Building a New Generation Committed to Quality Care: The Portfolio Program’s Value as a Professional Development and Educational Tool
This guest column first ran in the Summer 2017 issue of ABMS Insights, the free quarterly newsletter featuring news about Board Certification and the 24 certifying boards that comprise ABMS.
By Rani S. Gereige, MD, MPH, FAAP, Director of Medical Education, Designated Institutional Official, Miami Children’s Health System/Nicklaus Children’s Hospital, Department of Medical Education; Clinical Professor, Department of Pediatrics, Florida International University, Herbert Wertheim College of Medicine
Quality Improvement (QI) activities allow the implementation of small, repeated, systematic changes aimed at improving patient care quality, safety, and outcomes. The design, planning, and implementation of QI initiatives by physicians leading to Improvement in Medical Practice (Part IV) Maintenance of Certification (MOC) credit are essential to the formative growth of medical professionals who can critically assess system errors, systematically study the contributing factors, and creatively design and implement solutions that result in higher quality, safer, and evidence-based care.
The Accreditation Council of Graduate Medical Education (ACGME) Next Accreditation System requirements stipulate that sponsoring institutions and residency and fellowship training programs must provide education about the basics of QI using various methodologies (including Plan-Do-Study-Act, Lean Six Sigma, etc.) to physicians in training (residents and fellows). In addition, all residents and fellows must complete a mentored QI initiative during their training period and be able to demonstrate the related skills specified in the ACGME milestones under the “Practice-Based Learning and Improvement Competency.”
The certifying boards currently allow residents and fellows to “bank” MOC Part IV credits for approved QI efforts conducted during their training. This opens up an added value for Portfolio Program sponsor institutions to participate in the QI training of faculty and trainees. The reality is that all trainees need faculty mentors for their required QI initiatives, yet, in most instances, a large number of faculty lack QI knowledge and skills as this was not part of their training. Portfolio Program sponsors are positioned better than ever to leverage the program’s value for faculty development by training the trainers, or training a core group of QI coaches who will be instrumental in guiding the faculty and trainees in their QI efforts. Training the new generation of physicians to appropriately design a QI initiative, complete the MOC Part IV application, and ensure that the project design meets the requirements set forth by the Portfolio Program sponsor to qualify for MOC Part IV is an extremely valuable educational opportunity. This allows the Portfolio Program sponsor to collaboratively partner with its Graduate Medical Education Department to provide added value to the trainees and their mentors in their QI efforts. Before too long, we will have generations of health care providers committed to quality care and competent in the design and implementation of QI initiatives that will both benefit patients (through high quality care) and providers (through MOC Part IV-approved activities).
In the correct setting, and through collaboration with graduate medical education, Portfolio Program sponsors should leverage the program’s value as a professional development and educational tool for the future generations of specialists and subspecialists.
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