MAINTENANCE OF CERTIFICATION Part IV Practice Performance and Improvement

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MAINTENANCE OF CERTIFICATION Part IV Practice
Performance and Improvement
David L. Gillespie MD, FACS Professor of
Surgery University of Rochester School of
Medicine and Dentistry Rochester, NY
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Maintenance of Certification

• ongoing process
• continuous improvement
• Surgeons must demonstrate a program of
• ongoing learning
• professional assessment
• self improvement
• Facilitates maintaining expertise within
  specialty

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Maintenance of Certification

• patient centered initiative
• demonstrate high degree of professionalism
• improve patient care
• address concerns of public about quality
• will strengthen the value of Board certification
   

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Maintenance of Certification (MOC)     

• 1) Demonstration of Current Professional Standing
• every 3 years, unrestricted License, privileges
  to practice, letter of attestation
• 2) Demonstration of Lifelong Learning and Self
  Assessment
• 50 CME credits per year, demonstrate self
  assessment
• 3) Demonstration of Cognitive Expertise
• recertification examination, once every TEN (10)
  years.
• 4) Evaluation and Improvement of Performance in
  Practice

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Maintenance of Certification (MOC)     

• 1) Demonstration of Current Professional Standing
• every 3 years, unrestricted License, privileges
  to practice, letter of attestation
• 2) Demonstration of Lifelong Learning and Self
  Assessment
• 50 CME credits per year, demonstrate self
  assessment
• 3) Demonstration of Cognitive Expertise
• recertification examination, once every TEN (10)
  years.
• 4) Evaluation and Improvement of Performance in
  Practice

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Maintenance of Certification (MOC)     

• 1) Demonstration of Current Professional Standing
• every 3 years, unrestricted License, privileges
  to practice, letter of attestation
• 2) Demonstration of Lifelong Learning and Self
  Assessment
• 50 CME credits per year, demonstrate self
  assessment
• 3) Demonstration of Cognitive Expertise
• recertification examination, once every TEN (10)
  years.
• 4) Evaluation and Improvement of Performance in
  Practice

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Maintenance of Certification (MOC)     

• 1) Demonstration of Current Professional Standing
• every 3 years, unrestricted License, privileges
  to practice, letter of attestation
• 2) Demonstration of Lifelong Learning and Self
  Assessment
• 50 CME credits per year, demonstrate self
  assessment
• 3) Demonstration of Cognitive Expertise
• recertification examination, once every TEN (10)
  years.
• 4) Evaluation / Improvement of Practice
  Performance

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Part IV MOCPractice Performance and Improvement

• Verification required every three (3) years
• involved in one or more assessment programs
• focus on analysis of practice performance
• quantitative assessment
• Use info gained for performance improvement

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Part IV MOCPractice Performance and Improvement

• Requirements are subject of active discussion
• by the ABS, ACS, SVS, SCVS
• unclear what programs will qualify
• To show Performance Evaluation/Improvement
• will be more than participation in MM

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Part IV MOC- Practice Performance and Improvement

• Some examples which might apply include
• participation in Quality Outcome projects such as
  
• National Surgical Quality Improvement Project
  (NSQIP),
• Surgical Care Improvement Project (SCIP)
• practice databases such as those being developed
  through
• the ACS web portal
• the SVS carotid database

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Part IV MOC- Practice Performance and Improvement

• Participation in NSQIP (National Surgery Quality
  Improvement Program)

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Part IV MOC- Practice Performance and Improvement

• NSQIP (National Surgery Quality Improvement
  Program)
• Grew out of the National VA Surgical Risk Study
  1991
• now offered to all interested hospitals
• 2004 ACS began enrolling
• new private sector hospitals into the ACS NSQIP

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Part IV MOC- Practice Performance and Improvement

• NSQIP (National Surgery Quality Improvement
  Program)
• The ACS NSQIP is available to all private sector
  hospitals that
• meet the minimum participation requirements,
• complete a hospital agreement,
• pay an annual fee of 35,000.
• Many benefits by participating
• most importantly reduction of surgical morbidity
  and mortality
• VA NSQIP will continue in parallel system
• will compare its results against the ACS NSQIP
  private sector data

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Part IV MOC- Practice Performance and Improvement

• Participation in SCIP (Surgical Care Improvement
  Project)

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Part IV MOC- Practice Performance and Improvement

• SCIP (Surgical Care Improvement Project)
• A national quality partnership of organizations
• improving surgical care by reducing surgical
  complications
• Steering committee ACS, CMS, AHA, ASA, AORN, CDC,
  AHRQ
• Goal reduce preventable surgical MM by 25 by
  the 2010
• Hospitals can join SCIP to collect and submit
  data
• Hospitals that wish to sign up to participate in
  SCIP
• complete Hospital Letter of Participation and
  fax it

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Part IV MOC- Practice Performance and Improvement

• SCIP has four modules
• Infection
• 7 Infection Prevention Process Measures
• Venous Thromboembolus (VTE)
• 2 VTE Prevention Process Measures
• Cardiac Prevention Module
• 1 Cardiovascular Prevention Measure
• Respiratory
• Delayed implementation to use these measure in
  expanding the ICU Core Measure Set

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Part IV MOC- Practice Performance and Improvement

• Some examples which might apply include
• participation in Quality Outcome projects such as
  
• National Surgical Quality Improvement Project
  (NSQIP),
• Surgical Care Improvement Project (SCIP)
• practice databases such as those being developed
  through
• the ACS web portal
• the SVS carotid database.

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Part IV MOC- Practice Performance and Improvement

• ACS Practice Based Learning System (case log
  system)

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Part IV MOC- Practice Performance and Improvement

• ACS case log system
• allows surgeons to track their cases and outcomes
  
• convenient easy-to-use.
• Can compare personal outcomes to others
  confidentially
• opportunities for training from learning modules

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Part IV MOC- Practice Performance and Improvement

• ACS case log system
• The American Board of Surgery has
• identified Practice Based Learning and
  Improvement as a core competency.
• in the future the case logging system could
  support
• submission of case logs for maintenance of
  certification (MOC).
• open only to members of the American College of
  Surgeons.
• To register for the system you will need to log
  in to the ACS Web site.

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Part IV MOC- Practice Performance and Improvement

• SVS carotid database

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Part IV MOC- Practice Performance and Improvement

• SVS carotid database
• ensures eligibility for CAS reimbursement.
• CMS require data collection on CAS for
  reimbursement
• offers confidential benchmarking reports
• Site-specific CEA vs. CAS baseline risk factors
  and complications
• over time in your facility.
• to other institutions
• by individual provider
• "Real time" access to all your data for analysis.

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Part IV MOC- Practice Performance and Improvement

• SVS carotid database
• Facility benefits
• available now
• easy-to-use
• cost-effective way to meet CMS regulations for
  CAS
• downloadable database
• Collection of ongoing follow-up
• Collects both stenting and open repair data for
  comparison.
• Real-time comparative reports.
• one-time enrollment fee of 1,000
• annual subscription fee of 3,000

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Part IV MOC- Practice Performance and Improvement

• The ABS is investigating other data systems
• Personal
• national,
• regional,
• hospital-specific
• and is soliciting input
• e-mail at mocpart4_at_absurgery.org

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Thank you