Annual meeting of coordinators for CME activities

1. Annual meeting of coordinators for CME activities University of Vermont College of Medicine Continuing Medical Education April 3, 2012

2. Disclosures • No relevant financial relationships to disclose Cheung Wong, MD

3. Objectives of meeting • UVM CME office • Staff • Undergoing Reaccreditation • Decision to be announced March, 2013 • Recognize the efforts of CME coordinators in conducting CME accredited activities • Review mechanism for planning, monitoring and evaluation of CME activities

4. UVM CME Who are we? • Cheung Wong, M.D. • Associate Dean for CME, UVM COM • Department of Obstetrics/Gynecology, FAHC • E-mail: cheung.wong@uvm.edu

5. UVM CME Who are we? • Terry Caron • Director of CME, UVM COM • Conference coordinator • E-mail: terry.caron@uvm.edu • Phone: 802-656-2292

6. UVM CME Who are we? • Mary Gagné • Regional Program Coordinator • Conference coordinator • E-mail: mary.gagne@uvm.edu • Phone: 802-656-2275

7. UVM CME Who are we? • Kate Martin • Conference Coordinator • E-mail: katherine.martin@uvm.edu • Phone: 802-656-8449

8. UVM CME Who are we? • Natalie Remillard • Conference Coordinator • E-mail: natalie.remillard@uvm.edu • Phone: 802-656-2292

9. UVM CME Who are we? • Karen Whitcomb • Regional Program Assistant • E-mail: karen.whitcomb@uvm.edu • Phone: 802-656-2292

10. UVM CME Who are we? • Deborah Rhea • Conference Assistant • E-mail: Deborah.rhea@uvm.edu • Phone: 802-656-2292

11. UVM CME Who are we? • Sheila Dooley • Conference Assistant • E-mail: sheila.dooley@uvm.edu • Phone: 802-656-2292

12. UVM CME Who are we? • Michele Morin • Conference Assistant • E-mail: michele.morin@uvm.edu • Phone: 802-656-2292

13. UVM CME Who are we? • Moira Delahanty • Business/Accounting Specialist • E-mail: Moira.delahanty@uvm.edu • Phone: 802-656-2292

14. How should we communicate? • Phone: 802-656-2292 • E-mail: uvmcme@uvm.edu • Letter (CME office-Lakeside Avenue) • UVM CME web site • http://cme.uvm.edu • This meeting!

15. UVM CME activities • Postgraduate courses/seminars • Directly sponsored • Jointly sponsored • Regularly scheduled conferences • Grand rounds • M & M • Tumor boards • Lecture series

16. UVM CME Conducting CME activities • Planning and implementation • Monitoring • Evaluation

17. UVM CME Conducting CME activities • Planning and implementation • Monitoring • Evaluation

18. UVM CME Planning & implementation of CME activity • CME planning committee • Determines practice gaps/needs to be addressed • Sets goals and objectives to address the gaps/needs • Considers topics/formats appropriate to improving physician competence/performance or pt outcomes • Application forms • Disclosure forms • Commercial support form • Multiple speaker evaluation form • Forms at : http://cme.uvm.edu

19. UVM CME Planning & implementation of CME activity • All forms have been revised. • Forms • Application forms • Planning document • Checklist • Biographical data form • Disclosure forms • Disclosure statement/attestation form • COI resolution form • Disclosure documentation form • Monitoring form • Commercial support • Multiple speaker evaluation forms • Forms at : http://cme.uvm.edu

20. http://cme.uvm.edu

21. UVM CME website-forms

22. UVM CME – Planning DocumentREVISED Easier format - check off boxes - pdf instead of word doc. - “walk you through” gap/need analysis Some new info: - barriers - partners - new evaluation choices

23. UVM CME – Biographical data form

24. UVM CME Planning & implementation of CME activity • Forms • Application forms • Planning document • Checklist • Biographical data form • Disclosure forms • Disclosure statement/attestation form • COI resolution form • Disclosure documentation form • Monitoring form • Commercial support form • Multiple speaker evaluation forms • Forms at : http://cme.uvm.edu

25. UVM CME – Disclosure/attestation form Who Discloses? - Faculty - Course Director - Planning Committee What needs to be disclosed? Financial Relationship in the last 12 months with a commercialentity that provides healthcare products/services relevant to the topic of the presentation or series of presentations.

26. UVM CME – COI resolution form

27. UVM CME Conducting CME activities • Planning and implementation • Monitoring • Evaluation

28. UVM CME Planning & implementation of CME activity • Forms • Application forms • Planning document • Checklist • Biographical data form • Disclosure forms • Disclosure statement/attestation form • COI resolution form • Disclosure documentation form • Monitoring form • Commercial support • Multiple speaker evaluation forms • Forms at : http://cme.uvm.edu

29. UVM CME Monitoring of CME activity • Goals & objectives of activity communicated to learners prior to activity • Disclosure of sources of commercial support & relevant financial relationships from individuals controlling content (faculty andplanners) made to learners prior to activity • Relevant COIs resolved prior to activity • Completed disclosure documentation, COI, and monitoring forms collected and sent to UVM CME office

30. UVM CME – monitoring form • List Faculty • and • all planners. • Remember to post and sign! (Disclosure can be “posted” via PPT slide. Attach slide to signed form)

31. UVM CME Planning & implementation of CME activity • Forms • Application forms • Planning document • Checklist • Biographical data form • Disclosure forms • Disclosure statement/attestation form • COI resolution form • Disclosure documentation form • Monitoring form • Commercial support form • Multiple speaker evaluation forms • Forms at : http://cme.uvm.edu

32. UVM CME – commercial support form • List $ received and/or • In-Kind” contribution • Non-monetary such as equipment, supplies, etc. • Two signatures needed • Company Representative • UVM CME

33. UVM CME Conducting CME activities • Planning and implementation • Monitoring • Evaluation

34. UVM CME Evaluation of presentation • Activity was evaluated in terms of effectiveness at meeting objectives • Participants did not perceive commercial bias from the presentation • Changes/improvements in practice will result from presentation

35. UVM CME – immediate post activity evaluation form Affiliated/Jointly sponsored Grand Rounds

36. UVM CME Evaluation of overall activity • Did the activity adequately address an identified professional gap and result in improved physician knowledge, performance, or patient outcomes? • 3-4 month post-activity evaluation or chart audits, etc. (See planning doc for more options)

37. 3-4 Month Post Activity Survey(Sample) • 1. Regarding the treatment of osteoarthritis, my care for these patients has changed based on information presented at the course. • a. Yes • b. No • c. I do not see patients with this condition • 2. Based on what I learned at the course, I am now more likely to identify and treat osteoarthritis patients with NSAIAs. • a. Yes • b. No • 3. The lecture on “XXX” has altered at least one aspect of my use of “Z” in my practice. • a. Yes • b. No • c. I do not use “Z” in my practice

38. UVM CME – Planning document

39. Professional practice gap • Definition: “The difference between actual and ideal performance or patient outcomes.”

40. Planning Doc -Practice gaps • Examples: • Best/Ideal Practice: 100% of patients with osteoarthritis treated properly with NSAIAs. Current: Nationwide, only 20% of patients properly treated (AHRQ data). • Best/Ideal Practice: 0 Central Line Infections Current: X Central Line Infections last year due to significant variation in techniques. (Internal Data) • Best/Ideal: All shoes with laces would be tied Current: X% of providers have untied shoes (Observed)

41. Planning DocumentNeeds Analysis BASED ON THE GAPS…. What do the learners need to know, be able to do, or perform? (Knowledge, competence, performance) What strategy do they need to achieve “best practice”?

42. Planning Doc. - Needs Analysis • Examples: • Providers need to understand the use of NSAIAs in treating osteoarthritis (Knowledge) • Providers need to become standardized in their approach to central line placement. (Performance) • Providers need to tie their shoes so that fewer people trip. (Performance)

43. Objectives What can the learner expect to achieve by attending the lecture/event?

44. The participant should be able to… 1.1 …explain the use of NSAIAs in the treatment of osteoarthritis. 1.2 … determine when and how to properly use NSAIAs. 2.1 …discuss the need for a standardized approach in central line placement. 2.2 …successfully complete the standardized approach to central line placement. 3.1 …discuss the statistics of injuries associated with untied shoes. 3.2 …identify shoes that do not require laces.

45. Barriers (New) What potential barrier might prevent participants from implementing their new knowledge?

46. Evaluation (Revised) • Post Activity Evaluation – still required • 3-6 month measure of change still required but… • Other options: chart audits, patient outcomes… • Or, you may still prefer to do a follow up survey.

47. Summary • Activity planned by committee using multiple sources to identify gaps (QA, lit, evals) • Objectives tied to gaps/needs • Course structured to address gaps • Evaluation • Participants evaluated to assess change in knowledge and performance post activity • QA data analyzed to assess impact of activity

48. Case examples • Regularly scheduled conference • Tumor board

49. XYZ Hospital Planning & implementation of tumor board • XYZ Hospital conducts a weekly tumor board • The activity has a CME planning committee, comprised of a radiologist, a CME coordinator, an oncologist, a radiation therapist, a pathologist, and a surgeon • The committee identifies 2 specific objectives for the activity based on identified gaps in physician knowledge, performance, or in patient outcome for lung cancer patients:

50. XYZ Tumor Board Objectives • 1. Reduce the time interval for patients from presentation to diagnosis • Average time = 28 days • Goal = < 14 days (national statistics) • 2. Increase number of patients referred for minimally invasive treatment of lung CA • Emergence of thermal ablation techniques (literature, annual ASCO meeting)