the richest nation

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the richest nation

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an the unexpected happened
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SAFETY
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. . . the aftermath

• environmental hazards
• criminal element
• lack of infrastructure
• void in communication
• failed information technology
• population displacement
• destroyed/loss documents

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Focus
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the response
Residency Review Committee-Surgery
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RRC-Surgery

• L D Britt (Chair)
• J David Richardson (Vice-Chair)
• Pat Clagett
• Eric Van Eaton (resident member)
• Josef Fischer
• Jerry Goldstone
• Donald Kaminski
• Letch Kline
• Patrick OLeary
• Linda Reilly
• Bradley Rodgers
• Tom Whalen

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RRC-Surgery

• Doris Stoll (Executive Director)
• Frank Lewis (Ex Officio)
• Ajit Sachdeva (Ex Officio)

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Independent initiatives

• Southeastern Surgical Congress (Sharp,
  Richardson,Cofer et al)
• numerous individual programs

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a delicate balance


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Fact or Fiction?

• junior residents being told by their Chiefs to
  disperse
• residents/faculty receiving limited info(if any)
  regarding program matters
• residents working at medical facilities without
  their institutions knowledge
• dispersed faculty members

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Communication methods

• no land phones
• no fax machines
• erratic mobile phone communication
• inconsistent e-mail capability

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graduation requirements
time on task
education gap
certification requirements
makeup of didactic work
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ACGME
JCAHO
CMS/HIPAA
Local turf batttles
Medical Errors
Teaching Hospital
Nursing Shortages
Medicare and Medicaid Cuts
IME/DME Cuts
Uncompensated Care
Medical Liability
Added Patient Expectations
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RRC Oversight

• Optimal educational environment(with the
  necessary resources) for
• residency training

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• Executive Committee of the RRC Surgery
  Special Meeting

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Action items

• Committees post-Katrina plan
• strategy developed
• ACGME approval
• site surveyors chosen
• Deans/PDs notified
• dates confirmed
• on-site visits scheduled

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Decision

• Dispatch a senior team to visit the programs on
  a fact-finding mission

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Site Surveyors

• Dr. Jay Grosfeld (former vice-chair RRC)
• Dr. Phillip Burns (immediate past member RRC)
• Dr. Doris Stoll (Executive Director RRC)

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• Residency Review Committee
• Special Meeting( post-site visit)
• January 30, 2006

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CAUTION
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Two-hit phenomenon

• the devastation of the hurricane/flooding
• diminished appeal of the programs

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items to address

• temporary resident transfers
• permanent resident transfers
• redoing transfers
• major program reorganization strategies
• establishment of new institutions for GME
• new faculty and administration
• flexibility

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Format of Analysis

• History/background
• Infrastructure
• Faculty/staff
• Resident complement
• Education curriculum
• Clinical volume
• Commentary/recommendations

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Commendation
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Restructuring the education system
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Short cycle and a formal RRC site visit
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What could we have done better?
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ACGME

• 724 sponsoring institutions
• 7,800 accredited programs
• 99,000 residents
• 27 RRCs for 26 core specialties and 115
  subspecialties

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RRC for SurgeryProgram Accreditation Statistics
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the next chapter?
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? ? ?
CHALLENGES ? ?
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