ABMS

1
ABMS Patient Safety ProgramsABMS Patient
Safety Improvement ProgramABMS Patient Safety
FoundationsABMS Quality Improvement in Practice
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ABMS Patient Safety Programs

• ABMS has developed three online programs that
  provide leading edge content in patient safety
  and quality improvement (QI)
• ABMS Patient Safety Improvement Program
• Comprehensive program providing patient safety
  curriculum, quality improvement fundamentals,
  performance improvement activities
• ABMS Patient Safety Foundations
• Foundation level curriculum in key patient safety
  areas
• ABMS Quality Improvement in Practice
• Quality improvement fundamentals and performance
  improvement activities
• Programs are approved for AMA PRA Category 1
  credit
• Programs satisfy ABMS Maintenance of
  Certification (ABMS MOC) requirements based on
  individual Member Board criteria

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Goals and Objectives

• The ABMS Patient Safety programs enable
  healthcare professionals to
• Learn essential knowledge, skills and attitudes
  about patient safety
• Apply the principles to improve care in their own
  clinical environments
• Measure individual progress on changes made and
  provide feedback
• Integrate acquired QI skills into local and
  national patient safety activities
• Programs originally developed to satisfy ABMS MOC
  requirements, but are valuable resources for all
  healthcare providers regardless of MOC engagement
  or status

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ABMS program development alignment with other
initiatives

• ABMS program development
• Based on current research and best practices
• Guided by a blue ribbon advisory panel
• Developed by subject matter experts in patient
  safety and quality improvement
• Use evidence-based clinical performance measures
• ABMS programs align with major initiatives
• Joint Commission National Safety Goals
• World Health Organization Patient Safety
  Solutions
• ABMS programs address all six ABMS/ACGME
  competencies
• Medical Knowledge, Professionalism, Communication
  Interpersonal Skills, Patient Care,
  Systems-Based Practice, Practice-Based Learning
  and Improvement

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Program Highlights

• ABMS programs
• Engage the learner using dynamic, Web-based
  technologies
• Are self-contained with resource documents to
  guide through all exercises and activities
• Include documents, sample forms, transcripts and
  references that may be printed and retained for
  future reference
• Adapt to different learning styles
• ABMS programs are applicable to
• Clinicians, staff, leadership and administrators
  across the healthcare continuum
• All physician profiles, including
• Primary Care, Surgery/Proceduralist,
  Consultative, Non-Practicing
• All clinical environments, including
• In-patient, ambulatory, office practice

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Program modules and options

• Four key modules provide specific training and
  content
• Three programs use different combinations of
  modules

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Program contents, CME and ABMS MOC
ABMS Patient Safety Portfolio ABMS Patient Safety Improvement Program ABMS Patient Safety Foundations ABMS Quality Improvement in Practice
Content Included      
Core Curriculum Sections (Epidemiology, Systems, Communication, Safety Culture) ? ?  
Quality Improvement Fundamentals ?   ?
Performance Improvement Activities ?   ?
AMA PRA Category 1 Credit      
Practicing Physicians 20 1 2.5 2 20 1
Non Practicing Physicians 7.5 2 2.5 2 3 2
ABMS Maintenance of Certification (ABMS MOC) Part IV 3 Part II 3 Part II 3 Part IV 3
1 - Based on AMA PRA Category 1 Guidelines for
Performance Improvement Activities 2 - Based on
AMA PRA Category 1 Guidelines for Enduring
Activities 3 - Based on individual ABMS Member
Board requirements
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Improvement activities

• Clinicians with direct patient care choose from
• Hand Hygiene
• Medication Reconciliation
• Allergy List
• Critical Test Results Communication
• Correct Site / Patient / Procedure
• Safer Prescription and Order Writing
• Discharge Planning
• Clinicians not providing direct patient care
  (e.g. retired administrators researchers)
  choose from
• Safer Prescription and Order Writing
  (non-practicing version)
• Critical Test Results Communication
  (non-practicing version)

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Improvement activity structure

• Improvement activities include
• Case presentation (online)
• Initial measurement using de-identified practice
  data (online)
• Results benchmarked against national standards
• Immediate feedback provided
• Development/ implementation of improvement
  activity in the clinicians practice setting
  (offline)
• Re-measurement using de-identified practice data
  (online)
• Results benchmarked against national standards
• Immediate feedback provided
• All instructions and resources to develop and
  implement improvement activities are included

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Patient Safety Improvement Program

• Thank You.
• For more information, please contact
• HealthStream
• [phone]
• customer.service_at_healthstream.com
• ABMS
• [phone]
• products_at_abms.org

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Appendices

• About ABMS
• About ABMS Maintenance of Certification (ABMS
  MOC)
• ABMS Patient Safety Programs Appendix
• Curriculum Objectives
• Improvement Activity Objectives
• Sample Errors Illustrated
• Contributors
• Advisory Committee
• Content Development Team Leaders

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About American Board of Medical Specialties (ABMS)

• ABMS
• is a not-for-profit organization comprising 24
  medical specialty Member Boards (www.abms.org)
• establishes standards for physician specialty
  certification and Maintenance of Certification
  (ABMS MOC)
• communicates information about these standards to
  support the publics quest for safe, high-quality
  healthcare.
• serves as a unique and highly influential voice
  in the healthcare industry, bringing focus and
  rigor to issues involving specialization and
  certification in medicine

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What is ABMS Maintenance of Certification (ABMS
MOC)?

• ABMS MOC is a process designed to document that
  physician specialists, certified by one of the
  Member Boards of ABMS, maintain the necessary
  competencies to provide quality patient care.
• ABMS MOC assures that the physician is committed
  to lifelong learning and competency in a
  specialty and/or subspecialty using a process
  that is designed to keep certification
  continuous.

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Competency Mapping
ABMS/ACGME Competency Covered in ABMS Patient Safety Improvement Program
1. Medical Knowledge ? Yes 5 multiple choice knowledge assessments in patient safety curriculum and QI fundamentals
2. Professionalism ? Yes Throughout curriculum and improvement activities
3. Communication Interpersonal Skills ? Yes Patient safety curriculum, critical test results communication and discharge planning
4. Patient Care ? Yes Overall program objective to improve patient care
5. Systems-Based Practice ?Yes Systems curriculum and improvement activities
6. Practice-Based Learning and Improvement ?Yes Participation in QI activity in practice
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Patient Safety Improvement Program Appendix

• Curriculum Objectives
• Improvement Activities by Physician Profile
• Improvement Activity Objectives
• Sample Errors Illustrated

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Patient Safety Curriculum Objectives

• Epidemiology of Safety and Harm
• Identify issues creating a national focus on
  patient safety
• List common types, causes of adverse events
• Define a system for classifying errors
• Systems Approach to Patient Safety
• Define a system
• Identify workarounds and their effects on system
• Identify healthcare system layers that impact
  care
• Distinguish between error mitigation and error
  recovery

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Patient Safety Curriculum Objectives

• Communication
• Recognize role that communication plays in
  patient safety
• Identify barriers that affect patient/practitioner
  communication
• Apply steps for disclosure of adverse events to
  patients
• Improve information transfer from practitioner to
  practitioner
• Safety Culture
• Identify safety culture elements (beliefs,
  attitudes, values, risk and safety)
• Identify the value of learning in creating,
  sustaining patient safety
• Recognize relationship between reporting and
  learning

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Improvement Activity by Physician Profile
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Improvement Activity Objectives

• Hand Hygiene
• Ensure use of appropriate hand hygiene for every
  patient encounter.
• Medication reconciliation
• Ensure that accurate and complete information on
  all patient medications is updated at every
  encounter.
• Allergy list
• Ensure that accurate and complete information on
  patient allergies is updated at every encounter.

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Improvement Activity Objectives

• Critical Test Results Communication
• Improve the timely and effective communication of
  critical test results, including
• Reporting of information by specialties that
  provide results
• Tracking and follow-up of results by specialties
  that receive them
• Correct Person / Site / Procedure
• Implement key changes to improve communication
  and prevent surgical errors in person, site, or
  procedure

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Improvement Activity Objectives

• Safer Prescriptions and Medication Orders
• Avoid the use of terms from the Joint
  Commissions Official Do Not Use List when
  writing prescriptions or medication orders
• Discharge Planning
• Improve provider-patient communication at the
  time of discharge from the hospital

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Sample Errors Illustrated in ScenariosScenario 1

• Sylvia
• 42-year-old female presented to the emergency
  department with a two day history of headache,
  neck pain, and photophobia
• Errors illustrated
• HIV testing without informed consent
• Delayed diagnosis
• Drug prescribed despite known allergy
• Wrong medication dosage
• Lack of a robust system for lab result follow up

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Sample Errors Illustrated in ScenariosScenario 2

• Allison
• 2-year old with a history of prematurity, chronic
  lung disease and asthma, and congestive heart
  failure after Tetralogy of Fallot Repair
• Errors illustrated
• Medication overdose
• Lack of computerized physician order entry to
  alert the error at initial order
• Shortage of trained personnel
• Computer system failure (technology)

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Sample Errors Illustrated in ScenariosScenario 3

• Joan Morris
• 67-year-old female admitted to the interventional
  radiology service for cerebral angiography
• Errors illustrated
• Wrong patient
• Communication failures
• Technology (computer) incompatibility between
  units
• Flawed informed consent process

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Sample Errors Illustrated in ScenariosScenario 4

• Ms. Sinclair
• 30-year-old woman notices an abnormality on a
  monthly self-breast exam
• Errors illustrated
• Abnormal test report delay
• Wrong site surgery
• No tumor board presentation
• Communication failures
• Inadequate test reporting systems and wrong site
  surgery prevention systems

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Program Development

• Advisory Committee of Patient Safety subject
  matter experts Peter B. Angood, MD Kerm
  Henriksen, PhD
• James P. Bagian, MD, PE John Hickner, MD, MSc
• Paul Barach, MD, MPH Lucian Leape, MD
• David W. Bates, MD, MSC Eric Marks, MD
• Eric Coleman, MD, MPH Marlene Miller, MD, MSc
• David M. Gaba, MD Niraj Sehgal, MD, MPH
• Paula Griswold, MS Ajit K. Sachdeva, MD
• Content development teams led by curriculum and
  QI subject matter experts
• Carole M. Lannon, MD, MPH Julie K. Johnson, MSPH,
  PhD