Archive for August, 2010

A Busy Few Weeks

Monday, August 30th, 2010

These last few weeks have been quite busy. They started by me traveling to the Society of Critical Care Medicine (SCCM) headquarters to part of a small team asked to conduct a full headquarters review. Just a day or two later I was back in the Chicago area for a meeting of the American Society for Anesthesiology (ASA) Board of Directors meeting. I serve on the board as I am the president of a component society, the American Society for Critical care Anesthesiologists (ASCCA). As my two term as president of ASCCA concludes this October, this will be the last time I attend the ASA board meeting.

Then a day or two after that I was back in Chicago for three separate CME meetings. The first was a grant writing session with Moss Blachman and Betsy White-Williams wherein we began a draft of a large grant that the Society for Academic CME (SACME) plans to submit to acquire funds dedicated to accomplishing the CME consensus research agenda. The next day started with a Journal of Continuing Education in the Health Professions (JCHEP) owners meeting. I serve on this in my role as president of SACME. This strategic planning session will be just the beginning of ensuring the success of this journal for the future. Finally, I concluded the three days by representing SACME and attending the Conjoint Committee session held at AMA headquarters. This broad CME stakeholder meeting worked on the issue that stem from recommendation 5.3 (independence of CME) from the IOM report on conflict of interest in education, research and practice.

After being back in the office for a short period, I was again on the move. This time I went to the University of Wisconsin in Madison where I was asked to provide the Keynote address at their education strategic planning retreat. This retreat is the seventh such retreat by the university as one is held every five years. My presentation was on CME as a value center and through interactive design facilitated their ability to self-identify their value.

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Certified CME can make health care reform work!

Monday, August 16th, 2010

CME has been shown to be effective and of value in several large studies. Yes, its effectiveness has been shown more convincingly for knowledge transfer than patient outcomes, but that is mostly secondary to the fact that CME was originally designed as a knowledge transfer medium. Only in the last few years has certified CME focused at level 5, 6 and 7 outcomes. Preliminary data from certified CME activities already looks positive and over the next few years as these projects mature, the results will be published in peer review journals and much of the present argument by a few vocal naysayers will be muted by hard data of improved outcomes.

CME is a strategic lever for change. Providers simply will not change unless they are educated as to why change is needed, what aspects of their practice need to change based on hard data, and a program of change that can be accomplished given barriers to care that exist within the present health care system. This sort of information and access to the experts regarding advances in care are principally provided through certified CME and thus it is fundamentally essential for improvement.

Numerous CME activities focus at quality and safety topics. The activities can and do serve a pivotal role in advancing these important aspects of health care. In case you doubt how important these topics are, at least from a fiscal perspective, recently the actuaries released a report on the cost of errors in health care (see links at bottom). They estimate “that measurable medical errors cost the U.S. economy $19.5 billion in 2008. Commissioned by the Society of Actuaries (SOA) and completed by consultants with Milliman, Inc., the report used claims data to provide an actuarially sound measurement of costs for avoidable medical injuries. Of the approximately $80 billion in costs associated with medical injuries, around 25 percent were the result of avoidable medical errors.” Key findings from the study include:
There were 6.3 million measurable medical injuries in the U.S.(2008); of the 6.3 million injuries, the report estimate that 1.5 million were associated with a medical error.

The average total cost per error was approximately $13,000.

In an inpatient setting, seven percent of admissions are estimated to result in some type of medical injury.

The measurable medical errors resulted in more than 2,500 avoidable deaths and more than 10 million excess days missed from work due to short-term disability.

Given the focus on quality and safety as key components of health care reform and the clear focus on cost control, the role that certified CME can play in this domain is critically important and frankly quite exciting. Certified CME can make health care reform work!

http://tinyurl.com/25vj8ru
http://tinyurl.com/29mnart

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Relationships With Industry – A Twist

Monday, August 9th, 2010

An interesting twist to the debate on relationships with industry was published earlier this year in Mayo Clinic Proceedings. I suspect this publication went mostly unnoticed and thus I am drawing you attention to it now.

This short position statement is from a group of faculty who specialize in Oncology who have gotten together to craft this position statement regarding their concern for the conflict and funding pendulum swinging too far. We all have experienced that once we decide to change there is a tendency to change too much too fast and these clinicians and researchers have come together to voice their opinion. One of the unique aspects here is this is a grass roots style approach and first I am aware of this nature.

Read the short statement and form your own opinion. Realize as you read it that you bring base assumptions to it and will likely interpret based upon those preconceived opinions, but at least read it to be informed about this perspective.

http://www.mayoclinicproceedings.com/content/85/2/197.full

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SACME Inaugural Summer Leadership Institute (SLI) a Success!

Monday, August 2nd, 2010

The SLI was a huge success. The attendees were enthusiastic and engaged. The faculty utilized almost every conceivable type of interactive education available including (to name but a few) self reflection, small group discussion, large group discussion, game playing and simulation. We even survived a real world crisis management scenario!

Attendees filled out evaluations on the last day. 100% stated objectives were met and 100% stated that they would recommend the activity to a colleague. Only one attendee stated that they would not change their practice, but added the caveat that the course did validate and reinforce changes they have recently initiated.

The most common improvements to present practice stated by attendees included succession planning, enhanced use of strategic planning, especially strategic abandonment and economic evaluation of current system using Porter’s model. That being said team building, conflict management, and media training were also frequently mentioned.

In approximately 60 days a more robust follow up through the online Moodle classroom will be initiated. In addition, a follow up at approximately 9 months will also be pursued. The attendees and faculty will stay engaged through the Moodle classroom/networking site.

The planning team will be debriefing in the next few weeks and then subsequent plans for continued engagement by and with this cohort will be entertained as well as planning for a subsequent SLI with a new cohort.

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