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RRC Emergency Medicine Update for CORD at SAEM Meeting June 4, 2010 Robert Muelleman, MD RRC-EM Chair

RRC Composition. 3 appointing organizations - ABEM, ACEP, AMA10 voting members 6 year terms -- except resident (2 years)Program Directors, Chairs, FacultyGeographic DistributionAZ, CA, IL, MI, OH, NC, NE, NYEx-officio members from each appointing organization (non-voting) . . RRC-EM Com

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RRC Emergency Medicine Update for CORD at SAEM Meeting June 4, 2010 Robert Muelleman, MD RRC-EM Chair

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    2. RRC Composition 3 appointing organizations - ABEM, ACEP, AMA 10 voting members 6 year terms -- except resident (2 years) Program Directors, Chairs, Faculty Geographic Distribution AZ, CA, IL, MI, OH, NC, NE, NY Ex-officio members from each appointing organization (non-voting)

    4. RRC Review of Programs Peer Review 2 reviewers Reviewers use the following information to determine compliance with the requirements: Program Information Form (PIF) Site visitors report Resident survey findings (if applicable) Board scores The questions in the PIF correspond to program requirements Reviewers present program to Committee Committee determines degree of compliance and assigns accreditation status along with review cycle, range of 1-5 years

    5. Review Cycle of Cores and Subs Review cycle of the sub is normally aligned with the core. If core has a three year cycle, the sub (s) will have a three cycle. However, if needed, the RRC un-couples subs cycle from that of core. Subs are still considered dependent, but the cycle of the sub can be greater than or less than that of the core. ACGME document: Applying in seven easy steps: http://www.acgme.org/acWebsite/home/accreditation_application_process.asp

    6. Citation Citation = the program has not provided evidence of compliance with the requirements, or, an area identified by the site visitor is non-compliant Dont Have Patients (# & types); required certified faculty; required experience; facilities/equipment; time/support; required program personnel Dont Do Lack of evidence that required experience is provided; no documentation of compliance with requirements PIFmanship Incomplete or inaccurate information; did not fully describe/provide sufficient details; discrepant data

    8. Most Common Citations for Core EM Programs AY 2008/2009* Program Personnel & Resources: Responsibilities of Program Director (23) e.g. PIF completion and accuracy, environment where residents free to raise issues, ensuring residents relieved of duties to attend conferences, ensuring resident maintain documentation of procedures

    9. Most Common Citations for Core EM Programs AY 2008/2009* continued Program Personnel & Resources: Resources (17) e.g. Throughput times, patient care space, office space, lab & dx imaging results on timely basis The Education Program: Service to Education Imbalance (13)

    10. Most Common Citations for Core EM Programs AY 2008/2009* continued Program Personnel & Resources: Qualifications of Faculty (11) e.g. faculty staffing levels, faculty to resident ratio; board certification Program Personnel & Resources: Responsibilities of Faculty (11) e.g. protected time, conference participation, insufficient time teaching The Education Program: Scholarly Activities (10) faculty and resident

    11. For Core Emergency Medicine Programs in AY 09/10, there are. 155 accredited programs Specialty Length = 3 years* (124) or 4 years (32) 5675 approved resident positions 4982 filled positions Average Program Cycle Length = 4.57 135 programs with continuing accreditation 20 programs with initial accreditation 1 program with probation * Approximately 8 of the 3-yr programs require a prior yr

    12. For Medical Toxicology Programs in AY 09/10, there are. 24 accredited programs Specialty Length = 2 years 88 approved resident positions 52 filled positions Average Program Cycle Length = 4.23 20 programs with continuing accreditation 4 programs with initial accreditation

    13. For Pediatric Emergency Medicine Programs in AY 09/10, there are. 21 accredited programs Specialty Length = 2 years 75 approved resident positions 63 filled positions Average Program Cycle Length = 3.95 14 programs with continuing accreditation 7 programs with initial accreditation

    14. For Sports Medicine Programs in AY 09/10, there are. 5 accredited programs Specialty Length = 1 year 8 approved resident positions 8 filled positions Average Program Cycle Length = 3.80 3 programs with continuing accreditation 2 programs with initial accreditation

    15. For Undersea and Hyperbaric Medicine Programs in AY 09/10, there are. 6 accredited programs Specialty Length = 1 year 12 approved resident positions 7 filled positions Average Program Cycle Length = 3.60 2 programs with continuing accreditation 4 programs with initial accreditation

    16. Accreditation Activity February 2010 Meeting Approved Applications (5/5) Core (2/2) Med Tox (2/2) Underseas & Hyperbaric (1/1) General Emergency Medicine Continued Accreditation (CA) (9/9) Med Tox CA (2/2) Sports Med CA (1/1) Pilot Programs Reviewed CA (34) Approved Format Changes 1/1 Proposed Adverse Actions -- 0 Duty Hour or Progress Reports Reviewed 2 Approved Complement Increases 4/4 (Approved Prior to the Meeting)

    17. Number and Average Cycle Length by Program Type for all Currently Accredited Programs in AY 2008/2009

    18. Welcome to our New Core Programs! Staten Island University Hospital Program (Feb 2010) Moshe Weizberg, MD Baylor College of Medicine Program (Feb 2010) Girish Bobby Kapur, MD

    19. Welcome to our New Programs! Medical Toxicology Texas Tech University Health Sciences Center Paul L Foster School of Medicine Program (Feb 2010) Stephen Borron, MD Washington University/B-JH/SLCH Consortium Program (Feb 2010) Sarah Eliza Halcomb, MD

    20. Welcome to our New Programs! Undersea & Hyperbaric Medicine SUNY Upstate Medical University Program (Feb 2010) John McCabe , MD

    21. ACGME Communication Weekly e-communication Contains GME information: New requirements, newsletters; updates on ACGME issues/initiatives E-mail status of programs on RRC agenda 2-3 business days after meeting will receive email w/status and review cycle. E-mail notification when letter is available on Accreditation Data System (ADS) Hard copies of letters not provided Letter is posted approximately 8 weeks following meeting E-mail notification of site visit date For questions related to site visits contact: Ingrid Philibert: (312) 755-5003, iphilibert@acgme.org Jane Shapiro: (312) 755-5015, jshapiro@acgme.org Penny Lawrence (312) 755-5014, pil@acgme.org

    22. ACGME Data Collection All core programs and subspecialty programs (with 4 or more fellows) will be required to participate in the resident survey ANNUALLY More information is being/will be collected through ADS Common PIF = Questions all programs need to complete Information on faculty/teaching staff Residents/fellows - # completed; # transfer, withdrawn; dismissed Responses to previous citation Evaluation (resident, faculty and program) Duty hours Complement increases, PD/Institution changes Voluntary withdrawal

    23. RRC Newsletter A communication tool that: Enhances communication Provides updates on RRC/ACGME initiatives Allows Committee to clarify expectations regarding requirements Newsletter postings announced in the weekly ACGME e-Communications email Sent to core & fellowship PDs, coordinators, and DIOs The RRC-EM will be publishing its next newsletter after the September 2010 RRC meeting. http://www.acgme.org/acWebsite/navPages/nav_110.asp

    24. ACGME Resident Duty Hours Task Force Update The DH Task Force has met over many occasions, heard much testimony, received feedback from many stakeholders and has used an EBM approach in order to respond to the IOM report. Please expect a duty hour document for your review and comment later this summer, tentatively by the end of June, 2010. A notice will be sent out via the ACGME e-Communication when it is available for viewing and comment.

    27. Upcoming Meeting and Closing Dates September 10-11, 2010 Agenda Closes July 2, 2010

    30. RRC Staff Changes Lynne Meyer, PhD, MPH, Executive Director lmeyer@acgme.org; 312-755-5006 Sara Thomas, Senior Accreditation Administrator sthomas@acgme.org; 312-755-5044 Mary Hollis Inboden, Accreditation Administrator hinboden@acgme.org; 312-755-5037 Sarah Smith, Accreditation Assistant ssmith@acgme.org; 312-755-5085

    31. www.acgme.org Staff contact information ACGME Policies & Procedures Competencies/Outcomes Project List of accredited programs ADS Duty hours Information/FAQ Affiliation Agreements FAQ General information on site visit process and your site visitor EM Webpage Resident complement increase Program Requirements and PIFs EM Guidelines

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