Program Director Best Practices: Initial Survey Results University of Utah GME Annual Program Director Retreat Susan Stroud, MD Sonja Van Hala, MD, MPH, FAAFP September 25, 2014

Educational Objectives Describe the varied approaches applied across GME programs to meet common program requirements and conduct operations Identify resources to help you improve your program operations

Special Thanks to Survey Committee Amy Motta Program Coordinator, Pathology Christine Carlson Program Manager, Emergency Medicine Chris Springman Manager, Graduate Medical Education

What Survey and Why? Conceived after a discussion during a GME Committee meeting – Is it possible for PD’s and PC’s to have a shared pool of resources available within our institution to meet program requirements? NAS rollout Institution wide EMR New CLER requirements for programs and institution

Goals Identify requirements our programs are commonly having difficulty achieving Identify resources to assist PD’s and PC’s in compliance and operations Identify common tools/reports/resources that GME could advocate for hospital administration to provide to help us address these needs

Survey Specifics Survey monkey designed by committee and distributed to all program coordinators in August (thank you GME office) 54 Questions 16 respondents (it was a BIG survey)

Survey Categories PEC’s and CCC’s Evaluation Process Curriculum Goals and Objectives Final Summative Eval Letters Procedure Logs/Case Logs/Patient Encounters Quality and Patient Safety ACGME Annual Survey Duty Hours Meetings Resident Rehabilitation Recruiting ACGME and other web sites National Program Director Organizations

First Up: NAS Growing Pains Program Evaluation Committee (PEC) Clinical Competency Committee (CCC)

Program Evaluation Committee Chair of PEC? – 72% PD – Others: attending faculty, chief residents Member of PEC? – 43% did not include residents or fellows How often does PEC meet? – 50% annually – Others: monthly to quarterly – One: “as needed”

What Information does PEC review? Program Curriculum Policies Review of Last Meeting Progress on historical changes Plans for monitoring changes that will be implemented Faculty survey Resident survey (internal and ACGME) Trainee quality improvement projects Procedure and case logs Resident involvement in community service/advocacy committees In-service results Board score pass rates Teaching methods Evaluation methods Annual program evals by residents and faculty RRC citations Resident evals of faculty Resident evals of rotations Conference evaluations and attendance Trainee research efforts and publications Graduates employment demographics (academic vs. private)

What information does PEC review? “all” “We have a checklist with 10 items. We cover everything from the written evaluation of our program (attendings, fellows and mid-levels), reports from ACGME, ABS, RRC etc), Previous goals and future goals.”

Clinical Competency Committee Similar findings – 43% chaired by PD – Lots of different kinds of members, 14% included chief residents – Meet anywhere from yearly to 6 times per year – An exhaustive list of information is reviewed

What about just using the ACGME Website to find the specific requirements?

What problems do you have navigating ACGME or WebADS? 7 responses – 4 have no problems – Slow pages, browser incompatibility – “I find it difficult to find what I need and the search function is useless”

Oldies but Goodies Evaluations – New twist: patient satisfaction Procedures Case Logs Patient Encounters

Evaluations: “The program must” Provide objective assessments of competence in the 6 core competencies (includes procedural skills as part of patient care) based on the specialty-specific Milestones “Use multiple evaluators (e.g. faculty, peers, patients, self, and other professional staff)”

Opportunities for Improvement? Press-Ganey – Already being used for the faculty, with results published on our website, and the U has gained national recognition for this move An alternative institution wide GME sponsored mechanism – If PG not possible, what about an alternative specific to trainees?

How do Residents Track Their Procedures (software programs)? 12 responses – 58% in E*Value – 33% in ACGME Case Log/ ADS personal portfolio – “E*Value and Excel” – “minimum required in E*Value, all others they track in a paper book”

How do your residents track their patient encounters (software program)? 11 responses – 27% NA (don’t have patient encounters) – 36% EPIC – Others – E*Value, excel spreadsheet, personal portfolio, “I’m not sure this is happening”

How does your program ensure residents are recording these data? 12 responses – 8% use EPIC – Others are mostly a review of submitted logs by PD or CCC – Best answer: “whip”

Opportunities for Improvement? Many of the methods we are using to document these events require residents to double document Should we be able to access this info through EPIC reports? – Procedures are documented by residents – Patient encounters are documented by residents

Common Challenges with Common Solutions? We’ve gone poll crazy!!!! Bust out your smart phone, iPad, laptop, google glasses (just kidding) and help us out with a poll right now

Pollev.com/susanstroud214 From any browser your response From a text message Participating with Poll Everywhere How to vote via the web or text messaging 22333

Participating with Poll Everywhere How to vote via texting From a text message 22333

Participating with Poll Everywhere How to vote via the web Pollev.com/susanstroud214 From any browser