Accreditation Council for Graduate Medical Education

E M di i RRC U dEmergency Medicine RRC UpdatesCORD at ACEP13

Seattle, WA

Philip Shayne, MDVice-ChairReview Committee for Emergency MedicineReview Committee for Emergency Medicine

DisclosuresDisclosures

RRC-EM Composition – AY 2013-2014RRC EM Composition AY 2013 2014

AMERICAN BOARD OF EMERGENCY MEDICINEMichael Beeson, MD Philip Shayne, MD Vice-ChairWallace Carter, MD, Chair Earl Reisdorff, MD, Ex-officio

COUNCIL ON MEDICAL EDUCATION (AMA)Amy Church, MD Christine Sullivan, MDS P MDSusan Promes, MD

AMERICAN COLLEGE OF EMERGENCY PHYSICIANSLance Brown MD Suzanne R White MDLance Brown, MD Suzanne R. White, MD Victoria Thornton, MD Marjorie Geist, Ph.D., Ex-officio

EMERGENCY MEDICINE RESIDENTS ASSOCIATIONEMERGENCY MEDICINE RESIDENTS ASSOCIATIONBrandon Allen, MD

RRC-EM Staff – AY 2013-2014RRC EM Staff AY 2013 2014Accreditation Council for Graduate Medical Education

Felicia Davis, MHAExecutive DirectorRCs for Diagnostic Radiology Emergency Medicine & Nuclear MedicineRCs for Diagnostic Radiology, Emergency Medicine & Nuclear Medicine

Sara L. ThomasSenior Accreditation AdministratorSenior Accreditation AdministratorRC's for Emergency Medicine, Diagnostic Radiology & Nuclear Medicine

Lauren JohnsonAccreditation AdministratorRCs for Diagnostic Radiology, Emergency Medicine, and Nuclear Medicine

Review Committee Meeting Activities and Actions for September 2013Actions for September 2013

Approved Applications Continued Accreditation

Withdrawal  Other ActionsAccreditation

Emergency Medicine

3/3 2/2 0

Medical 0/1 2/2 0

Approved Format and Complement R t

0

Medical Toxicology

0/1 2/2 0

Pediatric EM 0/1 1/1 0

Requests

Progress or Duty Hour Reports

5

Undersea and Hyperbaric Medicine

0 1/1 0

EMS 12/13 0 0

pReviewed

EMS 12/13 0 0

SportsMedicine

1/1 0 0

New Core EM Programs

• Kaiser Permanente Southern California ProgramKaiser Permanente Southern California Program • Matthew Silver, MD

• University of Missouri-Columbia School of Medicine Program • Marc Borenstein MDMarc Borenstein, MD

• New York Medical College at St Joseph’s g pRegional Medical Center Program • Otto Sabando, DO

New EMS Programs

• 34 EMS programs have received initial34 EMS programs have received initial accreditation to date

February 2014 Meeting DeadlineDeadline

• The deadline for receipt of information or materials is December 13, 2013 in order to be reviewed at the February 21-22, 2014 RC M tiMeeting

Program Requirement Revisions & UpdatesRevisions & Updates

• EMS (New)( )• Effective 9/30/2012

• Core Emergency Medicine (Revised)g y ( )• Effective 7/1/2013

• Medical Toxicology (being revised)Medical Toxicology (being revised)• Will be posted for review and comment soon

• All Program Requirements updated forAll Program Requirements updated for NAS • (core detail and outcome categorizations)(core, detail, and outcome categorizations)

New Public Member of EM RC

• ACGME Board recommendation for all ReviewACGME Board recommendation for all Review Committees

• To foster accountability to the needs of the greater public and create a transparency to the work of the Committee.N i h ld t b MD ( ) di tl• Nominees should not be an MD or person(s) directly related to GME (i.e. GME coordinator, faculty members)members)

• Shall be appointed for a 6-year term

Next Accreditation System (NAS) Next Accreditation System (NAS) G lG lGoalsGoals

• Accredit programs based on outcomes

F d t i t• Free good programs to innovate

• Provide public accountability for outcomesProvide public accountability for outcomes

• Produce physicians for 21st centuryp y y

• Reduce the burden of accreditation

© 2013 Accreditation Council for Graduate Medical Education (ACGME)

How Can Programs Innovate in NAS?How Can Programs Innovate in NAS?How Can Programs Innovate in NAS?How Can Programs Innovate in NAS?

• Program Requirements classified:• Program Requirements classified:• Outcome

C• Core• Detail

• Programs in good standing*:g g g• May freely innovate in detail standards

© 2013 Accreditation Council for Graduate Medical Education (ACGME)

What are core, detail and outcome program requirements?program requirements?

• Core Requirements: Statements that define structure, l t ti l tresource, or process elements essential to every

graduate medical educational program.• Detail Requirements: Statements that describe aDetail Requirements: Statements that describe a

specific structure, resource, or process, for achieving compliance with a Core Requirement. Programs in substantial compliance with the Outcome Requirementssubstantial compliance with the Outcome Requirements may utilize alternative or innovative approaches to meet Core Requirements.

• Outcome Requirements: Statements that specify expected measurable or observable attributes (knowledge abilities skills or attitudes) of residents or(knowledge, abilities, skills, or attitudes) of residents or fellows at key stages of their graduate medical education.

* Core v. Outcome v. Detail

• The program must monitor and track each ofThe program must monitor and track each of the following areas: • including performance of program graduates on

the certification examination; (Core)• V.C.2.c).(1) At least 80 percent of a program’s graduates from

the preceding five years who take the American Board of t e p eced g e yea s o ta e t e e ca oa d oEmergency Medicine certification exams for emergency medicine for the first time must pass. (Outcome)

• program quality; and (Core)program quality; and, (Core)• V.C.2.d).(1) Residents and faculty must have the opportunity to

evaluate the program confidentially and in writing at least annually (Detail)annually (Detail)

NAS Timeline: Phase 1 SpecialtiesNAS Timeline: Phase 1 SpecialtiesNAS Timeline: Phase 1 SpecialtiesNAS Timeline: Phase 1 Specialties• July 2013: NAS Goes live

• New ACGME policies go into effect – no more proposed adverse actions

• July – August 2013July August 2013• EM programs complete ADS annual update

• October 2013• NAS data reports for EM made available to RC staff

• November – December 2013Milestones reporting• Milestones reporting

• Programs notified of requested site visits or due dates for clarification reports

• February 2014• Emergency Medicine RC conducts first NAS program reviews

© 2013 Accreditation Council for Graduate Medical Education (ACGME)

Clinical Competence CommitteeClinical Competence Committee© 2013 Accreditation Council for Graduate Medical Education (ACGME)

Clinical Competence CommitteeClinical Competence Committee

E d fSelf

E l tiCase LMock End of

Rotation Evaluations

Evaluations LogsOperative

Performance Rating

Orals

ITEUnsolicitedComments

Student Evaluations

Scales

Nursing and

ITESimLab

Clinical Competence

EvaluationsAncillary

Personnel Evaluations Clinic Work

Place Competence Committee

Peer Patient / A t f

EvaluationsOSCE

Evaluations Family Evaluations

Assessment of Milestones

CCC: How many faculty?CCC: How many faculty?CCC: How many faculty?CCC: How many faculty?

• Ideally five (or more) for broad consensusIdeally five (or more) for broad consensus

• Recognize small programs may have fewer

• May have to pre-review before discussion

© 2013 Accreditation Council for Graduate Medical Education (ACGME)

MilestonesMilestones• Milestones reporting for Phase I specialties expected

N b 1 D b 31 2013November 1 – December 31, 2013

• Second milestones reporting expected May 1 – June 15, p g p y2014

• ADS screens for milestones data entry completed andADS screens for milestones data entry completed and will be made available Nov 1

R t ill b id d t di l i ll• Reports will be provided to programs displaying overall performance by cohort

• Narrative reports will be provided to programs for formal feedback

Levels 1-5

Hover over radio-b tton to shobutton to show narrative

Questions??