Inaugural Forum of Innovative MOC Portfolio Program Features Best Practices and Research
New evidence presented at the June inaugural Forum on Organizational Quality Improvement demonstrates the success of integrating quality improvement (QI) initiatives with the American Board of Medical Specialties Maintenance of Certification (ABMS MOC®) program. The two-day forum hosted by ABMS in conjunction with its groundbreaking Multi-Specialty Portfolio Approval Program™ (Portfolio Program) and the American Board of Pediatrics Portfolio Program showcased best practices and evidence for a learning community of leading health care providers focused on enhancing QI and improving patient outcomes.
The Portfolio Program allows hospitals and health care organizations to apply Part IV MOC to team-based, multi-specialty projects that physicians are already engaging in at their organizations. The program eases the burden on physicians by reducing duplication of QI projects and promotes organizational effectiveness and efficiency through team-based initiatives. For example, rather than 20 physicians in the same health care organization working on individual diabetes care improvement initiatives, they can participate in one organizationwide effort to improve diabetes care and earn MOC Part IV credit.
"The ABMS Member Boards Community and the many hospital and health care organization portfolio sponsors are focused on the same goals — we want patients to receive safe, high quality health care and benefit from improved outcomes," said Lois Margaret Nora, MD, JD, MBA, ABMS President and Chief Executive Officer. "The Portfolio Program contributes to these goals by supporting institutionwide quality improvement programs, creating learning communities and identifying best practices across sponsor organizations. The program’s five hundred and twenty nine approved QI projects are just one way that ABMS MOC is improving the quality of health care across our country."
Among the forum’s attendees were representatives from Mayo Clinic, the University of Michigan, Dana Farber Cancer Institute, Kaiser Permanente, and Vanderbilt University School of Medicine. "As care providers, our end goal is to ensure the best possible outcomes for our patients," said Richard A. Berger, MD, PhD, Dean of the Mayo School of Continuous Professional Development (MSCPD) at Mayo Clinic, Rochester, Minn. "Mayo has long been dedicated to continuous improvement in all areas of patient care and we recognized that the Portfolio Program was a perfect extension of our vision. QI is a part of MOC and it makes a difference in patient care."
The forum was attended by ABMS Member Boards, portfolio sponsors, and other interested quality care organizations. In addition to 29 speakers, the forum’s Poster Session showcased 27 successful QI projects to provide insight and ideas and foster development of other collaborative efforts. Following are several examples of QI projects showcased at the Poster Session:
- Reducing adverse drug events: Through a common cause harm analysis, Nationwide Children’s Hospital (NCH) found that adverse drug events (ADEs) accounted for two-thirds of preventable patient harm events. To decrease ADEs, NCH initiated a multidisciplinary ADE quality collaborative (ADEQC) with its critical care staff in 2009. In three years, NCH reduced ADEs by 76 percent and the ADEQC was expanded to all inpatient and outpatient units in 2011.
- Ensuring continuous professional development: In 2010, the MSCPD and Mayo Clinic Quality Review Board developed a pilot program that has grown into a fully integrated initiative that engages physicians and allied health professionals in quality improvement projects (QIP) and meets MOC and continuing medical education requirements. The framework for this initiative helps identify QIPs that are relevant to daily clinical life and challenges teams to be more patient and quality focused. Results show participating physicians are more efficient with their own time which has allowed them to make better use of their time with patients and provide better care.
- Documenting QI: In an effort to align required physician-participation in QI projects with MOC Part IV, the University of Michigan Health System in Ann Arbor, Mich. (UMHS) designed documentation for physicians to participate in QI projects while fulfilling the requirements of MOC Part IV MOC. By identifying QI concepts within the MOC program requirements, UMHS developed a program framework that allows physicians to learn and apply structured, systematic processes to improve the quality and safety of patient care. Physicians who participated in the program have an improved understanding of QI processes that have had a positive impact on patient care.
To date, the Portfolio Program has approved 529 QI projects and more than 3,250 physicians have received MOC Part IV credit for participation, with many more in process. Currently, 32 health care organizations are active portfolio sponsors, and 51 are applying to become involved. Additionally, 18 ABMS Member Boards are participating. "We are impressed by the quality of the various organizational QI projects and gratified that the effort has been so successful," said David W. Price, MD, FAAFP, FACEHP, incoming Director of the Portfolio Program. "An additional fifty-nine health care organizations are actively exploring portfolio sponsorship participation. We look forward to watching the program grow, evolve, and get even better."
The program launched as a pilot in 2009 when three ABMS Member Boards – the American Board of Pediatrics (ABP), the American Board of Family Medicine (ABFM) and the American Board of Internal Medicine (ABIM) – collaborated with the Mayo Clinic. In the ensuing years, the program has been expanded to include other integrated multi-specialty systems and organizations across the country.
Nationwide Children’s Hospital was an early Portfolio Program participant. "We are very pleased with the success of the program," said Rick McClead, MD, Medical Director for Quality Improvement Services at NCH, Columbus, Ohio. "A key factor in the journey of best outcomes is aligning quality improvement initiatives with the MOC program to make QI more accessible, more efficient, and relevant to physicians."
Participating organizations and sponsors include: Advocate Physician Partners, ABMS, ABMS Research & Education Foundation, Better Health Greater Cleveland, Carolinas Health Care System, Cleveland Clinic, Dana-Farber Cancer Institute, Envision New Mexico, Health Teamworks, Health Partners, Marshfield Clinic, Mayo Clinic, Medical Society of Virginia Foundation, Medical University of South Carolina, Methodist LeBonheur Healthcare, Nationwide Children’s Hospital, New York State Department of Health, Partners Health, The Permanente Federation, Sentara Healthcare, Seattle Children’s Hospital, Seton Healthcare Family, University of California – San Francisco, University of Colorado School of Medicine, University of Kentucky, University of Michigan, University of Texas Science Center – San Antonio, University of Texas – MD Anderson Cancer Center, University of Utah, University of Wisconsin, Vanderbilt University School of Medicine, and Virginia Mason Medical Center.
Participating ABMS Member Boards include: the American Boards of Allergy & Immunology, Anesthesiology, Dermatology, Emergency Medicine, Family Medicine, Internal Medicine, Medical Genetics and Genomics, Obstetrics & Gynecology, Ophthalmology, Orthopaedic Surgery, Otolaryngology, Pathology, Pediatrics, Physical Medicine & Rehabilitation, Preventive Medicine, Psychiatry & Neurology, Surgery, and Thoracic Surgery.
For more information about participation in the MOC Portfolio Program and sponsor research projects, visit the program website.