The ABIM Practice Improvement Module (PIM) for Residency Programs

1. The ABIM Practice Improvement Module (PIM) for Residency Programs

2. Functional Anatomy of a PIM Survey Patients Review Charts Analyze Practice Collect Data Data Synthesized and Returned Develop Improvement Plan Develop Practice Improvement Plan P A Impact D Implement and Test Change S

3. ABIM PIM Topics • Asthma • Diabetes • Preventive Cardiology • Clinical Preventive Services • Hypertension • Care of the Vulnerable Elderly • Hospital Care (JCAHO measures) • Subspecialty PIMs (2006) • May be especially good for fellows

4. Learning (Improvement) Cycle Deliver Care Measure Care Make a Change Reflect on Feedback

5. Practice Improvement Module – Step 1 Deliver Care Chart Audit Patient Survey Practice Survey Measure Care Make a Change Reflect on Feedback

6. Practice Improvement Module – Step 2 Deliver Care Chart Audit Patient Survey Practice Survey Measure Care Make a Change Performance Report Guided Reflection Reflect on Feedback

7. Practice Improvement Module – Step 3 Deliver Care Chart Audit Patient Survey Practice Survey Ideas to Change System Measure Care Make a Change Performance Report Guided Reflection Reflect on Feedback

8. Practice Improvement Module – Step 4 New Process to Deliver Care Deliver Care Chart Audit Patient Survey Practice Survey Ideas to Change System Measure Care Make a Change Performance Report Guided Reflection Reflect on Feedback

9. Purpose of PIM Chart Audit • Physician self assessment • Competence in practice-based learning and improvement • Systematic analysis of care processes under physician’s control • Experience with data collection and management for population-based medicine

10. DEC 2002 230 105 43 98

11. Patient Survey • Invite patients to complete a questionnaire • Automated telephone or web • Confidential and anonymous • Provides valuable and specific information about specific aspects of care • Logistically most difficult in residency clinic setting

12. Examine Practice Systems • Builds awareness of systems-based practice • Residents often unaware of what “systems” exist in clinic • Identifies level of health information technology • Identifies practice staff organization and teamwork • Stimulates ideas for improvement

13. INFORMATION MANAGEMENT

14. Review Report and Develop a Plan • Download practice performance analysis compared to guidelines • Select opportunities for improvement • Develop a plan for improvement • Report the impact of the test through re-measurement

17. PROCESSES OF CARE

18. PROCESSES OF CARE

19. 50 60 80 80

20. Availability • PIMs available now • Web-based • $100 registration plus $25 dollars per resident • 5 medical record audits/resident with a minimum of 25 • 5 patient surveys/resident • Will score at 25 regardless of total number of residents • One practice assessment