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ACGME OUTCOME PROJECT : THE PROGRAM COORDINATORS ROLE Jim Kerwin, MD University of Arizona

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Objectives Review the ACGME Outcome Project Concept Review the ACGME Outcome Project Concept Identify the Outcome Project Timeline Identify the Outcome Project Timeline Acknowledge the Significance for Recertification Acknowledge the Significance for Recertification Identify the Program Coordinators Role Identify the Program Coordinators Role

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Accountability Shift from process centered focus to Shift from process centered focus to product /outcome focus product /outcome focus Are we producing competent physicians?

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Competencies: The SIX Domains

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PATIENT CARE Performs critical evaluation of data including risk awareness Develops appropriate patient management plans Implements appropriate patient management plans

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PATIENT CARE Demonstrates timely completion of clinical tasks Counsels and educates patients and families Attends to disease prevention and health care maintenance Demonstrates competency in relevant procedural skills Manages time efficiently

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MEDICAL KNOWLEDGE Demonstrates an investigative and analytic thinking approach to clinical situations Demonstrates appropriate fund of medical knowledge Applies basic, clinical, epidemiological and social-behavioral sciences to patient care

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INTERPERSONAL AND COMMUNICATION SKILLS Demonstrates active listening skills Able to elicit appropriate information Communicates effectively

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INTERPERSONAL AND COMMUNICATION SKILLS Documentation and Records The documentation in medical records is: The documentation in medical records is: Accurate Accurate Complete Complete Legible Legible Completes medical records in a timely manner Completes medical records in a timely manner

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INTERPERSONAL AND COMMUNICATION SKILLS Colleagues and Supervisors, Consultants, Support Staff Presentations are concise Presentations are relevant Works effectively as a leader

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INTERPERSONAL AND COMMUNICATION SKILLS Patients and Families Educates patient and family Communicates at patients education level Demonstrates respect, sensitivity and responsiveness to full spectrum of patients diversity

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INTERPERSONAL AND COMMUNICATION SKILLS Patients and Families Provides patient with clear instructions Provides clear plan for patient follow-up Maintains familial involvement

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Demonstrates respect Shows integrity: unity between principles and actions Maintains confidentiality Demonstrates ethical behaviors Maintains appropriate appearance with respect for surroundings and others Demonstrates emotional stability/maturity PROFESSIONALISM

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PROFESSIONALISM Demonstrates appropriate personal health behaviors Reliably completes assigned duties Uses feedback to improve performance Reports to clinical activities on time Answers pages in a timely fashion Prioritizes and balances required curricular activities, optional extra curricular activities and personal life

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SYSTEMS-BASED PRACTICE Practices cost effective health care Practices quality health care Demonstrates : Appropriate use of diagnostic tests Appropriate use of referrals/consults Appropriate use of alternative treatments Provides complete documentation for billing

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SYSTEMS BASED PRACTICE Acts as a patient advocate Collaborates with health care providers/managers (social services, home health, mental health) Coordinates discharge planning Coordinates follow-up

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PRACTICE BASED LEARNING AND IMPROVEMENT Applies evidence-based medicine to patient care Uses information technology to improve fund of knowledge Teaches student and other health professionals

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Review Curriculum Identify Specific Knowledge, Skills, and Attitudes Obtain Faculty Buy-In Define Specialty Specific Competencies Develop Tools to Assess Competency Identify Process to Implement Tools PHASE 1 Initial Response (2001 - 2002) PHASE 2 Define Competencies and Tools (2002 - 2006) PHASE 3 Integration (2006 - 2011) PHASE 4 Expansion (2011& beyond) Strategy to Implement Competency Based Education ACGME Outcomes Project

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RRC Review Minimal threshold model: Program review identifies whether or not a program has the potential to educate residents Minimal threshold model: Program review identifies whether or not a program has the potential to educate residents Program Director must offer documentation that the residents achieve the learning objectives set by the Program. Program Director must offer documentation that the residents achieve the learning objectives set by the Program.

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Improvement of Residency The Program should have a process to evaluate residents and itself The Program should have a process to evaluate residents and itself The Program must offer documentation of continuous improvement in the residency educational process The Program must offer documentation of continuous improvement in the residency educational process

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Program Coordinator Role Key role in Key role in Planning Planning -new or revised program goals -workshops, meetings, conferences

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Program Coordinator Role Key role in Key role in Evaluation Evaluation Whatever we measure we tend to improve.

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Program Coordinator Role Key role in Key role in Documentation Documentation Technology Advances

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Program Coordinator Role Key role in Key role in Communication Communication facilitating team integration liaison with students, faculty, staff, and everybody else recruits

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Program Coordinator Role Key role in Key role in Recertification Recertification