THE CHANGING CLIMATE OF

CME

Sara Lovell, CPCS

Education Coordinator

Providence Alaska Medical Center

I HAVE NOTHING TO DISCLOSE

OBJECTIVES Understand the history of CME and why

it had to change Discuss the 22 accreditation criteria to

ensure quality and value in a CME program

What you can do to strengthen your CME program

Using CME to continuously improve quality and patient care for your facility

A WHOLE NEW WORLD…

WHAT IS CME?Continuing Medical Education

Medical School Residency Fellowship CME

WHERE DOES CME COME FROM?

www.accme.org

WHO IS ACCME?

REACHING PHYSICIANS AND HEALTH CARE TEAMS ACROSS THE COUNTRY

700 ACCME –accredited organizationsMedical schools, nonprofit physician membership organizations (i.e. medical specialty and state medical societies, hospitals/ healthcare delivery systems, publishers and education companies, government and military organizations, and insurance and managed-care companies.

43 State and Territory Medical Societies as Accreditorsfor more than 1,300 local organizations, such as community hospitals, state specialty societies, and county medical societies, offering CME

REACHING PHYSICIANS AND HEALTH CARE TEAMS ACROSS THE COUNTRY

In total, there are more than 2,000 accredited CME providers, including organizations accredited by the ACCME and by ACCME recognized accreditors

Each year accredited providers offer more than 125,000 activities across the country.

Accredited education activities draw more than 23 million health care professionals annually.

Activities include• Live meetings and courses• Medical Journals• The Internet

WHERE DOES THAT LEAVE US?

WHAT IT

WAS…

Back in the day…

… Voila! Free CME

CME DRIVEN BY INDUSTRY…

Call from a drug rep “Mr. Pushy”

“The speaker would love to bring his knowledge to Alaska!”

“Our company will pay for everything!!!”

“It’s a win win”

CME DRIVEN BY INDUSTRY…

CME DRIVEN BY CONVENIENCE…

OR…

Administration

“My friend the expert”

Fishing trip to write off

CME to our physicians

Sound good???

CME ACCOUNTABILITY?

Where we are now…

ACCME 21ST CENTURY MILESTONES

2002 - Clinical Content Validation Policy Ensuring that patient care recommendations are based

on scientific evidence. Policy issued regarding clinical content validation in CME activities.

All recommendations involving clinical medicine in CME activities must be based on evidence that is accepted within the profession of medicine.

All scientific research used to support patient care recommendations must conform to generally accepted standards of experimental design, data connection and analysis.

Providers are ineligible for ACCME accreditation or reaccreditation if their activities promote treatments that are known to have risks or dangers that outweigh the benefits or are known to be ineffective in patient treatment.

ACCME 21ST CENTURY MILESTONES

2004: Standards for Commercial Support: Standard to Ensure Independence in CME Activities The ACCME safeguards CME’s independence

and freedom from commercial bias:  Building on guidelines first issued in 1992, the 2004 Standards for Commercial Support: Standards to Ensure Independence in CME Activities impose stringent restrictions on CME providers’ interactions with drug /device companies and other companies the ACCME defines as commercial interests. The ACCME allows providers to accept company funding for CME activities, but prohibits any commercial influence, direct or indirect, over CME content.

I HAVE NOTHING TO DISCLOSE

ACCME 21ST CENTURY MILESTONES

2006 ACCME Accreditation Criteria Criteria call on accredited providers to offer

educational activities that address physicians’ real-world practice needs, whether their scope of practice is in clinical care, research, health care administration, or other areas of medicine.

Accredited CME is now strongly positioned to support US health care quality improvement efforts and to align with emerging continuing professional development systems

ACCME 21ST CENTURY MILESTONES

2006 ACCME Accreditation Criteria CME activities go beyond giving physicians new

information—they help doctors translate knowledge into action that improves their performance and patient outcomes.

CME providers evaluate the changes in physician competence, performance, or patient outcomes that result from their educational programs.

The Accreditation Criteria foster leadership, collaboration and system-wide change by rewarding CME providers with Accreditation with Commendation if (among other requirements) they participate in quality improvement initiatives within their institution or health care system.

PURPOSE AND MISSION Criterion 1 – Mission Statement

CME purposeContent areas Target audienceType of activitiesExpected results

Changes in competence Changes in performance Changes in patient outcomes

NEW VOCABULARY… Competence

Knowledge into action Performance

Will this change their practice? Patient Outcomes

Partnering with quality to track and trend patient outcomes.

What are the results? Did it work?What is next?

EDUCATION AND PLANNING

Criterion 2: Identifying Educational Needs Identifying PRACTICE GAPS of learners

Criterion 3: Designed to changeCompetence PerformancePatient Outcomes

NEW VOCABULARY… Practice Gaps

WHAT IS A PRACTICE GAP? Where you are

currently… Where you

would like to be…

Being pro-active and identifying these practice gaps and creating meaningful ideas and solutions to close the gap

Is anyone asking for practice

gaps? What has been your experience

with this?

EDUCATION AND PLANNING

Criterion 4: Matching content to learners current and potential scope of professional activities

Criterion 5: Educational format appropriate for the followingSetting, objectives, and desired results

Criterion 6: Context of desirable physician attributes Institute of Medicine (IOM) competenciesACGME competencies

EDUCATION AND PLANNING

Criterion 7: Independent of commercial interests Criterion 8: Appropriately managing commercial

support If applicable Standards of Commercial Support

Criterion 9: Maintains a separation of promotion from education Vendors remain outside of the education room

Criterion 10: Actively promotes improvement in health care and NOT proprietary interests of commercial support

EVALUATION AND IMPROVEMENT Criterion 11: Analyzes changes in learners

as a result of the overall program’s activities/educational interventions Competence, performance, or patient

outcomes Criterion 12: Analysis of program on the

degree to which the CME mission has been met Ongoing review of the Mission Statement

EVALUATION AND IMPROVEMENT Criterion 13: Identifies, Plans and

implements the needed or desired changes in the overall program Planners/ Teachers InfrastructureMethods ResourcesFacilities Interventions, etc.

EVALUATION AND IMPROVEMENT Criterion 14: Identified program

changes/ improvements that are needed to improve in order to meet the mission are underway or completed.

Criterion 15: Demonstrate that the impacts of the program improvements, that are required to improve on the provider’s ability to meet the CME mission, are measured.

Does anyone have a CME committee?

ACCREDITATION WITH COMMENDATION

Criterion 16: Integrates CME into the process for improving professional practice.

Criterion 17: Utilizes non-education strategies to enhance change

ACCREDITATION WITH COMMENDATION

Criterion 18: Identifies factors outside provider’s control that impact patient outcomes

Criterion 19: Implements strategies to remove, overcome or address barriers to physician change.

ACCREDITATION WITH COMMENDATION Criterion 20: Builds bridges with

other stakeholders Criterion 21: Participates with in

a system framework for QI Criterion 22: Influence the scope

and content of activity/educational interventions

STRENGTHENING YOUR CME PROGRAM

TO RECAP Mission Statement Needs Assessment Practice Gaps Plan with a Purpose Standards for Commercial Support Evaluate and follow up Track and Trend Resources in your own backyard

-Bob Moawad

“Quality begins on the

inside… then works its way out.”

QUESTIONS?