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Residency Review Committee for Emergency Medicine Report to CORD Art Sanders, MD, Chairman October 2004

Residency Review Committee for Emergency Medicine Report to CORD Art Sanders, MD, Chairman October 2004. RRC for Emergency Medicine. AMERICAN BOARD OF EMERGENCY MEDICINE Dane Chapman, M.D. Daniel Danzl, M.D., Vice-Chair Rebecca Smith-Coggins, M.D. MaryAnn Reinhart, Ph.D, Ex-officio

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Residency Review Committee for Emergency Medicine Report to CORD Art Sanders, MD, Chairman October 2004

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  1. Residency Review Committee for Emergency MedicineReport to CORDArt Sanders, MD, ChairmanOctober 2004

  2. RRC for Emergency Medicine • AMERICAN BOARD OF EMERGENCY MEDICINE • Dane Chapman, M.D. • Daniel Danzl, M.D., Vice-Chair • Rebecca Smith-Coggins, M.D. • MaryAnn Reinhart, Ph.D, Ex-officio • COUNCIL ON MEDICAL EDUCATION (AMA) • Louis S. Binder, M.D. • Charles K. Brown, M.D. • Arthur Sanders, M.D. , Chairman • AMERICAN COLLEGE OF EMERGENCY PHYSICIANS • Francis Counselman, M.D. • Sandra Schneider, M.D. • David Overton, M.D. • Marjorie Geist, Ph.D., Ex-officio • EMERGENCY MEDICINE RESIDENTS ASSOCIATION • Kelly Corrigan, M.D.

  3. Review of Applications (9/2004) Committee Action September 2004 2nd Review of Program Application Confirmed Withhold 01 1st Review of Program Applications Proposed Withhold 02 Provisional Accreditation 02 • UMNDJ-New Jersey Medical School (Newark) • University of Utah (Salt Lake City)

  4. Status Decisions Accreditation Cycle • 2 Provisional - 3 year cycles • 2 Full Accreditation - 3 year cycle • 6 Full Accreditation - 4 years/7 years pilot • 6 Full Accreditation - 5 years/8 years pilot

  5. RRC-EM Pilot Project • Extend max accreditation cycle from 5 to 8 yrs • Require yearly QI indicators of the program • Update of citations • Changes in program • Procedures, resuscitations of graduating residents • ED volume, faculty supervision • Resident survey yearly

  6. RESIDENT SURVEY • 3 year plan to survey 1/3 of residents each year for 3 years • Year 1 had 85% compliance rate and over 25,000 respondents • Survey programs with 5 residents or more • Survey January through April • Internet based – Average 9 minutes to complete

  7. RESIDENT SURVEY • Used by site visitors as additional data element to augment resident interview and as early warning of non-compliance indicator • 32 Questions pertaining to Duty Hours, Competencies, Evaluation, and Supervision • Ability for residents to enter comments and/or connect to confidential resident complaint system

  8. RESIDENT SURVEY • PDs and DIOs have access to aggregate reports if compliance is 70% or higher • Plan to have every resident complete survey annually (5 or more in program) • Plan to add Specialty specific questions to aid in program review

  9. RRC-EM Pilot Project • It is inappropriate to claim that programs in the pilot with longer accreditation cycles are better than other programs.

  10. New Program Requirements • Approved in June 2004 • Effective January 2005 • Competencies - Guidelines on Competencies • Yearly competency assessment, 3 procedures, 3 chief complaints, 1 resuscitation, 50% off service • Duty Hours • New PIF

  11. Program Requirements RevisionSubspecialties • Toxicology • Pediatric Emergency Medicine

  12. New PIF Questions on Clinical Operations • ED volume and supervision ratio • Time to CT scan, blood, etc. • Throughput time for admitted and discharged pts. • Ambulance diversion time • On call consultants

  13. New PR - Clinical Operations • The hospital must assure that all clinical specialty and subspecialty services are available in a timely manner…If any clinical services are not available for consultation or admission, the hospital must have a written protocol for provision of these services elsewhere. This may include written agreements for the transfer of these patients to a designated hospital that provides the needed clinical services. (PR II.E.2)

  14. Guideline - EM Faculty Qualifications • All EM faculty supervising EM residents on EM rotations must be board certified by ABEM or have appropriate qualifications in EM. Examples of educational qualifications acceptable to the RRC: • Certification by the AOBEM • Certification by a subspecialty board of ABEM • Recent residency or fellowship graduates working toward certification by the above Boards • Qualifications must be relative to the pt population supervised

  15. RRC-EM Outcomes Project • RWJ Grant to ACGME - Competency Project • To identify patient care quality measures that are appropriate to use to assess the outcomes of GME in EM • To link patient care quality measures in EM to the quality and effectiveness of GME • Can accreditation decisions be outcome rather than process based?

  16. RRC Report to CORD • Questions???

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