ACCME Should Not Adopt Proposed Criteria – Yet

July 22, 2008 at 7:04 pm Leave a comment

ACCME should not adopt the proposed criteria for Commercial Support at this time. The recent review of literature commissioned by the ACCME examining the presence of bias in commercially supported CME activities does not support nor refute the notion that bias exists in activities receiving funding from a commercial source. Data does not exist to suggest that the current Standards for Commercial Support are not effective for the majority of CME providers.

A ten percent non-compliance rate should be of concern. But does this suggest more restrictive regulations should be adopted at this time? If CME is to be a “Bridge to Quality” perhaps the ACCME should approach the issue utilizing quality improvement science. That would suggest first examining the system to see if it is in control. In that examination some variation will be found. Some of that variation will be special cause variation. Systems and processes should not be changed to address special cause variation. Changing systems by addressing only special cause variation is tampering not improving.

If there is only common causes of variation in the system then that is how the system works. It is a system that is operating the way it is currently designed to work. It is in control. Only systems in control can be systematically improved. One place to start improving this system is to address the part of the 10% non-compliance that is common cause -not special cause-variation. Which of the common causes of variation that, if minimized, will have the greatest potential for system improvement? Identify it. Improve it and reassess the system. Did the improvements in the common causes of variation decrease the 10% non-compliance rate? If so, there is less variation in the system. The system is still in control and it is operating at a higher level than before the improvements were made. Isn’t that what we want

There are very robust tools available from improvement science to use in improving systems and the component processes that comprise the work of systems. If that important work has not been done any suggested changes as sweeping as that suggested by the ACCME has to be viewed as tampering and not improvement.

ACCME should use the science it touts. Approach this issue as an opportunity for system improvement. Use the tools offered by improvement science. Accreditation criteria encourage CME providers to find ways to engage in quality improvement. ACCME – Lead By Example.

Floyd Pennington

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Entry filed under: CME, CME Issues, Continuing Medical Education, Pharma Funding, Physician Continuing Education. Tags: , .

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