ABEM

EMCCWhat you need to do.

Generally your certificate will expire 10 years after initial or re-

certification.

Turns out Obama will not help you.

ABEM EMCC (Emergency Medicine Continuous Certification)

Four Components: 1-3 Implemented in 2004.    1.Professional Standing            You must hold at least one medical license.     2.LLSA (Lifelong Learning and Self Assessment)            8 completed out of the ten years between                                 certification/renewal or renewal/renewal.            Exceptions: renew 2011 6, renew 2012 7 needed. The primary goal of LLSA is to promote continuous learning by diplomates.  ABEM facilitates this learning by identifying an annual set of LLSA readings to guide diplomates in self-study of recent EM literature.  Readings are intended to address issues of relevance to current clinical practice at the time they are posted.  ABEM recognizes that EM is an ever-evolving science and that new knowledge becomes available on a continual basis.LLSA readings are designed as study tools and should be read critically.  They are not intended to be all-inclusive and are not meant to define the standard of care for the clinical practice of EM.  ABEM does not endorse a specific research finding or treatment modality by virtue of its being the subject of a selected LLSA reading.

LLSA into CME @ EMedHome.com

$99 per year to join. $85 this year for up to 25 CME credits (less this year due to less articles).  20 CME credits for completing the test (has been 25 in the past).

    3.  Concert:  Assessment of Cognitive Expertise

Component three of the EMCC program, the Continuous Certification (ConCert) examination, is available annually.  Like the previous recertification examination, it measures the knowledge base for the practice of Emergency Medicine (EM). The ConCert examination is a comprehensive examination based on the EM Model. ConCert will typically occur in the tenth year of each diplomate’s EMCC cycle. ConCert is a half-day examination. ConCert is administered at computer-based testing centers around the country

4. Assessment of Practice Performance

"Assessment of Practice Performance (APP) is the fourth component of EMCC.  Clinically active diplomates assess the quality of care they provide compared to peers and then apply the best evidence or consensus recommendations to maintain or improve that care. APP focuses on practice-based learning and improvement, particularly in the competencies of patient care, interpersonal and communication skills, and professionalism.  APP is based on diplomates’ involvement in a national, regional, or local practice

improvement plan of their choice that meets ABEM’s basic requirements.  A specific goal of the APP program is to recognize quality improvement activities in which most diplomates are already

participating." Started 2010.First Attestations are required 2011 for 2013 certificates.Two components:1.Communication/Professionalism (CP) Activity2. Patient Care Practice Improvement (PI) Activity

Communication / Professionalism (CP)

"Communication / Professionalism (CP) feedback program, such as the patient surveys used by most hospitals, in years one through eight."MAPPS will cover this.Chief of the department will be the attestor.

Not able/need to attest to yet, starts for certificates expiring in 2017.

Patient Care Practice Improvement (PI)"A PI activity must include the following four steps:1. Review patient clinical care data from ten of your patients.  The data must be related to a single presentation, disease, or clinical care process that is part of the Model of the Clinical Practice of Emergency Medicine (EM Model) for example

• clinical care processes • feedback from patients that relates to the clinical care given • outcomes of clinical care • access to care such as time for through-put, left without being seen, etc.

Group data and data collected through a national, regional, or local practice improvement program in which you participate is acceptable.2. Compare the data to evidence-based guidelines.  Evidence-based guidelines are based on published research subject to peer-review.  Only if such guidelines are not available, you may use guidelines set by expert consensus or comparable peer data.  Guidelines set by expert consensus are published, accepted, national standards, and guidelines set by peer data are set by individuals who practice in like or similar circumstances.3. Develop and implement a plan to improve the practice issue measured in Step #1.  You may plan for an individual or group improvement effort.  4. After implementing the improvement plan, review patient clinical care data from ten additional patients with the same presentation, disease, or clinical process as the first patient data review.  Use this data to evaluate whether clinical performance has been improved or maintained."

Acceptable Types of Patient Care Practice Improvement Activity

ABMS Patient Safety Module Core Measures o Acute Myocardial Infarction: aspirin on arrival  o Acute Myocardial Infarction: ACE inhibitor or ARB given for LVSDo Acute Myocardial Infarction: Beta-blocker within 24 hours of arrivalo Acute Myocardial Infarction: Fibrinolytic within 30 minutes of arrivalo Acute Myocardial Infarction: PCI within 90 minutes of arrivalo Pneumonia: Oxygenation assessmento Pneumonia: Blood cultures for ICU o Pneumonia: Blood culture before first antibiotic o Pneumonia: Antibiotic timing (within 4 hours; within 8 hours) PQRS Measures   o Aspirin at arrival for acute myocardial infarction. o Stroke and stroke rehabilitation: deep vein thrombosis prophylaxis (DVT) for stroke or intracranial hemorrhage. o 12-lead electrocardiogram (ECG) performed for non-traumatic chest pain.o 12-lead electrocardiogram (ECG) performed for syncope.o Community-acquired pneumonia (CAP): vital signs.o Community-acquired pneumonia (CAP): assessment of oxygen saturation.  o Community-acquired pneumonia (CAP): assessment of mental status.  o Community-acquired pneumonia (CAP): empiric antibiotic.o Prevention of catheter-related bloodstream infections (CRBSI): CVP insertion protocol Door to Balloon Time Sepsis Pathways

Stroke Protocol/Pathways Activation Asthma Pathways Throughput Time Measures Door to Doctor Times Left without Being Seen Unscheduled Return Visits Patient Call Back Program: Assessment of Clinical Care Given (not a satisfaction survey)

Patient Care Practice Improvement

Paulo the Attestor

When to attest

One required year in year 1-4 and one in years 5-8.For those required (year 2013 and on) one one PI done and attested to in 2010 through 2013.Stroke care pathway will cover initially until we need a new project 2015.

I would recommend everyone attest to completing the project this year.

Year        LLSA        PI activity year range.2011        6                none    2012        7                none2013        8                2010 through 20112014        8                2010 through 20122015        8                2010 through 20132016        8                2011 through 2014  ***2017        8 *cp starts 2010 through 2011 and 2012 through 2015   2018        8  cp           2010 through 2012 and 2013 through 20162019        8  cp           2010 through 2013 and 2014 through 20172020        8  cp           2010 through 2014 and 2015 through 2018

Bottom Line this will not impact you.  You must go online and attest only.

Activity Details Activity    Local ActivityActivity / Program Name    Acute Stroke Care Activity Location / Organization Name    San Diego Medical Center/Kaiser Foundation Hospital Dates you performed the activity: 04/01/2010-04/18/2011Step 1. My program included reviewing the following patient care data from at least ten of my patients: Clinical care processes Outcomes of clinical care Step 2. I compared my data to the following clinical standards: Evidence-based guidelines Expert consensus Comparable peer data Step 3. I developed and implemented a PI plan, either individually or as part of a group, in the following areas: Clinical reminders Personal education Change in systems or process Clinical pathway

Step 4. Using patient care clinical data from at least ten additional patients of mine, with the same presentation, disease or clinical process as the first patient data review, I re-measured my clinical performance: Yes My clinical performance improved or maintained the standard I used in Step 2: Yes

Step by Step Instruction for Attestation

After signing into ABEM.org, click on EMCC Online

Step by Step Instruction for Attestation

Click on Assessment of Practice Performance

Step by Step Instruction for Attestation

Click on Attest for PI

Step by Step Instruction for Attestation

Click on Update License(s)

Step by Step Instruction for Attestation

After updating License Info, Select Stroke Protocol/Pathways

Step by Step Instruction for Attestation

Fill out section as noted above and then click Continue

Step by Step Instruction for Attestation

Confirm information and Check box and Click on Save and Continue

Step by Step Instruction for Attestation

Fill out Verifier Info as above and Click on Save and Submit

Step by Step Instruction for Attestation

Click on Attest for Communication and Professionalism

Step by Step Instruction for Attestation

Select MAPPS for Communication and Professionalism Activity

Step by Step Instruction for Attestation

Fill out Attestation as noted above and Click Continue

Step by Step Instruction for Attestation

Verify info, Check box and Click Save and Continue

Step by Step Instruction for Attestation

Fill out Verifier Info as above and Click on Save and Submit

Questions?