Program Director Best Practices: Initial Survey Results

1. Program Director Best Practices:Initial Survey Results University of Utah GME Annual Program Director Retreat Susan Stroud, MD Sonja Van Hala, MD, MPH, FAAFP September 25, 2014

2. Educational Objectives • Describe the varied approaches applied across GME programs to meet common program requirements and conduct operations • Identify resources to help you improve your program operations

3. Special Thanks to Survey Committee • Amy Motta Program Coordinator, Pathology • Christine Carlson Program Manager, Emergency Medicine • Chris Springman Manager, Graduate Medical Education

4. What Survey and Why? • Conceived after a discussion during a GME Committee meeting • Is it possible for PD’s and PC’s to have a shared pool of resources available within our institution to meet program requirements? • NAS rollout • Institution wide EMR • New CLER requirements for programs and institution

5. Goals • Identify requirements our programs are commonly having difficulty achieving • Identify resources to assist PD’s and PC’s in compliance and operations • Identify common tools/reports/resources that GME could advocate for hospital administration to provide to help us address these needs

6. Survey Specifics • Survey monkey designed by committee and distributed to all program coordinators in August (thank you GME office) • 54 Questions • 16 respondents (it was a BIG survey)

7. Survey Categories • PEC’s and CCC’s • Evaluation Process • Curriculum Goals and Objectives • Final Summative Eval Letters • Procedure Logs/Case Logs/Patient Encounters • Quality and Patient Safety • ACGME Annual Survey • Duty Hours • Meetings • Resident Rehabilitation • Recruiting • ACGME and other web sites • National Program Director Organizations

8. First Up: NAS Growing Pains • Program Evaluation Committee (PEC) • Clinical Competency Committee (CCC)

9. Program Evaluation Committee • Chair of PEC? • 72% PD • Others: attending faculty, chief residents • Member of PEC? • 43% did not include residents or fellows • How often does PEC meet? • 50% annually • Others: monthly to quarterly • One: “as needed”

10. What Information does PEC review? • Program Curriculum • Policies • Review of Last Meeting • Progress on historical changes • Plans for monitoring changes that will be implemented • Faculty survey • Resident survey (internal and ACGME) • Trainee quality improvement projects • Procedure and case logs • Resident involvement in community service/advocacy committees • In-service results • Board score pass rates • Teaching methods • Evaluation methods • Annual program evals by residents and faculty • RRC citations • Resident evals of faculty • Resident evals of rotations • Conference evaluations and attendance • Trainee research efforts and publications • Graduates employment demographics (academic vs. private)

11. What information does PEC review? • “all” • “We have a checklist with 10 items. We cover everything from the written evaluation of our program (attendings, fellows and mid-levels), reports from ACGME, ABS, RRC etc), Previous goals and future goals.”

12. Clinical Competency Committee • Similar findings • 43% chaired by PD • Lots of different kinds of members, 14% included chief residents • Meet anywhere from yearly to 6 times per year • An exhaustive list of information is reviewed

13. What about just using the ACGME Website to find the specific requirements?

14. What problems do you have navigating ACGME or WebADS? • 7 responses • 4 have no problems • Slow pages, browser incompatibility • “I find it difficult to find what I need and the search function is useless”

15. Oldies but Goodies • Evaluations • New twist: patient satisfaction • Procedures • Case Logs • Patient Encounters

16. Evaluations: “The program must” • Provide objective assessments of competence in the 6 core competencies (includes procedural skills as part of patient care) based on the specialty-specific Milestones • “Use multiple evaluators (e.g. faculty, peers, patients, self, and other professional staff)”

18. Opportunities for Improvement? • Press-Ganey • Already being used for the faculty, with results published on our website, and the U has gained national recognition for this move • An alternative institution wide GME sponsored mechanism • If PG not possible, what about an alternative specific to trainees?

19. How do Residents Track Their Procedures (software programs)? • 12 responses • 58% in E*Value • 33% in ACGME Case Log/ ADS personal portfolio • “E*Value and Excel” • “minimum required in E*Value, all others they track in a paper book”

20. How do your residents track their patient encounters (software program)? • 11 responses • 27% NA (don’t have patient encounters) • 36% EPIC • Others – E*Value, excel spreadsheet, personal portfolio, “I’m not sure this is happening”

21. How does your program ensure residents are recording these data? • 12 responses • 8% use EPIC • Others are mostly a review of submitted logs by PD or CCC • Best answer: “whip”

22. Opportunities for Improvement? • Many of the methods we are using to document these events require residents to double document • Should we be able to access this info through EPIC reports? • Procedures are documented by residents • Patient encounters are documented by residents

23. Common Challenges with Common Solutions? • We’ve gone poll crazy!!!! • Bust out your smart phone, iPad, laptop, google glasses (just kidding) and help us out with a poll right now

24. Participating with Poll EverywhereHow to vote via the web or text messaging From any browser From a text message Pollev.com/susanstroud214 22333 your response

25. Participating with Poll EverywhereHow to vote via texting From a text message 22333 744402

26. Participating with Poll EverywhereHow to vote via the web Pollev.com/susanstroud214 From any browser Pollev.com/susanstroud214