Vivacity Consulting

Bringing energy and experience to your CME activity

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Quality Improvement (QI) and Me

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Stretch Assignment: 5 toe touches and a QI Initiative

We CME professionals often go about our day, working feverishly to ensure compliance for upcoming events and to finish the file for completed events. We all know that there is change brewing in healthcare, but if we have a chance to think about the big picture, it may not include the idea that quality improvement (QI) is in our wheelhouse. Well, some have suggested IF NOT US, THEN WHO?! 

Remember: the ACCME/IMQ requirements are not just rules we have to follow. They are designed to facilitate the planning of education which will enable/inspire physicians to do their jobs better.

During a recent webinar regarding the ACEhp’s Education Initiative, Jack Kues defined quality improvement as the process by which current practice is moved towards best practice. Isn’t that what we CME professionals do all day, every day?

In the same webinar, Robin King stated that we need to remember to help practitioners implement best practices in their practice setting if we are going to initiate any change. This is our stretch assignment, because although we think about barriers to implementation, how many of us actively plan to address these barriers? We still buy-in to Francis Bacon’s statement that knowledge is power. (He was an Elizabethan from the 17th century. We now know it takes more than knowledge to change behavior.) 

As we CME professionals take ownership of this QI issue, or at least, an appropriate portion of the ownership, we can be part of the change. I’m ready. Are you?

CME Consultant Musings: If I Ruled the World

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Caution: CME Consultant at Work

If I ruled the world, educational activity objectives would be measurable every time. The word “understand” would be outlawed.

If I ruled the world, disclosure forms would be turned in 2 weeks BEFORE the deadline, completely filled out, signed and dated.

If I ruled the world, all of my activity data would batch upload into PARS at the ACCME the first time.

If I ruled the world, hospital IT departments would seamlessly allow emails about upcoming CME activities to flow, and would allow CME staff to participate in webinars using any webinar software the vendor suggests.

If I ruled the world, every ACCME Progress Report and IMQ Interim Report issued would also come with a box of See’s Candy dark chocolate covered mint patties. (That’s only fair.)

If I ruled the world, every Quality Department in the hospital would talk to the staff in the Medical Education office and figure out how they could help each other reach their goals.

If I ruled the world, the public would understand that continuing medical education is NOT a vehicle to get more money into doctor’s pockets but instead the best possible way to ensure health professionals are providing best-practice, evidence-based care to them and their loved ones.

Whoops, there’s that word understand. I guess I would outlaw that word for everyone but me, if I ruled the world!

(Musing: A product of contemplation; a thought.)

Perspectives on PARS

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The ACCME’s PARS – Program and Activity Reporting System

Ready or not, it’s time to get ready for another year of data input into PARS. PARS is the online data input system all ACCME providers and soon, all state providers, must use to input detailed date regarding their CME program. It’s a lot of data.

What happens to all of this data? Why are we, providers, required to enter so much information (even more in 2014!)

According to the ACCME, the data entered “will provide a more detailed and comprehensive picture of the national CME enterprise and assist the ACCME, accredited providers and other stakeholders in demonstrating the value and scope of CME.”

My opinion is that much of this data probably is useful to the ACCME behind the scenes, in the way that providers’ individual activity data can be useful as a guide to the development of overall educational curriculum. (See my post about Criterion 6 as an example of this.)

However, I think it’s providers who ultimately will need to make the argument on behalf of accredited CME. I want to call out a fantastic presentation from the recent Alliance for CE in the Health Professions Annual Conference. I didn’t get t see it live, but I saw a Tweet from Erik Brady, PhD about it, and so I downloaded the slides when I got home.  The talk is titled, “Estimating Healthcare Cost Savings Resulting from CME Activities Using the Outcomes Impact Analysis Model.” It was presented by Dana Ravyn, PhD, MPH, Scientific Director, and Rob Lowney, BA, MBA, Managing Director, CMEology, West Hartford, CT, West Hartford, Connecticut. In a nutshell, “CME-related learning, when favorably affecting clinical practice, can yield substantial cost savings…” in this instance, over $5 MILLION as a result of the decrease in surgical bleeding-related complications and reoperation for bleeding.

$5 MILLION! 

How would you like to walk into your Director or CEO’s office and tell them you can potentially save your organization millions??? Obviously, we have a ways to go before we get there. But in the meantime, kudos to CMEology, don’t forget to enter your data into PARS, and then let’s get to work!

Using Data to Improve Medical Education

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A Case-Study: Using Data From Participant Evaluations

When the ACCME came out with the new Criteria (back in the 2000s!), many of us from  non-hospital-based organizations struggled to understand how to incorporate the concept of using data into our planning process. I remember whining a lot. “We’re a specialty society. We don’t have patient data!”  Not only that but, “we only see our attendees one time a year!”

Flash forward 7 years. The SAGES Continuing Medical Education Committee is pleased to announce the publication of the article entitled, “Evolution of practice gaps in gastrointestinal and endoscopic surgery: 2012 report from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Continuing Education Committee.” In this article, we describe the process by which we have collected data from our attendees through post-activity surveys, analyzed this data by “Learning Themes,” and then identified potential practice gaps which have or may be addressed at future educational activities.

If you have a subscription, you can access the article here:

http://link.springer.com/article/10.1007%2Fs00464-013-3263-2

I just read that some journal publishers are getting tougher about copyright violations, so message me if you would like me to send you a “draft” version of the paper. I’ll present a summary of this work during CMEPALOOZA, a web-conference being held March 20, 2014.

And congrats to my co-authors who did the bulk of the data work,

  • John T. Paige, MD
  • Timothy M. Farrell, MD
  • Simon Bergman, MD
  • Niazy Selim, MD
  • Alan E. Harzman, MD
  • Yumi Hori,
  • Jason Levine,
  • Daniel J. Scott, MD

Turns out specialty societies actually do have the ability to collect valuable data, and there are ways of using this data to, dare I say, improve the education delivered.

CME Research – Let’s Get Serious

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Does CME Research Impact My Job?

Every time the JCEHP arrives in my in-box, I’ll admit it,  I groan a little. Will it be another study about improvements made by implementing an ongoing clinical intervention connected to a patient outcomes tracking system? Many of us don’t have access to something so sophisticated (or expensive).

Or maybe it’s another “Framework” for doing something – measuring outcomes, assessing effectiveness, etc, etc. Who has time to implement another framework?! I’ve got work to get done!

But recently, one of my physician clients asked in all seriousness, “Is there really a correlation between being ACCME compliant and providing an excellent meeting experience for attendees?” My gut answer is a resounding, “YES!” And lucky for me, many of our esteemed colleagues have created an incredible pool of proof, in the JCEHP and elsewhere, putting their time and possibly tears into producing research that backs up my experience with data.

Ah, data. Tricky thing, data. Tricky to collect, tricky to analyze, tricky to write up.

So to those of you who are contributing to this important and evolving area of study, THANK YOU! And to the rest of us, let’s get serious. Serious about how important it is to support those who work to improve our profession. If research isn’t your thing, perhaps you can inspire others to participate?

The editors of the JCEHP recently published a helpful editorial, pointing out errors that are often made when reporting evaluations of educational outcomes. This will be useful as I work with one of my clients to finalize the update to this manuscript. I commit to doing everything I can to support this effort and advocate/nag them into producing the next update as soon as possible.

Will you join me?

 

 

Can CME Make You Happy?

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Or, Is It Possible to Follow CME Rules/Regulations/Criteria and Still Be Happy?

Often, new clients come to me when they are drastically unhappy. Their organization has received a Progress Report or Interim Report or even a Probation decision, and they don’t know what to do. Or they have had a staff member leave and they have to do the job now. Or they are a physician struggling to apply the CME criteria to their upcoming educational activity.

So a big part of my job is to help these very unhappy people find the fun in the challenges facing them.

“Fun?!” you may say, “Where’s the fun?” I once had an otolaryngologist say to me, “You really love this. I can tell. You love it ….” Implying that HE did not.

Perhaps my love of continuing medical education is a bit over the top, but I have found a few tricks over the years which help on those down days or weeks. You can do this as well. Here’s some ideas to turn the perceived burden of CME into an opportunity to be happy:

1. List your successes. Did you make a change to your evaluation form that helped you collect better data? Did you find an interesting journal article that describes a best practice? Did a physician provide an excellent practice gap on their CME activity request application? Research shows that writing down small positive memories enhances your mood, and this is as true in work life as in personal life.

2. Share your list with others. Incorporate successes into your Medical Education Committee agenda. Solicit successes from your Chairs and highlight them in your newsletter.  See this blog post about how one of my clients made Criterion 6 useful.

3. Smile. People react to positively to body language, and I have found this is true even when they cannot see you. Smile when you are talking, even on the phone, and you will be amazed at the change.

4. Remember that you are on a continuum. The ACCME rewards programs for growth and improvement. Rome wasn’t built in a day. Track your successes and set goals for the future.

If you want to hear an amazing talk about Happiness, listen to Nataly Kogan’s TedXBoston talk here. Also, I would recommend Gretchen Rubin’s book, The Happiness Project, and her blog on the same subject.

(Credit to http://terriblycute.com/ for the dog photo!)