The ABMS Member Boards community engages in many activities to unite people and organizations and to make a difference through quality specialty care.
Member Boards Reach Out to Residents
Member Boards are reaching out to residents in myriad ways to create stronger ties with current and future specialists.
- The American Board of Anesthesiology (ABA) presented residency training program directors in anesthesiology an overview of the new staged examinations process for primary certification. They discussed the Accreditation Council of Graduate Medical Education’s Anesthesiology Milestone project and its impact on residency training reporting. The ABA also shared recent enhancements made to its Resident Training Information Database.
- In an effort to remain up-to-date and relevant to their residents, as well as Board Certified physicians, the American Board of Dermatology (ABD) launched a Facebook page. Reminders about application deadlines, updates about the availability of exam results, announcements concerning new developments at ABD, and pictures from ABD events are among the items commonly posted.
- The American Board of Emergency Medicine (ABEM) established the Residency Visitation Program (RVP) to identify ABEM’s role in Emergency Medicine and to answer the most important questions residents have about training, certification, and related issues. On a periodic basis, current and former directors of the ABEM Board Directors make presentations at residency programs, give topical lectures and meet with faculty and the chief resident.
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ABIM Launches Assessment 2020
The American Board of Internal Medicine (ABIM) launched an initiative to define what competencies physicians will need as the field of medicine continues to evolve and the best ways to measure those competencies. The Assessment 2020 initiative engages physicians, the public, and other important stakeholders in helping ABIM think through the future of cognitive assessment in internal medicine and associated subspecialties. ABIM will use feedback from the community, analysis of the latest research in assessment and results from focus groups and surveys to inform future enhancements to ABIM’s Certification and Program for Maintenance of Certification (ABMS MOC®).
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Choosing Wisely® Initiative Encourages Patient-Physician Dialogue
Choosing Wisely, an initiative of the American Board of Internal Medicine (ABIM) Foundation, encourages physicians, patients, and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances cause harm. ABIM Foundation convened national physician groups to develop evidence-based lists of five tests and procedures that may be overused in their field. Since its inception in 2012, sixty societies and 16 consumer groups have joined the initiative. More than 220 tests and procedures have been identified that may be unnecessary and could be harmful to patients. Launched by the ABIM Foundation and in collaboration with Consumer Reports, Choosing Wisely is reaching millions of physicians and consumers nationwide. Learn more and sign up for the Choosing Wisely e-newsletter at www.choosingwisely.org.
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Family Physicians Improve Diabetes Care
Family physicians who participate in the American Board of Family Medicine (ABFM) Maintenance of Certification for Family Physicians program improved their care for patients with diabetes, according to a study published in the January/February 2013 issue of the Annals of Family Medicine. The study reviewed nearly 8,000 web-based diabetes Performance in Practice Modules (PPMs) completed by physicians across the country from 2005 to October 2012. Successful completion of the PPMs developed by ABFM required quality measure abstraction from 10 patient charts before and after a plan-do-study-act cycle improvement effort. Nearly half of the physicians selected diabetic foot examination or eye examination as their quality improvement measure.
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ABA Participants Recommend Simulation Education
The American Board of Anesthesiology (ABA) simulation education courses offer contextual learning opportunities for ABA Board Certified physicians to assess and improve their practice in areas such as crisis management by utilizing a simulation setting at a center endorsed by the American Society of Anesthesiologists (ASA). Simulation courses focus on teamwork, communication and realistic patient care scenarios. They are designed to stimulate practice improvement and are not pass/fail examinations. Currently, there are 33 ASA-endorsed simulation centers throughout the United States.
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ABPeds Hand Hygiene PIM Yields Significant Improvement
More than 10,000 pediatricians have completed the American Board of Pediatrics (ABPeds) Hand Hygiene Performance Improvement Module (PIM), documenting the adequacy of hand hygiene rates for nearly one million physician-patient encounters.
Statistical analysis of self-reported, unaudited aggregate data from more than 2,000 initial users shows significant improvement after two improvement cycles compared to baseline performance. Pediatricians who completed a user survey stated they would recommend the activity to their peers and believe that completing the module had a positive impact on their practice. ABPeds is pleased with the high rate of utilization of this module, given the magnitude of the problem of health care-associated infections and the continued focus on this problem as a national health care priority.
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ABIM Offers AQI Pathway Options
ABIM offers Quality Improvement projects from 10 different organizations for credit in its MOC program through the Approved Quality Improvement (AQI) Pathway. This pathway creates relevant quality-focused options for physicians to earn MOC credit. The AQI activities are in the areas of gastroenterology/sedation patient safety, dialysis, adult obesity, reducing cardiovascular events, diabetes care, ameliorating low back pain, evaluating thyroid nodules, improving transitions of care (pediatric/adult), and adult vaccination and education.
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ABFM Launches Smart Phone Apps for Patients and Physicians
ABFM launched two apps that help the public determine a physician’s Board Certification status and help family physicians prepare for the MOC examination. The ABFM Physician Directory provides real-time information from the ABFM database allowing the user to determine if a family physician is currently Board Certified. Both iPhone and Android versions are available.
ABFM also has launched the ABFM Exam Prep app for the iPhone. The free app offers exam preparation guidelines, videos, practice quizzes and links to relevant information. While the app is designed for family physicians, it also may be useful for medical students and other health care providers.
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ABO Launches PIM and PEC Survey
In 2012, the American Board of Ophthalmology launched PIMs for its MOC program. Through collaboration with the American Academy of Ophthalmology, the PIMs provide a meaningful online interactive process of self-evaluation and improvement. The ABO’s Patient Experience of Care (PEC) Survey Process is a stand-alone tool for those interested in assessing patient perceptions in pursuit of continuous improvement in their patient experience. The PIMs and attestation of a PEC survey completion are core expectations for participation in the elective PQRS: MOC incentive program.
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ABPeds Creates Patient Safety Module Self-Assessment
ABPeds, in collaboration with ABIM, ABFM and patient safety experts, created a module that allows physicians to self-assess their knowledge of patient safety principles. The 50-question module is based on the AHRQ and Quality Patient Safety Morbidity & Mortality website, which is the definitive source of information about patient safety. The site contains 22 primers that succinctly describe key patient safety concepts and are augmented with links to relevant resources. Each question in the self-assessment has been developed from material in the primers. Physicians completing the module can receive MOC credit.
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ABPS Provides Practice Improvement Through MOC
Practice improvement is the result of measurement and education and, with the help of the American Board of Plastic Surgery (ABPS) Practice Assessment in Plastic Surgery (PA-PS) module, Board Certified plastic surgeons have been steadily making improvements.
Cooperating with the major specialty societies to provide education, the module is based on the surgeon selecting one of 19 procedures, reviewing data from 10 consecutive patient records on specific operations and entering the data on the ABPS secure website. The data are compared with cumulative data of all surgeons selecting that procedure. A benchmarking report is sent directly to the surgeon. An educational activity specific to the procedure is then completed and confirmed by ABPS. The activity is completed with recording of an action plan containing changes that the surgeon plans to implement in practice. At the next interval of data entry, improvement is evaluated.
Launched in 2008, the module has been used to evaluate approximately 41,900 operations. Eighty percent of the diplomates who used the module have reported plans to change at least one aspect of their practice based on the MOC experience.
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ABR Foundation Receives Grant for National Brachytherapy Registry
Varian Medical Systems awarded a grant to the American Board of Radiology Foundation to establish a national brachytherapy registry. The registry, which is the first nationwide modality-based project in radiation oncology, is linked to the ABR Innovation Pathway in MOC for Focused Practice Recognition in Brachytherapy (FPRB).
Brachytherapy involves the delivery of radiation therapy through the placement of one or more radioactive sources into a tumor or an area of the body where a tumor was surgically removed. The technique is designed to deliver a large dose of radiation to the area while sparing surrounding healthy tissue.
The FPRB initiative is a voluntary component of the ABR MOC program. It is designed to allow ABR Board Certified radiation oncology physicians, who are enrolled in MOC and active in brachytherapy practice, to achieve an added credential that demonstrates their commitment to quality and safety, expertise and volume of practice. Participants must meet the case-mix, data and volume requirements, as well as additional CME and self-assessment activities.
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Surgeon-Specific Registry Takes Shape
The American Board of Surgery (ABS) is working closely with the American College of Surgeons (ACS) to modify the ACS’ existing case log system to create a robust surgical outcomes registry for practice assessment.
To assist in this project, ABS has identified common surgical procedures performed by its Board Certified surgeons and developed specific outcome measures for each that could be risk-adjusted and benchmarked against other surgeons. This new-and-improved case log, named the Surgeon Specific Registry (SSR), also has been created with an eye toward making data entry as easy as possible and is currently being tested in a pilot phase.
As part of its involvement, ABS has asked that ABS Board Certified physicians who are not ACS members also be given access to the SSR once it become available, to assist all surgeons in satisfying practice performance requirements of the ABMS MOC program.
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ABA Simulation Receives High Marks in Practice Relevance, Catalyst for Improvement
A resounding 98 percent of the nearly 3,000 American Board of Anesthesiology (ABA) diplomates who have completed simulation courses, to date, reported that the course content was relevant to their practice. Furthermore, 95 percent had successfully implemented improvements in their practice based on what they identified during the simulation. Additionally, 95% of diplomate participants would recommend simulation to their colleagues, according to follow-up surveys conducted by ABA.
In 2008, ABA added simulation as a requirement for Part IV of the Maintenance of Certification in Anesthesiology Program (MOCA®). Simulation courses are designed to help diplomates identify challenges/vulnerabilities in their practice environment and implement steps to improve patient outcomes. They are contextual learning opportunities focusing on teamwork, communication, and realistic patient‐care scenarios. Simulation courses are designed to stimulate practice improvement; they are not pass/fail examinations.
After participating in the simulation course, diplomates are asked to identify three quality improvement initiatives; these are often identified during the course. Thirty days later, diplomates are asked what steps they were able to implement or what barriers prevented them from doing so. Diplomates reported implementing many compelling initiatives that overcame barriers and, in many cases, exceeded the scope of the original plan. Among them are improving teamwork and communications skills, involving designated leadership, implementing standardized hand-offs, and implementing the widespread dissemination of management guidelines via checklists across departments and a hospital network. Other changes implemented by diplomates resulted in improved access to knowledge, equipment, and medications for other anesthesia practitioners within the practice. These results could benefit patients.
A new video posted on the ABA website helps diplomates better understand simulation courses and their role in MOCA, offers an overview about what diplomates can expect in a course, and shows how simulation serves as a practice improvement activity that can be used to improve patient outcomes. As noted by ABA Director Thomas M. McLoughlin, Jr., MD, on the video, a 95 percent success rate is a remarkably high level of implementation that could benefit both patient care and physician practice.
Currently, there are 43 simulation centers endorsed by the American Society of Anesthesiologists (ASA) in 25 states across the country where MOCA simulation courses are held. Their location can be found on the ASA website.
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ABEM Develops Patient Safety Activity with ACEP
The American Board of Emergency Medicine (ABEM) launched a new option for diplomates to meet their Lifelong Learning and Self-Assessment requirements for the ABEM Maintenance of Certification (MOC) program. The Patient Safety Lifelong Learning and Self-Assessment (PS-LLSA) activity resulted from a collaborative effort between ABEM and the American College of Emergency Physicians (ACEP). It includes the following components:
- A pre-test
- A review of 10 patient safety-related articles
- An audio-supported slide presentation that emphasizes the key patient safety points in each article
- A post-test
Recognizing the lack of an existing activity that addresses patient safety issues specific to the emergency department, ABEM issued a request for proposal (RFP) to develop such an activity. By reaching out to the Emergency Medicine community with this RFP, ABEM was seeking to better integrate it into the MOC process. The ACEP proposal was selected. ABEM and ACEP project teams worked closely on developing the activity, which took approximately 18 months to complete. Although the two organizations frequently communicate and interact, this was the first time they collaborated on the creation of an ABEM MOC project.
Beginning with diplomates whose certifications expire in 2017, the PS-LLSA activity will be required once in each 10-year certification cycle. Though this is a new requirement, it is not additional work for the diplomate; the activity will count as one of the four required LLSA activities each diplomate must complete during each five-year certification period. Diplomates also have the opportunity to participate in an optional associated continuing medical education activity, for which 20 AMA PRA Category 1™ credits are available. Diplomates may register for the PS-LLSA on ABEM’s MOC portal.
*Passing requires a minimum score of 85 percent.
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ABD Offers New Tools to Meet MOC Part II, IV
The American Board of Dermatology (ABD) recently announced the availability of two new tools diplomates may use to satisfy Maintenance of Certification (MOC) Part II and IV requirements.
These tools are designed to provide realistic feedback about diplomates’ clinical knowledge and quality of their practice, noted ABD Executive Director Thomas D. Horn, MD, MBA. “As a result, they are expected to add value to the MOC process.” Both tools are available at no charge to diplomates enrolled in the MOC program.
The new self-assessment activity offers a means to efficiently accumulate credits for MOC Part II: periodic self-assessment. This online educational exercise consists of 25 questions that are both written and image-based multiple choice items in a “single, best answer” format. After submitting an answer for each item, the correct answer immediately appears, along with a rationale and references that can be printed for future study. A summary screen displays the results of the exercise and allows navigation back to any item for further review.
Participation in the Basal Cell Carcinoma Registry is a practice assessment/quality improvement activity that fulfills MOC Part IV. It consists of data entry on a secure website to capture information from 10 consecutive patients diagnosed with basal cell carcinoma. Feedback on most of the data entry is available in Year 1. However, the entire process takes three years to complete since questions concerning tumor recurrence cannot be reasonably assessed until sufficient time has passed after treatment. Data entry at Year 2 consists of only two questions and at Year 3 consists of a single question.
As part of the activity, the ABD prepares an annual personalized, confidential benchmark report that summarizes each diplomate’s data and compares the results to nationwide averages of other diplomates completing this exercise. Upon receiving the benchmark report and reflecting on the results, diplomates are expected to submit a short paragraph to ABD summarizing their thoughts or action plan. Diplomates will be granted partial credit each year and full credit when the exercise is completed. Both tools are available on the ABD’s MOC portal.
Currently, six ABMS Member Boards offer registries and four are considering doing so. While 11 Member Boards currently accept diplomate participation in third-party registries, three are considering doing so.
ABD is in the process of developing more complimentary tools for diplomates, including additional quality improvement modules, self-assessment exercises, and overhauled patient/peer surveys. “We are excited to provide these tools to our diplomates and encourage feedback on their relevance and usefulness,” Dr. Horn noted.
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