Christiana Care Health System has joined a select group of institutions approved by the American Board of Medical Specialties (ABMS) to confer Maintenance of Certification upon doctors in Delaware who actively participate in quality improvement projects.
“It’s a way for us to support our physicians’ efforts in making our care better,” said Robert Dressler, M.D., MBA, quality and safety officer, Academic and Medical Affairs. “In the past several years, we’ve been asking physicians to dedicate time to be involved in quality improvement projects. Now, clinicians can use their participation in those projects to earn credit through the Multi-Specialty Portfolio Program. It’s one way we can acknowledge their commitment to enhancing the value of care provided to the community.”
Once physicians are board-certified, one component for the maintenance of their medical specialty expertise is through professional development aimed at enhancing patient care and outcomes. But with 24 different specialty boards, each with its own requirements and timelines, the process for achieving the necessary credit became confusing, Dr. Dressler said.
The ABMS recognized physicians’ frustration in 2010 by creating a pilot program between three specialty boards and the Mayo Clinic.
“The general idea is that there are a lot of health care organizations that are doing really good, meaningful things in quality improvement and performance improvement,” said David Price, M.D., FAAFP, FACEHP, executive director of the ABMS Multi-Specialty Portfolio Program. It made sense to devise a mechanism to recognize that work, he said.
By 2014, the number of specialty boards participating had increased, along with the organizations invited into the pilot, and the Portfolio Program became official. Now, 21 of the 24 boards plus 71 institutions are engaged in the program. About half of the organizations are academic medical centers, Dr. Price said.
The program covers 95 percent of all practicing ABMS diplomates in the United States, he said.
Christiana Care, whose participation was finalized in late 2015, joins a number of venerable institutions, including the Johns Hopkins Hospital, Stanford Health Care and the Dana Farber Cancer Institute.
So far, two projects have been submitted for Maintenance of Certification consideration, said Carol Pashman, MS, BSN, RN, director of Continuing Physician Professional Development, Continuing Medical Education and the Multi-Specialty Portfolio Program.
One addresses the protocol for treating patients in the intensive care unit who are in alcohol withdrawal. The other aims to improve the connection with quality outpatient care for patients 60 and older after they are discharged from the Emergency Department.
“We have a number of patients who need follow-up after having a visit in the Emergency Department. Sometimes they’re not able to get in to see their primary care physician in a timely manner,” said Loretta Consiglio-Ward, MSN, RN, education specialist, Quality and Safety, Institute for Learning, Leadership and Development (iLEAD). “We’re creating the option for these patients to come in for follow-up care. Our goal is to prevent readmissions by helping them stay healthy and well out in the community.”
Consiglio-Ward said it’s too early to estimate how many submissions the program will receive annually.
A multidisciplinary board composed of leaders from multiple service lines will provide oversight review of the projects, Pashman said, while she, Consiglio-Ward and Dr. Dressler make up a subcommittee that will screen the submissions before they are brought to the full board.
Projects could address health outcomes of the patient population, efficiency of service, safety of care, effectiveness of treatment and access to care, among other improvements, said Consiglio-Ward.
To qualify, physicians must participate during the entire process of their effort.
“Physicians must be able to verify and attest that they have participated throughout the entire quality-improvement effort, engaged with others involved in the project, and helped implement change,” Pashman said. “Additionally, they must personally reflect on their experience and on the impact of the project on their practice.”
Participating physicians also must commit to implementing their protocols into their own practice or systemwide.
In reviewing the applications, the committee will be looking at how the proposed improvement was implemented and how its success was measured, Consiglio-Ward said.
Christiana Care’s application impressed the ABMS on several points, Dr. Price said.
“One is the multi-pronged approach to teaching safety and quality improvement,” he said.
One example was the use of video surveillance to improve inter-professional teamwork during neonatal resuscitations.
With the Portfolio Program, he said, “We have a chance to be a fly on the wall and see what kind of cool stuff organizations are doing. Every time I talk to the organizations, I learn something different. It’s important to how we continue to evolve to make ABMS more relevant to the community. It’s a learning opportunity — we can learn from you.”