”


State Licensure Requirements

• American Academy of Family Physicians – Prescribed Credit

• American College of OB/GYNs – Cognate Credits

• American Academy of Dermatology – AAD CME Award

Membership & Certification Requirements


April 13, 2016


Panelists

Mary KellyProgram Administrator, AMA PRA Standards & PolicyAmerican Medical Association (AMA)

Danielle GriggsCredit System SpecialistAmerican Academy of Family Physicians

Susie FlynnDirector, Academic ServicesAmerican Board of Medical Specialties

Kelly Alfred, MSSenior Director, Education ServicesFederation of State Medical Boards

Setting Expectations for

the Workshop

Workshop Agenda

Thursday, April 14

– The Strategic Value of Accredited CME as a “Bridge to QualityTM”

– Accreditation for Learning and Change (Planning a CME Activity)

– Ensuring Independence in CME Activities

C2-6, 11 and C7-10Criteria related to

activities


April 13, 2016


Workshop Agenda

Friday, April 15

– Program Evaluation & Improvement

– Achieving Accreditation with Commendation

C1, 11-13 and C16-22Criteria related to overall program

www.accme.org

Answers to an accreditation-related question

The latest news from the ACCME

Subscribe to ACCME’s monthly Newsletter


April 13, 2016


Information about CME Credit

American Medical Assoc. www.ama-assn.org/go/pra

American Academy of Family Physicians

www.aafp.org

Licensure Requirements by State

Federation of State Medical Boards www.fsmb.org

About Board Certification

American Board of Medical Specialties - www.abms.org


April 13, 2016


When you are looking for…

Anything accreditation related that you just can’t find anywhere else

[email protected](312) 527-9200

Setting the Stage - Accreditation Council for Continuing ... · Setting the Stage An Overview of...

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