The Accreditation Council for Continuing Medical Education (ACCME) recently announced a new four-part video interview series that discusses how the ACGME’s Next Accreditation System (NAS) supports physicians’ continuous professional development and explores opportunities for medical education accreditors and hospital leaders to collaborate to improve health care safety and quality. The interview series is with Timothy P. Brigham, MDiv, PhD, Chief of Staff and Senior Vice-President, Department of Education, Accreditation Council for Graduate Medical Education, (ACGME).
As Brigham explained, the NAS moves away from a catch them being bad model to a quality improvement model. In other words the ACGME is moving away from torturing the really good programs to find the toxic ones to one where we celebrate and reward the really good ones and everybody, the ACCGME, the ARCs within the ACCGME and the good programs work to help the programs that are struggling a little bit to move up. A fundamental building blocks of that are the CLER visits, which CLER stands for Clinical Learning Environment Review, where the ACGME visiting every institution , every sponsoring institution in the country, every 18 months to ascertain how the residents are integrated into the safety and quality movements of the hospital.
And that has all kinds of ramifications from duty hours to supervision to handovers to seeing how the residents are involved, all of the residents not just one or two who are on a committee of safety, are really integrated into learning about safety and quality and helping their institutions become a safer place. In most institutions, ACGME found there’s a bit of parallel play going on, where the residents are doing one thing, taking care of most of the patients and there’s this sort of rigorous robust safety and quality movement that does not engage them at all. So, they’re not learning, they’re not contributing to it and the hospital’s struggling because the residents are doing a lot of the patient care if not most of it.
The second piece of the next accreditation system if you move from the CLER as sort of the foundation, making sure that the institution has all those qualities that the ACGME wants to see in an institution that will be educating our residents, future physicians , is a model of continuous improvement. Accordingly, the RRCs instead of episodically biopsying the program, will be getting information on an annual basis that they can look at and say, this indicates that the program is going along in a fine way or there may be something going on in here and we’re going to have to take a look at it.