All answersSQuestionIDGroupResponseCategorySub-CategoryStrategic Priority11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?1ACGME EmployeeFully implement the strategic priorities; be more explicit about empowering the RRCs to develop improvement models, link patient care outcomes with educational accreditationImplementEA111b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?1ACGME EmployeeFully implement the strategic priorities; be more explicit about empowering the RRCs to develop improvement models, link patient care outcomes with educational accreditationOutcomesEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?1ACGME EmployeeFully implement the strategic priorities; be more explicit about empowering the RRCs to develop improvement models, link patient care outcomes with educational accreditationRRCsSP111b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?2ACGME EmployeeBe more representative of medical education groups and reduce the influence of specialty groups or associations trying to use the ACGME to further their own agendaRelationshipsSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?2ACGME EmployeeBe more representative of medical education groups and reduce the influence of specialty groups or associations trying to use the ACGME to further their own agendaRelationships11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?5Parker Palmer AwardeeEnsure that site reviewers are derived from the program community, that they are well-trained and show consistency in the application of the rules and requirements. Make the site reviews timely.ConsistencyEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?6Review Committee MemberACGME staff functions need to be more efficient and accurate. I've noted lots of secretarial mistakes of late. Openness and transparency are improving, although more needs to be done. I often see glitches where, by the time issues percolate thru the chain of SV, SVR, RRC member, RRC meeting and letter, that the eventual citation bears little resemblance to the real problem.ACGME Staff11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?9Review Committee MemberBe less authoritarian and more responsive to input from individuals that work in residency programs. LISTEN!CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?11Past Board MemberI would suggest that ACGME also concern itself with public policy that affects resident education. For example, speaking out on Medicare-derived reimbursement for teaching physicians and staff, facilities, equipment (such as simulators), and supplies. Accountability and transparency do not quite capture this.Public Policy11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?12Board Member1. acknowledge other areas which have the potential to impact residency funding: especially with respect to sponsorship by industry. Should some constraints be placed in common program requirements? 2. address GME cap as it pertains to perceived needs for increasing medical school class size, impact on residency training programs. What adaptations will we make to manpower/ supply and demand issues?Public Policy11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?12Board Member1. acknowledge other areas which have the potential to impact residency funding: especially with respect to sponsorship by industry. Should some constraints be placed in common program requirements? 2. address GME cap as it pertains to perceived needs for increasing medical school class size, impact on residency training programs. What adaptations will we make to manpower/ supply and demand issues?Public Policy11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?15Board Member1. Help to define outcomes. 2. Begin an educational process for Program Directors and DIO's. 3. Establish a method for consistency of RRC and ACGME committee actions. 4. Work to establish and work with Specialty program directors organizations.RRCsEA111b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?15Board Member1. Help to define outcomes. 2. Begin an educational process for Program Directors and DIO's. 3. Establish a method for consistency of RRC and ACGME committee actions. 4. Work to establish and work with Specialty program directors organizations.TrainingEA111b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?15Board Member1. Help to define outcomes. 2. Begin an educational process for Program Directors and DIO's. 3. Establish a method for consistency of RRC and ACGME committee actions. 4. Work to establish and work with Specialty program directors organizations.ConsistencyEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?15Board Member1. Help to define outcomes. 2. Begin an educational process for Program Directors and DIO's. 3. Establish a method for consistency of RRC and ACGME committee actions. 4. Work to establish and work with Specialty program directors organizations.RelationshipsSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?16Appointing OrganizationTie the education to a goal of preparation for the delivery of quality patient carePatient Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?21Past Board MemberThe statements are valid in terms of the goals and aspirations of the ACGME. The ACGME has tried to put these concepts into effect, but so far there still is a disconnect between what the ACGME wants to be and how it is currently functioning.MissionEA311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?26Review Committee ChairEnhanced collaboration when new initiatives are developed. For example, the Duty Hours and Competencies were developed without much input from residency directors or RRC members.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?27Review Committee MemberIncrease communication with constituencies. Improve the IT infrastructure.IT Infrastructure11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?27Review Committee MemberIncrease communication with constituencies. Improve the IT infrastructure.CommunicationSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?35Program DirectorThe outcomes we are measuring are resident education, not the health care of patients. If ACGME is to embrace the new mission, then there should be some assessment that shows that the care of patients is improved by the Outcome Project.Patient Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?36Member OrganizationUnderstand that the lives of program directors are getting very complicated due to excessive prosciptive requirements.....CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?39Board MemberEvery employee and volunteer of the ACGME should be asked to subscribe to the statements by attesting their signature to itACGME StaffEA311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?40pain fellowship committeeMove more rapidly toward exemplary accreditation and longer cycles between survey while holding teams (programs) accountable through more on-line 'always alive' PIFs.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?40pain fellowship committeeMove more rapidly toward exemplary accreditation and longer cycles between survey while holding teams (programs) accountable through more on-line 'always alive' PIFs.IT Infrastructure11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?42ACGME EmployeeThe current accreditation system remains cumbersome and paperbased with a 'snapshot' of a program or institution at a given moment in time--ie when the PIF is completed. In addition, the system has just begun to migrate in the direction of outcomes and improvement.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?43consultantI'm putting some data here to learn how this survey works.11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?45Review Committee Membernone11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?48Review Committee MemberMAKE THE ACCREDITATION PROCESS MORE TRANSPARENT TO PROGRAMS. PROGRAMS OFTEN DO NOT UNDERSTAND THAT RRCs ONLY MEET A FEW TIMES A YEAR. THEY FIND THE LONG WAIT BETWEEN SITE SURVEY AND RRC ACTION DIFFICULT.TransparencySP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?54Review Committee MemberDesign linkages with continuing accreditation programs to determine whether or not training program performance can be lonked to ultimate professional competence and recredentialing.Continuum11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?58Designated Institutional OfficialsAlways tie our work to Patient Safety and Patient Wellness, not just to the resident's life. Outcomes bottom line should always be the patient.Continuum11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?59was program director; now Director of Education for departmentSimplify paperwork. Provide more defined and realistic guidelines for accreditation requirements.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?62Review Committee ResidentEstablish well-defined parameters for accreditation and a transparent review process.TransparencySP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?63Designated Institutional Officialsthe recent changes we have seen at the DIO level clearly indicte that you are on the right path to accomplish this missionTrainingSP2d11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?67Designated Institutional OfficialsBe in tune with Progaram Directors and DIO's ZI don't mean even more altruistic emails, but recognize that there is horrible frustration in the trenches. More and more rules, paperwork, inconsistent RRC and IRC edicts. You are now your own top-down hegemony.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?68Parker Palmer AwardeeI strongly agree that the mission and vision accurately reflect the work of acgme. It would be hard to endorse that acgme expectations regarding the outcomes project have been supported by reliable or valid outcome measures. Also to a program director, the acgme seems anything but collaborative.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?71Designated Institutional Officialsby monitoring relevant outcomes to see if they are achieving their stated goals and objectivesOutcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?77Program DirectorI like the values implied by the old mission statement.11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?78Review Committee MemberNo suggestions for modification. I believe that the ACGME has already been doing what the 'new' mission, vision, and values reflect. The 'new' mission, vision, and values actually are better aligned with what the ACGME has symbolized and more reflective of the breadth and depth of what the ACGME has been doing.11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?81Review Committee MemberMove toward more outcome based accreditation and away from process based methods.OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?82Parker Palmer AwardeeWe can work together to improved the quality of the PIFs and the level of understanding of programs by site visitors. Further we can work together to test evaluation measures and develop 'gold standards' for the field. Outcomes measures should be standaradized and tested in multiple sites. Faculty development seminars should be implemented in programs -- a big problem for many.OutcomesSP3d11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?82Parker Palmer AwardeeWe can work together to improved the quality of the PIFs and the level of understanding of programs by site visitors. Further we can work together to test evaluation measures and develop 'gold standards' for the field. Outcomes measures should be standaradized and tested in multiple sites. Faculty development seminars should be implemented in programs -- a big problem for many.OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?82Parker Palmer AwardeeWe can work together to improved the quality of the PIFs and the level of understanding of programs by site visitors. Further we can work together to test evaluation measures and develop 'gold standards' for the field. Outcomes measures should be standaradized and tested in multiple sites. Faculty development seminars should be implemented in programs -- a big problem for many.Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?82Parker Palmer AwardeeWe can work together to improved the quality of the PIFs and the level of understanding of programs by site visitors. Further we can work together to test evaluation measures and develop 'gold standards' for the field. Outcomes measures should be standaradized and tested in multiple sites. Faculty development seminars should be implemented in programs -- a big problem for many.TrainingEA411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?85Designated Institutional OfficialsThe ACGME moves forward impressively with Dr. Leach's leadership. These are good years for the ACGME.11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?86Program DirectorI do not think that the ACGME is responsive to the community of Program Directors. My major concern here is the competencies-based curriculum. My impression from oonversations with many program directors at the consortium meetings is that a large number of program directors, probably a majority find the competencies-based approach to be very contrived and artificial, confusing explicit testable skills and knowledge (e.g. medical knowledge, patient care) with overarching aspects of medical culture (professionalism, communication). Although most, if not all, consider all of these things to be very important aspects of training, I think that most judge that generating Leikert scales of a resident's professionalism or of such vaguely defined things as systems-based practice is a foolish, useless, and burdensome exercise of pseudoquantification. I am not aware that the ACGME has asked resident directors their opinion of the competencies.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?87Review Committee MemberThe priciples that are at the basis of these modifications are very reasonable. Moves to incorporate outcomes-based performance measures will provide an objective basis for the evaluation of programs, for the PDs evaluation of residents, to enable the PDs ability to comment on past residents' performance following the completion of their training, etc. It is important, however, for these preformance measures to be linked to accurate indicators of relevant performance. It is also preferable that the methodology is seen by the trainee as an tool to the process of life-long learning (and can be used as a tool for self-assessment and learning) Ideally, residency training should not only represent a period of time during which residents learn, but also a time during which residents learn how to learn.Continuum11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?88Review Committee MemberAlthough the ACGME considers Fellows residents; the 'real world' does not. Consider including fellows in the mission statement.Mission11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?91Designated Institutional OfficialsMore supportive and pro-active work with programs and institutions.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?92Appointing OrganizationThe word 'CONSISTENCY' comes to mind.ConsistencyEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?94Review Committee MemberThere do not appear to be adequate numbers and quality of knowledable administrative staff to support the lofty mission.ACGME StaffEA311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?95Designated Institutional OfficialsTo achieve the level of accountability and reliability in the values statement, the RRC's need to have a level of consistency and reasonableness in requirements and actions that is now not present. The RRC's appear to act independently of the ACGME.ConsistencyEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?97Parker Palmer AwardeeImprove communication with Program Directors (for example, if an RRC has a schedule of site visits, give timely notification to involved programs of planned schedule changes).CommunicationSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?98Review Committee MemberProvide more education to program directors and institutions about their mission, goals, philosophy, long range plans, etc.TrainingEA411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?103Board MemberThe mission statement assumes there is a relationship between resident education and the quality of health care. Does this refer to the care specifically delivered by residents, the care in the institution in which education occurs or the care provided by those that graduate from accredited programs. Evidence for this connection beyond the actual care delivered by a resident to a patient seems weak.Continuum11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?107Review Committee MemberOur accreditation process is not yet outcomes based; we are moving in that direction but are not there yet.OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?108Review Committee ChairThe new emphasis on educational support has the potential to help the ACGME in fully realizing its mission and vision.11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?109Review Committee ChairPeople involved in administrative capacity in RRC should have clinical experience in a hands on practice setting as medical staff members in order to understand what the majority of residents are going to face upon completion of their training.StructureEA111b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?112Designated Institutional OfficialsThe revised statements are appropriate goals. They do not reflect all current practices. For example, common citations now are referable to web surveys of residents 1.5 years old by the time the citation is received, and 2.5 years from an event a resident reported, even if the problem had long sense been dealt with and when that fact is known to the RRC from both prior written communications and report of site visitor. The RRCs often require immmediate responses from programs/institutions and expect them to act based on current data, but do not hold themselves to that standard. This is not respectful, responsive, or fair.Communication11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?114Review Committee MemberSTRESSING CONTINUED IMPROVEMENT AND INNOVATION ARE VERY IMPORTANT. ENCOURAGING THE COMMITTEES TO INNOVATE IS IMPERATIVE.InnovationSP111b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?116Program DirectorFor some time, it has been my hope that the ACGME would work with PD's in a collaborative fashion to maintain accreditation rather than simply passing judgment at the conclusion of an accreditation cycle. I conduct or supervise all of the internal reviews for our institution. This is the way I work with PD's in that process. It is time consuming but successful.Collaborate11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?118ACGME EmployeeTake time to see the outcome,do not make changes too rapidly, it burns out the system and people who are trying to work with itSimplify11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?120Review Committee ChairThere is a dose of reality needed. There should be representatives from teaching hospitals on either the committees or the ACGME committee to comment on the feasibility of standards developed by the RRCRRCs11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?124Parker Palmer AwardeeNo suggestions for modification or change.11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?126Parker Palmer AwardeeWork to streamline PIFs as their increasing complexity and length make it tediousto both fill out and review.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?127Member OrganizationThe operational issues still fall short of the aspirational issues. For the programs, the paperwork burdens for documentation sap limited staff resources with questionable outcomes. Moving to a tracer methodology like JCAHO has implemented would be more valuable than the current process.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?129Member OrganizationMore transparency in discussions about future direction. e.g. the decision to keep membership of the portfolio committee confidential is counter to openness and transparency. In addition, the program review process focuses on detail of process more than on outcomes.OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?129Member OrganizationMore transparency in discussions about future direction. e.g. the decision to keep membership of the portfolio committee confidential is counter to openness and transparency. In addition, the program review process focuses on detail of process more than on outcomes.Collaborate11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?134Appointing OrganizationMove aggressively to outcomes based assessment of training programs.OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?135Review Committee Memberemphasize quality over feelingConsistency11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?136Member OrganizationIt is critical that the ACGME be responsive to its RRC's needs (along with the understanding that the members of the RRC are the best qualified to judge what is needed for training the best possible physcians for their specialty). The ACGME should be more of a 'state's rights' model as opposed to a 'federal' modelStructure11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?137Sister organizationThese statements do not hint at the fragmentation that is a natural outgrowth of the authority and structure of the individual RRC's. In fact, the mission, vision, values imply a cohesive, integrated approach to accreditation. A careful reevaluation of the relative roles of specialty-specific authority and more generic educational authority could be useful.RRCs11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?138Parker Palmer AwardeeIn order to be fully aligned with the mission, vision and values, the whole accreditation process needs to be revised. The process is not consistent with the direction ACMGE is takingProcess Improvement11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?147Program DirectorNeed to show that in fact the actions of the ACGME will impact the changes being sought, as currentlly it is assumed without any evidence that much of the regs (esp re: the core competen cies) actually impact outcome. You must be evidence-based just as you require us to be.OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?153Review Committee MemberThe vision statement is vague and self-serving.11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?154Review Committee ChairThe ACGME is mandating a lot of added paperwork and resources that are not in place for this new phase of the outcome project. The process not only involves educating the resident but all the health care personnel (faculty and support staff)who will need to accept this educational change. At this point the most invested individuals are the program director and DIO. Not even all chair persons understand the ACGME process. ACGME can modify their emphasis on their goals and objectives in sending forth their mission, vision and value statements by a marketing process to inform these non-PD and non-DIO individuals about their goals. To the department chair and other faculty, the PD is doing a job that they don't have to do.Marketing11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?155Past RRC memberI beleive that some of the major changes in recent years in ACGME requirements, namely general competencies and work hour rules, were instituted without adequate collaboration and inadequate evidence of their validity. These rules, while in theory sensible, have had many negative unintended consequences. My impression is that implemetation of these guidelines did not follow the processes listed in the new mission statement.Collaborate11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?156Review Committee MemberMission: ACGME maintains and improves health care..... Some programs are fellowships, so term resident seems too narrow, in MISSION. Ethical and fair seems redundant.Mission11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?157Review Committee MemberThe mission states to improve health care. I assume this is patient centered, but would be better if explicitly stated. The ACGME serves the public not the organization.Mission11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?159Review Committee MemberExamine resident life-style choices and base-line values prior to residency and after residencyRRCs11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?161ACGME EmployeeThe two areas that will benefit from expanding are 1) commnication with internal and external stakeholders, to continously refine their understanding of the ACGME, and to use these conversations to refine the work, and 2) a conscious effort to continuously examine the accreditation standards and processes for opportunities for innovation and improvement.Communicate11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?161ACGME EmployeeThe two areas that will benefit from expanding are 1) commnication with internal and external stakeholders, to continously refine their understanding of the ACGME, and to use these conversations to refine the work, and 2) a conscious effort to continuously examine the accreditation standards and processes for opportunities for innovation and improvement.Continual Improvement11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?163Asst program director1. The accreditation process needs to be made more efficient. Our site visit preparation involved creating several hundred pages of documents in addition to the hundred page PIF. The more frequent online interim review process hopefully will streamline the periodic reaccreditation visits. 2. The accreditation processes need to be more responsive to the educational community; currently there is still too much emphasis on bean-counting and process measures in education (e.g. hours of orthopedic curriculum, number of patients seen, number of procedures) rather than educational outcomes (competency). ACGME policies should be informed by knowledge from the field of educational research. Program requirements should be reviewed by physicians in the respective specialty who are also trained in educational theory. 3. Innovation is mentioned as a value- the current requirements in Family Medicine are so lengthy, detailed, and constraining that innovation is stifled.OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?163Asst program director1. The accreditation process needs to be made more efficient. Our site visit preparation involved creating several hundred pages of documents in addition to the hundred page PIF. The more frequent online interim review process hopefully will streamline the periodic reaccreditation visits. 2. The accreditation processes need to be more responsive to the educational community; currently there is still too much emphasis on bean-counting and process measures in education (e.g. hours of orthopedic curriculum, number of patients seen, number of procedures) rather than educational outcomes (competency). ACGME policies should be informed by knowledge from the field of educational research. Program requirements should be reviewed by physicians in the respective specialty who are also trained in educational theory. 3. Innovation is mentioned as a value- the current requirements in Family Medicine are so lengthy, detailed, and constraining that innovation is stifled.InnovationSP111b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?163Asst program director1. The accreditation process needs to be made more efficient. Our site visit preparation involved creating several hundred pages of documents in addition to the hundred page PIF. The more frequent online interim review process hopefully will streamline the periodic reaccreditation visits. 2. The accreditation processes need to be more responsive to the educational community; currently there is still too much emphasis on bean-counting and process measures in education (e.g. hours of orthopedic curriculum, number of patients seen, number of procedures) rather than educational outcomes (competency). ACGME policies should be informed by knowledge from the field of educational research. Program requirements should be reviewed by physicians in the respective specialty who are also trained in educational theory. 3. Innovation is mentioned as a value- the current requirements in Family Medicine are so lengthy, detailed, and constraining that innovation is stifled.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?165Appointing OrganizationContinued greater focus on outcomes and validity of the accrediting process.Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?167ACGME EmployeeThe change in philosophy from a minimum standards orocess to exemplary accreditation will make a huge difference. Actions taken need to be focused in that direction.OutcomesSP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?168Program DirectorWhen making decisions about curricular changes / rules, a focused group of program directors from different program sizes and styles should be consulted for applicability and sustainability of rules. Currently there is a small representation and volunteer input. It is better to have a 'testing' group assigned to evaluate and feedback on suggested changes.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?171Federation of State Medical BoardsThe work and impact of the ACGME is felt throughout organized medicine and the vision should so reflect.Mission11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?172Review Committee MemberNeed to work on open and transparent - although I believe that there is consistency in the process, this is not always evident. Also, we need to move more quickly to outcomes based and improvement oriented accreditationTransparencySP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?172Review Committee MemberNeed to work on open and transparent - although I believe that there is consistency in the process, this is not always evident. Also, we need to move more quickly to outcomes based and improvement oriented accreditationOutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?172Review Committee MemberNeed to work on open and transparent - although I believe that there is consistency in the process, this is not always evident. Also, we need to move more quickly to outcomes based and improvement oriented accreditationContinual Improvement11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?173Review Committee Membermore efficiency and streamlining of requirements which is currently taking placeSimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?174Member OrganizationUtilize more program director involvement so that new standards are realistic based on the workload of the PDs.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?175Designated Institutional OfficialsCollaborating with other education focused national organizations ( AMA, AAMC, AHME, etc.) to better define the elements of determining self refelection and the interface of self recognition of educational needs and external validation of such an analysis and how that can lead to utilizable strategies for lifelong learning and improvement of clinical skills.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?176Review Committee MemberBecome more user friendly and less regulatory for regulation sake. Limit amt of paper workSimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?177Member OrganizationThe vision and values set high standards but are currently more aspirational than operational.Implement11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?182Review Committee MemberUnderstand that the mission requires time and that time is money and that healthcare delivery has been consistently devalued. This is a paradoxMission11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?184Review Committee MemberMore communication with implementation plans prior to adoption of new requirments (eg., assist the DIO's and PD's to achieve accreditation).CommunicateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?185Review Committee MemberMore transparency - RRCs are not consistently transparentTransparency11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?188Review Committee MemberTo better educate the medical education community about the accreditation processesMarketingSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?190Designated Institutional OfficialsProfessionalism also entails apersonal dedication to put patients before self11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?192ACGME EmployeeWe are not as clear as we can and should be about the accreditation processes. All review committtees (RCs) need to agree on common interpretatons of the common requirements and make the expectations very clear to PDs and DIOs. It is not apparent that the RCs fairly apply the standards to all programs. there is much confusion re this with the Pds/DIOs. A few RRCs still have the 'silo' mentality with little interest in collaborating with other RCs re processes to make fair, reliable, consistent accreditation decisions.TransparencyEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?193Program DirectorIt needs to translate to the daily work of the program director. More concrete direction with competencies for exampleTraining11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?194Board MemberContinued streamlining and communicationSimplify11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?195Past Board MemberSimplify the regulations. Eliminate unnecessary data collection. Confine discussions of future accreditation systems to a small inner circle until the time to consider implementing them gets closer. We're driving program directors and DIOs insane.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?197Review Committee MemberThe ACGME will need to evaluate 'health care delivered' if the mission is to improve health care.Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?200Review Committee MemberThere must be a balance between excellence and cost. some call this value. I fear the accreditation tends to drive up cost in pursuit of value, without attention to clinical outcomes. The game is not education or accreditation, it is clinical care. As Votaire put it, 'the best is the enemy of the good'Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?201Review Committee MemberCurently, the ACGME's work focuses on assuring that training occurs in settings that meet ('substantial compliance') a set of standards. Meeting such standards does not assure excellence. Going forward, the ACGME will need to invest in emperical research that identifies what in fact defines 'excellence' and to developing accreditation standards that promote such excellence.OutcomesEA611b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?202ABMS Board ExecMVV statements are always somewhat Pollyannaish. The reality of people's behavior and corporate processes usually belie them. It would be hard to identify much in the current ACGME work processes that are particularly emblematic of these statements.Implement11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?203Review Committee MemberI don't think the ACGME is to improve healthcare;it is to improve the quality of physicians who will work in the healthcare system.Mission11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?204Member Organizationless intrusive, less proscriptive, smallerCollaborate11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?205Board MemberIthink these statements will serve as a constant measuring stick against which new program initiatives and new requirements should be measured.OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?207Review Committee ChairACGME is, because of its leadership role, a service organization. It has many customers, including its many volunteer physicians, the 8,000+ programs and institutions that it impacts, etc. I believe that the new mission, vision, and values are fine as written, but ACGME will need to change, especially its internal culture and operations, to be seen by its customers as being respectful, collaborative, and responsive (see 1.c.).CollaborateEA311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?207Review Committee ChairACGME is, because of its leadership role, a service organization. It has many customers, including its many volunteer physicians, the 8,000+ programs and institutions that it impacts, etc. I believe that the new mission, vision, and values are fine as written, but ACGME will need to change, especially its internal culture and operations, to be seen by its customers as being respectful, collaborative, and responsive (see 1.c.).Collaborate11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?208Review Committee MemberI would stress Innovation as we move forward. We need a complete 'new look' at medical education and some innovative pilots, under the auspices of the ACGME.InnovationSP111b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?209Parker Palmer AwardeeI don't think the mission / vision statements accurately reflect the complex interplay between the ACGME and the RRC's in defining the 'rules' with content, duration, volumes, kinds of encounters, etc.Transparency11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?212Parker Palmer AwardeeTransparency needs work if the vision is not the same from Board Member through staff-RRCs-DIOs-Site Visitors & program Directors....... An 'outcome' to assess......are all on the same page?Alignment11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?213Program DirectorThe paperwork of accreditation is cumbersome and should be markedly streamlined. The process should be continuous rather than at 5 year intervals mirroring what most specialty board certification exams are doing. Perhaps the accreditation could be done in small chunks yearly. This would allow for more timely give and take between the RRCs and the programs to solve issues.IT InfrastructureSP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?213Program DirectorThe paperwork of accreditation is cumbersome and should be markedly streamlined. The process should be continuous rather than at 5 year intervals mirroring what most specialty board certification exams are doing. Perhaps the accreditation could be done in small chunks yearly. This would allow for more timely give and take between the RRCs and the programs to solve issues.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?217Appointing OrganizationIt seems that the primary work of the ACGME is focused on physican training programs. No where is that focus mentioned. What is accredited? Where is the attention to be placed? What is the role of the ACGME relative to the training programs?Training11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?219ACGME EmployeeI disagree with the wording. The word 'To' would be better than the word 'We' and the word 'advancing' probably should be 'enhancing.' I don't believe ACGME makes any medical break-throughs in health care but rather through the process of accreditation it enhances health care by monitoring compliance with established requirements.Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?221Review Committee MemberDon't know,since to me the organization seems to be doing a good job consistent with the statement.11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?222Parker Palmer AwardeeMore transparency in accreditation processTransparencySP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?223Designated Institutional Officialsuniform interpretation and application of standards across RRCsConsistencyEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?225Designated Institutional OfficialsI believe the standards by which the RRCs judge programs should be more public and transparent. Programs should clearly know where the bar is set and then would be better prepared to achieve the stated standard.TransparencySP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?226Review Committee MemberPlace a little less emphasis on board pass rate in evaluating programs, although I do think it is important. IF you can help streamline the PIFs to make them easier for everyone. Not an easy task.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?229Program DirectorThe ACGME can decide not to create regulations that are unfunded mandates--and get input from users into the unintended consequences of new regulations. Rule interpretation has not always been transparent, or open to the userCollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?230Designated Institutional OfficialsMore outreach to individual medical schools and hospitals GMEC through on-site presentations, other literature - you are too remote.Marketing11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?233RC Chair & Parker Palmer Awardee1. Decrease paper work burden for programs 2. Try to connect that competency based education leads to improvements in care quality 3. Improve consistency of accreditation decsions. 4. Add to common requirements, for more consistent expectations re resident educationSimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?233RC Chair & Parker Palmer Awardee1. Decrease paper work burden for programs 2. Try to connect that competency based education leads to improvements in care quality 3. Improve consistency of accreditation decsions. 4. Add to common requirements, for more consistent expectations re resident educationOutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?233RC Chair & Parker Palmer Awardee1. Decrease paper work burden for programs 2. Try to connect that competency based education leads to improvements in care quality 3. Improve consistency of accreditation decsions. 4. Add to common requirements, for more consistent expectations re resident educationConsistencyEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?239Review Committee ResidentCollaboration and the request for feedback seems to be improving. This should continue.CollaborateSP411b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?243Program DirectorAdvance the current work of ACGME. Careful surveillance of participating institutions is critical. Other priorities (eg financial ones) readily eclipse an educational mission.Implement11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?250ACGME EmployeeContinue to stress the values internally with employees. Challenge the staff to work with the Accreditation Committees to be more innovative in their views of accreditation.ACGME StaffEA311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?252Review Committee ChairThe new vision statement has 14 words, yet the 2 most important are repeated. This seems to be defining the term exemplary accreditation in terms of itself. What IS exemplary accreditation? How do we become exemplary?Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?254Board MemberThe ACGME needs to continue to increase the transparency of its processes and governance.Transparency11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?260Review Committee MemberLESS BUREAUCRACYStructureEA311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?262Parker Palmer AwardeeStrive to be less bureaucratic and mre responsive when issues arise that are #grey#Structure11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?264Designated Institutional OfficialsI think the leadership models this . Modeling by the rank and file ( executive directoirs, site visitors etc) should be encouraged. It often seems like everyone is not on the same page. This includes the RRC's. Some member's interpret the requirements differently, and give different info to program directors. The RRC's should have a common message that they give to programs in their specialty.AlignmentEA211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?265Review Committee ChairSimplification of the 'processes' of accreditation.SimplifySP311b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?267Past Board MemberNo changes. But in pursuing 'exemplary accreditation,' we must keep in mind that the perfect (or exemplary) is sometimes the enemy of the good.Outcomes11b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?272Review Committee MemberContinue to evolve from process assessment focus to outcomes assessment; improve the constructive feedback to PDs to facilitate/guide program improvement (as trialed in the RRC workshop on competency assessment/feedback).OutcomesSP211b. How can the work of the ACGME be modified or changed to reflect the mission, vision, and values?11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?1ACGME EmployeeRestructure the board to include equal represntation of RC chairsStructure11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?2ACGME EmployeeSmaller Board, standardization of reviews and decisions across specialtiesStructure11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?2ACGME EmployeeSmaller Board, standardization of reviews and decisions across specialtiesConsistencyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?5Parker Palmer AwardeeExcellent communication with the program directors, faculty and residents.CommunicationSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?6Review Committee MemberNot sure.11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?11Past Board MemberA public policy work group, made up of board membersPublic Policy11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?12Board Member1. Enhance board participation in strategic planning. Request input from all.Collaborate11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?15Board Membersee aboveConsistencyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?15Board Membersee aboveTraining11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?15Board Membersee aboveRRCsEA111c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?16Appointing OrganizationI think that the way the mission and vision are stated, it leaves one hanging and left with the imopression that you are advancing the resident's education, but to what end. It is the latter which is missing.OutcomesEA611c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?21Past Board MemberOne way to approach the problem would be to deconstruct the mission/vision/goals statements and then develop a work plan for each of the components of the statements, with clear articulation of the measurements of success. That way we could know when and if we are successful in reaching any of the aspirations in the mission/vision/goals statements.ImplementEA611c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?31Review Committee MemberBe somewhat less prescripitve; Make documentation of compliance more efficientSimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?35Program DirectorHaving directed a program both before and during the Outcome Project, and in a leadership role in a national program director's organization, I can tell you that program directors want most is guidance as to how to proceed.TrainingSP211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?36Member OrganizationSimplify the process and save more trees.SimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?37ACGME EmployeeThe ACGME has too many inititives. Focus on one or two. Reducing the burden of accreditation should be number 1. That will not happen when the ACGME continues to add to accreditation requirements and propose new programs. Reduce the number of ACGME Committees. FOr the next few years, focus on streamlining and reducing burden.SimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?37ACGME EmployeeThe ACGME has too many inititives. Focus on one or two. Reducing the burden of accreditation should be number 1. That will not happen when the ACGME continues to add to accreditation requirements and propose new programs. Reduce the number of ACGME Committees. FOr the next few years, focus on streamlining and reducing burden.Structure11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?39Board MemberThe ACGME must remind itself frequently that besides the public,its customers include the DIOs, program directors, employees and all the volunteers.CollaborateSP211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?40pain fellowship committeeimprove ACGME information systems - perhaps invest significant resources in this area to help make data management more up to date.IT Infrastructure11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?42ACGME Employee(1) Resident portfolio project; (2) completion and implementation of the Common Program Requirements; (3) full development of the EVE/ADAM system; (4) revision of the 'site visit' purpose, process, and time frames.portfolio projectSP3e11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?42ACGME Employee(1) Resident portfolio project; (2) completion and implementation of the Common Program Requirements; (3) full development of the EVE/ADAM system; (4) revision of the 'site visit' purpose, process, and time frames.ConsistencyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?42ACGME Employee(1) Resident portfolio project; (2) completion and implementation of the Common Program Requirements; (3) full development of the EVE/ADAM system; (4) revision of the 'site visit' purpose, process, and time frames.IT InfrastructureEA2b11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?42ACGME Employee(1) Resident portfolio project; (2) completion and implementation of the Common Program Requirements; (3) full development of the EVE/ADAM system; (4) revision of the 'site visit' purpose, process, and time frames.Redesign11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?43consultantI like in the field, first hand interviews and observations as a way to learn more about what is going on.Redesign11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?45Review Committee Membercontinuing the openness of the process; be a source of info about meeting the Core CompetenciesTransparency11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?48Review Committee MemberAn ongoing process of a residency program's accreditation, rather than gearing up every 3-5 years for site visit.IT Infrastructure11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?53Appointing OrganizationI would suggest greater engagement with residency program directors in providing feedback to the ACGME on the impact of new 'rules' on their day-to-day efforts to train residents. I would encourage the ACGME to get involved in advocacy efforts to facilitate programs' capacity to train residents in the best possible settings without unnecessary limitations and hurdles. An example would be the volunteer preceptor issue with CMS that limits programs' capacity to train residents in the community settings in which they will be practicing.CollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?54Review Committee MemberContinue education of RC members and encourage professional educational/programming help for resdidency training directors through enhanced DIO networks and increased resource allocation. Stress importance of PD and program support through mnandatory institutionakl finding to ensure excellence and support staff. Encourage institutional educational programmming to encompass common program requirements and to foster collegial and educational relationships among resident learners and faculties.TrainingSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?56Appointing OrganizationI find some of the ACGME RRCs work under very strictly interpreted, rigid guidelines. I understand the legal need for consistency, but I think there is a disconnect between the noble goals of the ACGME and how some of the Executive Directors execute their particular charges.ConsistencySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?58Designated Institutional OfficialsInclude Patient Safety and Health Outcomes experts in your planningOutcomesSP211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?59was program director; now Director of Education for departmentWhile the ACGME goals are laudatory many of them will be expensive to implement. Providing more standardized on-line computer programs to meet the requirements would be helpful, especially concerning the portfolios. The ACGME should also try and work with other national organizations to reduce the redundancy of all the data collection being required.IT Infrastructure11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?59was program director; now Director of Education for departmentWhile the ACGME goals are laudatory many of them will be expensive to implement. Providing more standardized on-line computer programs to meet the requirements would be helpful, especially concerning the portfolios. The ACGME should also try and work with other national organizations to reduce the redundancy of all the data collection being required.ConsistencySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?61Review Committee ChairIncreasing use of the internet to be able to give rapid feedback to programs on accreditation decisions, etc.IT InfrastructureSP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?62Review Committee ResidentThe IM RC has been working toward the 1b. goals. Creating uniformity across specialties would be helpful.ConsistencyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?63Designated Institutional Officialsonce and a while we run into an RRC that is not completely on board with the 'transparency' and 'openness' parts of the mission, or we occasionally see lack of consistency across different RRC's. Certainly it would be important to ensure that there is full penetration of the message internally in the organization.ConsistencyEA111c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?67Designated Institutional OfficialsAcknowledge our frustration and your failings when brought to your attention. Arrogance doesn't work.Culture11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?68Parker Palmer AwardeeI'm not sure the acgme outreach has extended far enough. For instance, while the acgme and abms collaborate on the 'quadrads' none of this work with respect to my specialty ever trickled down to front line program directors. Our rrc has never shared any 'best practices' with the PD group. Our acgme rrc representative sometimes doesn't even answer email questions.AlignmentSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?70Review Committee ChairMore marketing so the public understands that ACGME acreditation is the 'gold standard' for GME and has value over other comparable organizations.marketing11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?71Designated Institutional Officialsthey need an effective feedback mechanism to determine whether the goals and objectives are being achieved. I think it is really a parallel process to the Outcome Project. I believe they should be held accountable just as programs are. There should be objective, measurable outcomes that are reported and reviewed.Outcomes11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?77Program Director1. Not have the site visitors have such lattitude in what the are able to request. More standardization of what is expected by the site visitor. 2. Having more reasonable expectations. Currently the number of regulations is staggering and very hard to meet. 3. The ACGME and the various RRC could work to make a more reasonably achievable set of requirements. 4. Make the duty hour survey more easy for the residents to understand. It currenlty leads to inaccurate answers.RedesignEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?77Program Director1. Not have the site visitors have such lattitude in what the are able to request. More standardization of what is expected by the site visitor. 2. Having more reasonable expectations. Currently the number of regulations is staggering and very hard to meet. 3. The ACGME and the various RRC could work to make a more reasonably achievable set of requirements. 4. Make the duty hour survey more easy for the residents to understand. It currenlty leads to inaccurate answers.SimplifyEA111c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?77Program Director1. Not have the site visitors have such lattitude in what the are able to request. More standardization of what is expected by the site visitor. 2. Having more reasonable expectations. Currently the number of regulations is staggering and very hard to meet. 3. The ACGME and the various RRC could work to make a more reasonably achievable set of requirements. 4. Make the duty hour survey more easy for the residents to understand. It currenlty leads to inaccurate answers.ConsistencyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?78Review Committee MemberI think that the ACGME is well on track to realizing its new mission, vision and values.11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?81Review Committee MemberEnhance professionalism through interactions between EDs and program directors and DIOs.CollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?82Parker Palmer AwardeeSee 1b.Outcomes11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?85Designated Institutional OfficialsThe survey questions to residents, prior to the site visit, are generating debate and frustration at the program level. Perhaps the quality of the questions needs mmore stakeholder input.RedesignSP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?86Program DirectorAsk the program directors and residents their opinion of the competencies-based curriculum, and make revisions based on their responses.CollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?87Review Committee MemberDuring the implementation of various methodologies developed to teach problem-based learning skills, to measure outcome-based performance, etc., it is crucial to 'measure the methodologies'. We need to know if the intended outcome of these changes are, in fact, accurate and accomplishing their intended goals. It would be a shame to set out on a course that is misdirected.TrainingSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?91Designated Institutional OfficialsSee above. In addition - lobbying with government agencies to increase funding for GME. These 'unfunded mandates' while exemplary in intent have put enormous strain on both hospitals and residents.Public Policy11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?91Designated Institutional OfficialsSee above. In addition - lobbying with government agencies to increase funding for GME. These 'unfunded mandates' while exemplary in intent have put enormous strain on both hospitals and residents.Collaborate11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?92Appointing OrganizationAcross the board consistency in evaluating programs and actions taken by the ACGME.ConsistencyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?94Review Committee MemberBecome more user friendly. Hire enough administrative staff to assist the physician members of the RRC in doing their (volunteer) work, rather than rely on the physician members to help the RRC staff.ACGME StaffEA311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?95Designated Institutional OfficialsSee above.Consistency11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?97Parker Palmer AwardeeOpen communication with end users AND their support personnel (for example, assuring that any changes in reporting or forms are user friendly and allow uploading or importing of data without a lot of typing).SimplifyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?98Review Committee MemberBe more transparent in operations and open to feedback from your customers: directors and institutions.TransparencySP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?103Board MemberThe problem you have is there are too many programs engaged in educating 1-2 residents a year in systems where the infrastructure and workforce is ill prepared. ACGME needs to set the bar higher for the faculty and program directors in the system.OutcomesSP111c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?104Past Board MemberNeeds to be more timely (shorten delays in reporting accreditation decisions).RedesignSP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?106Member OrganizationContinue to improve the basic accreditation functions, particularly consistency among site visitors and review committees, timeliness and correctness of accreditation letters, efficiency of processes.SimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?107Review Committee MemberEach RC will have to develop an outcomes based approach to accreditation for its specialtyOutcomesSP211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?108Review Committee ChairI think more effective communication is critical. This is difficult to accomplish but worth some soul searching for how to best reach stakeholders.CommunicationSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?109Review Committee ChairAs above, people involved in administrative capacity in RRC should have clinical experience in a hands on practice setting as medical staff members in order to understand what the majority of residents are going to face upon completion of their training.StructureEA111c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?111Review Committee ChairDon't simply encourage Pilot Programs, force them coupled with an across the board mandate to decrease the unproductive never cited burden of accreditation (eg 30% 'goal' of trimming the PR should be mandatory)Collaborate11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?116Program DirectorWhen all we dealt with was the Program Requirements it was an open book test. I think as a community Program Directors remain somewhat confused as to what is really expected of us in each phase of the competencies implementation.CollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?118ACGME EmployeeSimplify accreditation process. Have institutions,programs,Field staff,executive directors of RRC, RRC members all work together to accomplish the same mission.Alignment11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?118ACGME EmployeeSimplify accreditation process. Have institutions,programs,Field staff,executive directors of RRC, RRC members all work together to accomplish the same mission.SimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?124Parker Palmer AwardeeNone to suggest.11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?126Parker Palmer AwardeeGreater transparency. E.g.,PDs should be able to review the report forms that site visitors use. There should also be better clarification of interpretations of Essentials with examples.TransparencySP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?127Member OrganizationListening to your customers and showing rapid cycle change as a result. But not dumping more requirements with limited time to implement.CollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?129Member OrganizationFocus on outcomes for specialty programs, reduce the number of process requirements and give more latitude for reaching the outcomes in different ways (innovation).OutcomesSP211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?129Member OrganizationFocus on outcomes for specialty programs, reduce the number of process requirements and give more latitude for reaching the outcomes in different ways (innovation).SimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?129Member OrganizationFocus on outcomes for specialty programs, reduce the number of process requirements and give more latitude for reaching the outcomes in different ways (innovation).InnovationSP111c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?134Appointing OrganizationDevelopment of tools to assist residency training programs to measure and assess training outcomes.Outcomes11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?135Review Committee Membermeasure training and evaluation of operative careOutcomes11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?137Sister organizationReview the role of specialty-specific RRCs and seek means of reducing inconsistency of approach among RRCs. Seek a more integrated, collaborative position as part of the continuum of medical education with the undergraduate and continuing medical education communities.Continuum11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?137Sister organizationReview the role of specialty-specific RRCs and seek means of reducing inconsistency of approach among RRCs. Seek a more integrated, collaborative position as part of the continuum of medical education with the undergraduate and continuing medical education communities.ConsistencyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?138Parker Palmer AwardeeThe accredition process should be based on outcomes and not on policies and procedures. The field staff do not seem to be on the same page.OutcomesSP211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?139Review Committee MemberDevelop a formal feedback mechanism for the Program directors in the field. Both for the RRC and the ACGMEOutcomesSP211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?147Program DirectorAs above, it is incumbant on the ACGME to demonstrate the valkue of it's policies.OutcomesEA611c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?150Board MemberHave a more diverse representation, board,RRCsCulture11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?153Review Committee MemberInstead of a vision that emphasizes process and bureaucracy, focus on realization of the mission (ie, how does this organizationImplementEA311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?154Review Committee ChairMake the new common program requirements more reasonable and obtainable. Benchmark programs are good but are idealistic. There needs to be a minimal 'getable' level of compliance that a program achieves to maintain accrediation...or there will be many programs (particularly the small ones) that will withdraw from the accrediation process. If the 1st time Board pass rate can be used as one level of academic outcomes accomplishments, then a level of passage may be recommended according to the number of board eligible candidates. Patient care and professionalism factors can also be devised and monitored on a common scale with a minimal level of competency acceptance. This would be defined and not vague and adds a more practical approach. With this type of process, program directors may actually sense that the ACGME understands their situation.SimplifyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?155Past RRC memberThe ACGME should not institute new guidelines affecting all residency programs without compelling evidence that the guidelines will improve the results of training programs, and without thorough discussion wiht each RRC and their constituents.CollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?156Review Committee MemberTo the extent possible, competencies and any other aspects that CROSS specialties should be similar if not identical. Providing aids (educational materials to PD, etc; templates for common documents) could facilitate PD performance, and reduce 'scut' work, leaving more time for innovative efforts.SimplifyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?156Review Committee MemberTo the extent possible, competencies and any other aspects that CROSS specialties should be similar if not identical. Providing aids (educational materials to PD, etc; templates for common documents) could facilitate PD performance, and reduce 'scut' work, leaving more time for innovative efforts.ConsistencyEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?158ACGME EmployeeThe development and use of a strategic plan with associated targeted and timed goals -linked to the mission-vision-values- could prove useful.Implement11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?159Review Committee MemberRecommend greater government funding of teaching hospitals both for patient care and training. Unfortunately many programs and the faculties within are seeing compliance as an unfunded mandate with inability to comply and the frustration displayed in some faculty members helps drive trainees into private practice.Public Policy11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?161ACGME EmployeeConversations and focus groups with internal and external constituents to give them a solid understanding of the mission, vision and values, and to ensure that ACGME's actions are congruent with a common understanding of the meaning of these words.MarketingSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?163Asst program director1. The accreditation process needs to be made more efficient. Our site visit preparation involved creating several hundred pages of documents in addition to the hundred page PIF. The more frequent online interim review process hopefully will streamline the periodic reaccreditation visits. 2. The accreditation processes need to be more responsive to the educational community; currently there is still too much emphasis on bean-counting and process measures in education (e.g. hours of orthopedic curriculum, number of patients seen, number of procedures) rather than educational outcomes (competency). ACGME policies should be informed by knowledge from the field of educational research. Program requirements should be reviewed by physicians in the respective specialty who are also trained in educational theory. 3. Innovation is mentioned as a value- the current requirements in Family Medicine are so lengthy, detailed, and constraining that innovation is stifled.SimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?165Appointing OrganizationContinued greater focus on outcomes and validity of the accrediting process. Push development of portfolios.OutcomesEA511c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?165Appointing OrganizationContinued greater focus on outcomes and validity of the accrediting process. Push development of portfolios.PortfoliosSP3e11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?167ACGME EmployeeContinue the committment to reducing the burden by accelerated development of the Eve/Adam project. Encourage RCs to develop pilot programs to foster innovation and enhance the competency assessment initiatives.InnovationEA2b11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?167ACGME EmployeeContinue the committment to reducing the burden by accelerated development of the Eve/Adam project. Encourage RCs to develop pilot programs to foster innovation and enhance the competency assessment initiatives.SimplifyEA2b11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?168Program DirectorSee aboveCollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?171Federation of State Medical BoardsI believe the ACGME is currently meeting the m,v and v.11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?172Review Committee MemberMore rapid movement to outcomes based standardsOutcomesSP211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?174Member Organizationsee above.CollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?175Designated Institutional Officials1.Some mechanism to gather information from programs about their indivdual needs and concerns , perhaps as a feed back loop to program directors after they have been through their internal review and may require some assisitance in developing a remedial plan. 2. Also to borrow a method form the JCAHO to consider an 'ongoing' accreditation mechanism allowing , perhaps selected programs , at first, to develop processes to maintain their accreditation in a continuum , rather than gear up periodically.CollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?175Designated Institutional Officials1.Some mechanism to gather information from programs about their indivdual needs and concerns , perhaps as a feed back loop to program directors after they have been through their internal review and may require some assisitance in developing a remedial plan. 2. Also to borrow a method form the JCAHO to consider an 'ongoing' accreditation mechanism allowing , perhaps selected programs , at first, to develop processes to maintain their accreditation in a continuum , rather than gear up periodically.IT InfrastructureEA211c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?176Review Committee Memberas noted aboveSimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?177Member OrganizationProvide quicker communication of accreditation decisions to programs. Give programs more flexibility to adapt to local circumstance in creating learning environments.InnovationEA111c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?177Member OrganizationProvide quicker communication of accreditation decisions to programs. Give programs more flexibility to adapt to local circumstance in creating learning environments.SimplifySP311c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?182Review Committee MemberPromoting efforts to pay for the increased costs of improving education.Public Policy11c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission, vision and values?184Review Committee Memberincreased interaction with the RC's and on down to the DIO's and PD'sCollaborateSP411c. What changes/improvements would you suggest to greatly enhance the chances of the ACGME realizing its new mission