ACCME March Board Meeting: Dialogue and Decisions

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The Accreditation Council for Continuing Medical Education (ACCME) has released the executive summary of its Board of Directors meeting, held March 15 –16, 2011, at its Chicago offices.  According to the executive summary, the ACCME ratified 45 accreditation and reaccreditation decisions, including 10 providers (22%) that received Accreditation with Commendation, which confers a six-year term of accreditation. The list of accredited providers on the ACCME Web site will be updated in May 2011 to reflect the March 2011 accreditation decisions.

The ACCME has now completed accreditation reviews for 458 accredited providers using the 2006 Accreditation Criteria. In total, there are 691 ACCME-accredited providers and 1,466 providers accredited by ACCME Recognized Accreditors (state or territory medical societies that accredit local organizations offering CME).

There are two graphs in the executive summary; one shows overall compliance results for each criterion from November 2008 through March 2011, while a second graph shows compliance results for the March 2011 cohort.  The differences in the graphs show that compliance has significantly improved over the last few years.

Dialogue Session with Stakeholders

The executive summary also discus a strategic dialogue session held by the Board in March, with stakeholders to gather input about three areas:

  • The ACCME’s accreditation process;
  • The connections between the ACCME, accredited CME, and the emerging Maintenance of Licensure and Maintenance of Certification® programs; and
  • How to build on the ACCME’s Bridge to Quality™ model to further enhance accredited CME’s value.

The dialogue session built on the discussions held during the ACCME’s December 2009 Roundtable, the work done by the ACCME Board of Directors’ 2010 task forces, and the interactive forums the ACCME has convened with various stakeholder groups.  During this session, it was noted that “the needs of MOC are addressed by the ACCME accreditation requirements.” 

In addition, the summary of the session noted that the ACCME needs to increase enforcement of the Standards for Commercial Support: Standards to Ensure Independence in CME Activities to assure that CME is above reproach. Specifically, the summary stated that this effort needs to be supported by the member organizations, credit systems, providers, and physician learners.

Accordingly, it recommended that ACCME explore whether all noncompliance issues are the same and differentiate the egregiousness of violations. Additionally, the ACCME could use focused interventions to close compliance gaps.  Ultimately, it was noted that stakeholders are examining the next level of commercial support issues: are there direct financial relationships between physicians and industry that should preclude physicians’ participation in CME?

Accreditation Decision-Making: Accreditation with Commendation; Nonaccreditation

During their March meeting, the Board clarified eligibility requirements for providers that seek a change in status from Accreditation to Accreditation with Commendation after receiving a noncompliant finding for an ACCME policy. To be eligible for a change in status, a provider must have been found compliant with Accreditation Criteria 1-15 and have no more than one noncompliant finding for relevant ACCME policies or one noncompliant finding for Criteria 16 – 22. Once the provider demonstrates that it has come into compliance through an accepted progress report, it will be eligible for a change in status.

The Board amended the policy concerning Nonaccreditation decisions. From now on, Nonaccreditation decisions will be effective immediately, unless the ACCME Board of Directors specifies otherwise. Previously, the policy stated that Nonaccreditation decisions became effective one year after the decision, except in egregious cases, when a shorter timeframe could be implemented. The Board made the modification to bring the policy in line with the ACCME’s current decision-making practices, and to strengthen the ACCME’s oversight and accountability.

Reporting of In-Kind Commercial Support

The Board modified the requirement for reporting in-kind commercial support, in response to provider feedback. Since the early 1990s, the ACCME has required providers to quantify the dollar value of in-kind commercial support (for example, when a company loans a provider a device to use for teaching purposes). All commercial support, whether in-kind or cash, is aggregated and listed in one commercial support category in the ACCME annual reports. Providers told ACCME however, that it is not always possible to determine accurate, standardized estimates for the dollar value for in-kind support, and that information about the type of in-kind support would be more meaningful and valid.

With the Program and Activity Reporting System in place, ACCME said it can offer providers an easy method for reporting the type of in-kind support they receive. As a result, ACCME noted that the modification will increase transparency, enabling ACCME to produce more detailed trend data about commercial support. The ACCME will communicate the requirement modification and implementation timeframe to providers.

Intrastate Accreditation System

The Board adopted “The ACCME’s Recognition Process: Responsibilities of Maintenance of Recognition.” The continuous Maintenance of Recognition approach improves the quality, value, and efficiency of the recognition process, and enables the ACCME and Recognized Accreditors to identify areas for improvement on an ongoing basis. To further support the intrastate accreditation system, the Board expanded the CRR from seven to nine members.

Elections

The Board elected Stuart L Abramson, MD, PhD, to serve on the Accreditation Review Committee.

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