Residency Review Committee for Emergency Medicine Report to CORD Art Sanders, MD, Chairman October 2

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Residency Review Committee for Emergency
MedicineReport to CORDArt Sanders, MD,
ChairmanOctober 2004
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RRC for Emergency Medicine

• AMERICAN BOARD OF EMERGENCY MEDICINE
• Dane Chapman, M.D.
• Daniel Danzl, M.D., Vice-Chair
• Rebecca Smith-Coggins, M.D.
• MaryAnn Reinhart, Ph.D, Ex-officio
• COUNCIL ON MEDICAL EDUCATION (AMA)
• Louis S. Binder, M.D.
• Charles K. Brown, M.D.
• Arthur Sanders, M.D. , Chairman
• AMERICAN COLLEGE OF EMERGENCY PHYSICIANS
• Francis Counselman, M.D.
• Sandra Schneider, M.D.
• David Overton, M.D.
• Marjorie Geist, Ph.D., Ex-officio
• EMERGENCY MEDICINE RESIDENTS ASSOCIATION
• Kelly Corrigan, M.D.

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Review of Applications (9/2004)

• Committee Action September 2004
• 2nd Review of Program Application
• Confirmed Withhold 01
• 1st Review of Program Applications
• Proposed Withhold 02
• Provisional Accreditation 02
• UMNDJ-New Jersey Medical School (Newark)
• University of Utah (Salt Lake City)

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Status Decisions Accreditation Cycle

• 2 Provisional - 3 year cycles
• 2 Full Accreditation - 3 year cycle
• 6 Full Accreditation - 4 years/7 years pilot
• 6 Full Accreditation - 5 years/8 years pilot

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RRC-EM Pilot Project

• Extend max accreditation cycle from 5 to 8 yrs
• Require yearly QI indicators of the program
• Update of citations
• Changes in program
• Procedures, resuscitations of graduating
  residents
• ED volume, faculty supervision
• Resident survey yearly

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RESIDENT SURVEY

• 3 year plan to survey 1/3 of residents each year
  for 3 years
• Year 1 had 85 compliance rate and over 25,000
  respondents
• Survey programs with 5 residents or more
• Survey January through April
• Internet based Average 9 minutes to complete

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RESIDENT SURVEY

• Used by site visitors as additional data element
  to augment resident interview and as early
  warning of non-compliance indicator
• 32 Questions pertaining to Duty Hours,
  Competencies, Evaluation, and Supervision
• Ability for residents to enter comments and/or
  connect to confidential resident complaint system

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RESIDENT SURVEY

• PDs and DIOs have access to aggregate reports if
  compliance is 70 or higher
• Plan to have every resident complete survey
  annually (5 or more in program)
• Plan to add Specialty specific questions to aid
  in program review

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RRC-EM Pilot Project

• It is inappropriate to claim that programs in the
  pilot with longer accreditation cycles are better
  than other programs.

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New Program Requirements

• Approved in June 2004
• Effective January 2005
• Competencies - Guidelines on Competencies
• Yearly competency assessment, 3 procedures, 3
  chief complaints, 1 resuscitation, 50 off
  service
• Duty Hours
• New PIF

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Program Requirements RevisionSubspecialties

• Toxicology
• Pediatric Emergency Medicine

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New PIF Questions on Clinical Operations

• ED volume and supervision ratio
• Time to CT scan, blood, etc.
• Throughput time for admitted and discharged pts.
• Ambulance diversion time
• On call consultants

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New PR - Clinical Operations

• The hospital must assure that all clinical
  specialty and subspecialty services are available
  in a timely mannerIf any clinical services are
  not available for consultation or admission, the
  hospital must have a written protocol for
  provision of these services elsewhere. This may
  include written agreements for the transfer of
  these patients to a designated hospital that
  provides the needed clinical services. (PR
  II.E.2)

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Guideline - EM Faculty Qualifications

• All EM faculty supervising EM residents on EM
  rotations must be board certified by ABEM or have
  appropriate qualifications in EM. Examples of
  educational qualifications acceptable to the RRC
  
• Certification by the AOBEM
• Certification by a subspecialty board of ABEM
• Recent residency or fellowship graduates working
  toward certification by the above Boards
• Qualifications must be relative to the pt
  population supervised

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RRC-EM Outcomes Project

• RWJ Grant to ACGME - Competency Project
• To identify patient care quality measures that
  are appropriate to use to assess the outcomes of
  GME in EM
• To link patient care quality measures in EM to
  the quality and effectiveness of GME
• Can accreditation decisions be outcome rather
  than process based?

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RRC Report to CORD

• Questions???