Posts filed under ‘CME People’

CME – Who Gets the Assignment

I recently visited a small community hospital to talk to them about PI CME. Like  in many  small settings.  responsibility for coordinating the CME program is an add on role. The person assigned the responsibility has other responsibilities. They have no training in CME. They may or may not have experience in education. They may or may not have clinical experience.

One person at the session had just been given the responsibility for CME and was in the Marketing Department. This person had no idea what was required of CME providers. No idea what it means to be an accredited CME provider. Absolutely no knowledge or understanding of what is required by the ACCME, AMA,  etc.  All they know is that the setting in which they work wants to offer the physicians  “CME’s” Whatever CME’s are.  What a learning curve.

In situations like this the person assigned responsibility for the CME Program should get together with the Quality Improvement people and ride the quality improvement initiatives like a tight saddle on a bucking bronco. in fact the CME program should probably be assigned to the QI people in these settings. They have they data. They can learn the CME rules and regulations. They can link  CME to quality initiatives  that make a difference to the patients in that setting.

All approved CME activities have to be evaluated in improvement terms.  Improvement in competence, performance or patient outcomes. Lets put CME where the people have the skills to assess these improvements. Quit screwing around with CME as part of marketing or even the medical affairs office. Enhance the educational skills of some of the the improvement people. Enhancing the improvement  skills of  the CME people doesn’t seem to be working. Let’s try another way to link education to physician competence and performance. Especially if they have patient outcomes data.

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May 10, 2012 at 11:48 pm 1 comment

Communities of Practice – A Framework for Learning and Improvement

One of the sessions at the 2011 annual meeting of Alliance for Continuing Medical Education that I was supposed to participate in was to report on the work of a “Community of Practice”. The session was canceled because an attempt to get a community established failed to materialize. So what are these things called Communities of Practice (COP)? Take a look at the graphic. It provides a good description of a COP.

COP’s are usually comprised of a group of individuals who find they have a common area of interest or a common concern. They build a trusted relationship with each other around the area of common interest and begin to share their unique knowledge and experience related to the issue. By doing so they soon develop a shared understanding and approach to the issue and build a collective knowledge base which informs their practice guiding how they approach the common area of concern. The end result is that the experience of the COP builds in each member a collective knowledge base that, when applied, improves their individual performance and can have a dramatic impact on improving the issue they were drawn together to address.

Think of all of the things happening in CME that might benefit from COP’s forming to explore issues, develop deeper levels of understanding, produce resources for all of us to use. Things like Maintenance of Certification, Maintenance of Licensure, Integrating QI and CME, PI CME, Utilizing Social Media in Healthcare and Physician Learning – and this just scratches the surface of possibilities.

COP’s are engaging, intellectually stimulating, and fun. Find one or start one. You’ll be glad you did.

Integrating Education and Quality Improvement – The New Normal

February 4, 2011 at 2:19 am 7 comments

Alliance for CME Meeting- Got a little less busy for me

If you are a CME Professional or are related to the CME Enterprise at all you want be at the meeting of the Alliance for Continuing Medical Education in San Francisco later this month. There is something for everybody at the meeting.

My meeting is actually a little less hectic than I had hoped it would be. Both sessions I was to participate in as a presenter have been canceled. In one session I had hoped to present results of a pilot study where a group of CME professionals agreed to learn about A3 Problem Solving and use the approach to address an improvement opportunity in their CME operation. Regardless of the encouragement and prodding from the pilot study leaders the project flopped. Several participants in the pilot said they used the approach but we received no evidence that it happened. So I canceled the session. No data. No session.

The second session I was involved in that was canned was to report on establishing a “Community of Practice” focused on PI CME. As hard as the leaders tried to get this one going it didn’t happen.

Both of these failed efforts required a time commitment and a willingness of the CME professional to participate in something a bit cutting edge for the CME Profession. Another commonalty between the two projects was me. I suppose I just might have been the kiss of death for both efforts. Not. Or was it?

See you in San Francisco.

January 7, 2011 at 10:46 pm Leave a comment

Maintaining Relevance in a Changing Environment

If you have followed this Blog at all you know I am of the opinion that all CME is improvement focused. I am a proponent of establishing a systematic, repeatable, and sustainable approach to improvement that is evidence based and meets as well as exceeds the requirements imposed on the CME field by the ACCME. A3 Thinking is a proven way to meet that challenge. It is being adopted in healthcare across the country. It is a skill set people not currently in CME have and are willing and eager to share. Medicine has embraced skill sets outside of its core competencies for decades. It is doing it again by embracing Lean Healthcare thinking and tools like A3 Thinking.

A few weeks ago I was asked to participate in a meeting to address the topic of “A3 Thinking in Healthcare”. The topic is not what is as interesting as the group I was asked to speak to. It is an organization called APICS. They use terms like “Advancing Productivity, Innovation and Competitive Success” to describe themselves. APCS is a trade organization of people highly skilled in operations and supply chain management. These are people from manufacturing. They are systems and process experts with a highly developed skill set in solving problems using an array of quality improvement tools.

I was joined in the presentation by someone who works in their field. We came at the topic from two perspectives. His from manufacturing with an interest in applying A3 Thinking to business processes. Mine, from CME, with an interest in applying A3 Thinking to improving physician performance in the clinical setting. These people get it. They understand data based decision making. They understand identifying the root causes of problems using data. They understand addressing root causes of problems through carefully designed interventions and then measuring their progress in solving problems and eliminating system or process performance concerns.

Lean experts, like members of APICS, are finding their way into healthcare settings across the country. And they have a skill set that is woefully needed in many healthcare settings. If you watch you’ll see an increasing number of people and groups talking about “Lean Healthcare”. One of their basic problem solving tools is A3 Thinking.

As CME professionals we can up our value by learning these skills and applying them to our part of the medical education continuum. If we don’t there are others eager to do so. We can choose to make ourselves more relevant or be replaced. What is your choice?

November 12, 2010 at 5:44 am Leave a comment

CME Professionals Have Performance Gaps Too

From time-to-time I am asked to review grant request seeking support for CME activities. Recently I had the opportunity to review a nine requests seeking support for CME activities in a specific therapeutic area. Applicants could apply for the grants through one of the myriad of online grant application systems we all have come to either love or hate. This particular system asked applicants a series of questions that provides the granting agency information that would be required to meet ACCME accreditation and AMA CME credit requirements.

After asking the applicants the title and proposed target audience for the project they were asked two questions:

  • What is the professional practice gap your project will address?
  • How do you know that your target audience has this professional practice gap?

With the exception of one applicant, the answers showed a definite lack of understanding of what comprises professional practice gaps. The most common response to the questions referred to the prevalence of the medical condition of concern in the patient population in their service area. Not one word was said about the capabilities or lack of capabilities of the target audience in screening, diagnosing, or treating the medical condition. These applicants completely missed the boat regarding what constitutes a professional practice gap. Remember, these applicants are CME “professionals” working in accredited CME provider organizations. These CME providers demonstrate a clear professional practice gap of their own.

The groups providing funding for CME initiatives know the CME requirements imposed on CME providers. They expect CME providers to demonstrate an understanding of these requirements. When we submit funding requests demonstrating a clear lack of understanding of the most basic requirements in our enterprise it is no wonder these projects are summarily rejected. We need to get our individual and collective acts together. We are demonstrating our deficiencies every time we submit proposals that show we don’t get it.

CME professionals must be able to demonstrate a working understanding of what is required of accredited CME providers to offer approved CME activities. For example, as demonstrated in the proposals I reviewed, if we don’t even know what constitutes professional practice gaps and how to measure them we have a huge performance gap of our own. (By the way there were other things that these folks demonstrated they didn’t understand) These gaps absolutely must be addressed. Current CME staff not possessing the basic skill set to operate a CME program in compliance with ACCME expectations need to get the skill sets or get out of the business. There are lots of resources to help us acquire and develop these skills. Use them or we need to lose you.

August 16, 2010 at 5:46 pm Leave a comment

CME in the News and on the Blogs March 28th, 2010

This is not a  story directly related to CME but this appointment could have huge ramifications for the CME world.

Berwick to Head Centers for Medicare and Medicaid (CMS); Who Is Don Berwick and What Will This Mean for Reform? Part 1

Health Beat, March 28, 2010

“:…………… President Obama will name Dr. Donald Berwick, president of the Institute for Health Care Improvement (IHI), to run Medicare and Medicaid. Berwick, who is a professor of pediatrics and healthcare policy at the Harvard Medical School and a professor of health policy and management at the Harvard School of Public Health, will have to be confirmed by the Senate Finance Committee…………”

Read More:

March 29, 2010 at 7:56 pm Leave a comment

CME in the News and on the Blogs January 23rd, 2010

CME in the News and on the Blogs

Doctor quits Brigham to speak for pay.

Partners has strict rules on drug-firm honoraria

Boston.com, January 23, 2010

I know I said I wasn’t going to post any more news items on the whole issue of industry involvement in CME. But this one is a bit different than any I have seen to date. Here is a doc  who is giving up his academic position in part, we have to assume to continue speaking in and industry supported  educational activities and serving as a consultant for industry. With no comment from the physician we are not sure why he is making this decision. Some will surely say it is for the money and leave it at that.. And perhaps it is. But it could also be a protest against the restrictive policies of his university against these types of relationships. We don’t know.

Anyway, if you are interested in reading more go here.

NOTE: Here is one for you. It is a bit off our CME focus but it shows that medicine is not the only profession  universities are looking at with regard to conflicts of interest.

University of Maryland  Professor reprimanded for apparent conflict of interest.

Baltimore Sun, January 23, 2010

“A professor at the University of Maryland, College Park is facing conflict-of- interest questions after he used university letterhead to deliver a legal opinion in his role as a consultant to a labor union.

Fred Feinstein, an adjunct professor at the School of Public Policy, wrote a letter saying that California health care employees could jeopardize their contract benefits if they left Service Employees International for a competing union. Feinstein received $240,000 in consulting fees from SEIU in 2007 and 2008, which he did not mention in the Jan. 12 letter that was distributed as a flier in the continuing union battle.”

Read More:

January 24, 2010 at 5:59 pm Leave a comment

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