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Trends at the ACGME (where we are going

Published byCarmel Bond Modified over 6 years ago

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Presentation on theme: "Trends at the ACGME (where we are going"— Presentation transcript:

1 Trends at the ACGME (where we are going
Trends at the ACGME (where we are going?) Louis Ling, MD Senior VP, Hospital-based accreditation Professor of Emergency Medicine University of Minnesota

2 Evolution of the ACGME Courtesy of John Potts MD CLER Milestones
Single Accreditation CLER NAS ACGME-I Milestones Project JGME First residency RRC ACGME established independent Outcomes Project 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 Pace of change is accelerating Courtesy of John Potts MD

3 Evolution of the ACGME 60 yrs Courtesy of John Potts MD CLER
Single Accreditation CLER NAS ACGME-I Milestones Project 60 yrs JGME First residency RRC ACGME established independent Outcomes Project 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 Pace of change is accelerating Courtesy of John Potts MD

4 Evolution of the ACGME 91 yrs Courtesy of John Potts MD CLER
Single Accreditation CLER NAS 91 yrs ACGME-I Milestones Project JGME First residency RRC ACGME established independent Outcomes Project 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 Courtesy of John Potts MD

5 Evolution of the ACGME 15 yrs Courtesy of John Potts MD CLER
Single Accreditation 15 yrs CLER NAS ACGME-I Milestones Project JGME First residency RRC ACGME established independent Outcomes Project 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 Courtesy of John Potts MD

6 Evolution of the ACGME 15 yrs 2003 Duty Hours 2011 Duty Hours
Single Accreditation CLER NAS ACGME-I Milestones JGME First residency RRC ACGME established independent Outcomes Project 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 2015 Duty Hours studies in Medicine and Surgery 2003 Duty Hours 2011 Duty Hours Courtesy of John Potts MD

7 Megatrends at the ACGME
Change in attitude at the ACGME Limitation of rules Need to improve and innovate faster Need to train physicians for future practice Partners with programs, institutions and others

8 Megatrends at the ACGME
Professional expectations to Public expectations Expert-based to Evidence-based Process to Outcomes based Rules based to QI based ACGME control to Local control Focus on Accreditation to GME Improvement Periodic review to Annual review Paper (PIF) to Computer (ADS) ACGME focus to Collaborative focus

9 Trends at the ACGME 1. Professional expectations to Public expectations Patient safety and competency concerns Duty hours and IOM reports Public members added Congress and GME funding ACGME Resource accountability

10 Trends at the ACGME 2. Expert-based to Evidence-based JGME
Milestones 2.0 Duty Hours: FIRST and iCOMPARE Future program requirement changes

11 Trends at the ACGME 3. Process based to Outcomes based
Outcomes project Core Competencies Milestones NAS screening Focus from individual citations to overall accreditation status

12 Trends at the ACGME 4. Rule-based model to QI model:
Minimum compliance (just getting by) to encourage excellence (to be the best) Internal reviews CLER Pathways to Excellence Annual Program Review 10 Year Self-studies/Program Aims

13 Trends at the ACGME 5. ACGME Control to Local Control
Internal reviews and GMECs Annual Program Evaluations and PECs Linking core programs and fellowships Areas for Improvement (AFIs) Recognition of programs and institutions Best practices

14 Trends at the ACGME 6. Accreditation moving to Improving GME
Feedback at the site visit More Education Annual Education Conference larger New Assessment workshops Coordinator and chief resident training Distance learning Wellness and Learning Environment

15 Trends at the ACGME 7. Periodic 4.5 year avg to Annual Review
Annual review of data Annual review to resolve citations Annual review of surveys Annual review of case logs Shift from citations to accreditation

16 Trends at the ACGME 8. Paper (PIF) to Electronic (ADS)
Overall GME Summary reports Analysis (and research) is possible Trends are measurable More uniformity between specialties Expect initial bugs and transition woes

17 Trends at the ACGME 9. ACGME focus to Collaborative focus
Comment period before requirement changes Milestones process Wellness efforts Duty Hours Reassessment Research efforts

18 Trends at the ACGME Impact on RCs Embrace and track outcomes
Let go of reliance on process every year Not checking on all requirements for CA More use of annual data and trends Review of only high risk programs

19 Trends at the ACGME Impact on RC workload
Target: Review 20% of programs annually Ten year review at steady state 10% Data review identify 10%

20 Trends at the ACGME Impact on programs
Greater importance of annual data Less oversight of good programs Earlier detection of programs at risk Need faster response to citations AFIs may or may not need attention

21 Trends at the ACGME Impact on programs
More self-assessment and improvement More focus on what you do best More focus on your outcomes Graduation based on competency

22 Trends at the ACGME Impact on institutions
Importance of annual program data More responsible for programs Know program needs before the ACGME CLER as a mirror, not as a hammer Develop a wellness culture (supportive environment for all)

23 Trends at the ACGME Impact on institutions
Help programs self-assess and improve Shift focus: compliance to education

24 Megatrends at the ACGME
Professional expectations to Public expectations Expert-based to Evidence-based Process to Outcomes based Rules based to QI based ACGME control to Local control Focus on Accreditation to GME Improvement Periodic review to Annual review Paper (PIF) to Computer (ADS) ACGME focus to Collaborative focus

25 Program Coordinator Advisory Group
To advise ACGME administration concerning coordinator, GME, learning environment and accreditation matters One source of insight in improving communications, ACGME process and interactions with the GME community Responsible to the ACGME Overall goal is to further ACGME mission

26 Program Coordinator Advisory Group
Represent coordinators as a whole Not representative of any specific organization, institution or specialty Diverse group by location, size of program, specialty

27 Program Coordinator Advisory Group
September 8-9, 2016 topics Improving the Next Accreditation System Input on Sponsoring institution 2025 Improving communications Understanding the Coordinator role

28 Understanding the Coordinator role
Joys Always learning Variety Purpose Relationships Career, not just a job

29 Understanding the Coordinator role
Frustrations Lost connections with residents Relationship with PD Non-responsive faculty Overwork and overwhelmed Lack of respect Lack of communication Lack of recognition and thanks

30 Understanding the Coordinator role
Advice Reminders of seasonal tasks Tutorials and professional developmen Accessible training Learning from others and mentoring Redundant data entry GME finance

31 Program Coordinator Advisory Group
Ongoing conversation Input considered with other stakeholders

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