Christiana Care physicians, who strive to be health care innovators by seeking new knowledge and using resources wisely, are increasingly lending their expertise to quality improvements within their service lines.
But identifying the root causes of medical challenges and developing effective interventions is an investment of time in a profession where physicians are already handling many critical responsibilities.
To recognize the importance of delivering sustained advances for patients, Christiana Care is enabling physicians to use their quality improvement projects to achieve another important goal. Over the last three years, Christiana Care has assisted physicians in fulfilling Part 4 of their maintenance of certification with one or more of the 24 specialty boards that affiliate with the American Board of Medical Specialties.
A physician who has been able to dovetail his quality improvement efforts with his maintenance of certification — through the Multi-Specialty Portfolio Program —is Cem Soykan, M.D., associate pediatric hospitalist chief and director of medical education in the Women’s and Children’s Service Line. Dr. Soykan said the guidance offered through the Portfolio Program helps physicians achieve the core values of continuously striving to implement novel and value-added innovations. “In addition, the program streamlines the submission of quality improvement projects and can save physicians hundreds of hours of work as well as maintenance of certification fees,” he said.
Dr. Soykan explained that his ongoing quality improvement project deals with the opioid crisis, and the fact that Christiana Care doctors deliver more than 200 babies a year who are exposed to drugs in the womb and develop neonatal abstinence syndrome, a set of short-term withdrawal symptoms that often require treatment. By establishing a series of best-practice protocols, the babies, on average, now stay in the hospital 11 days less than three years ago.
As one of the physician leaders of the Neonatal Abstinence Syndrome Length of Stay Quality Improvement Project, Dr. Soykan is proud of the effort to use both pharmacologic management and interventions, such as calming techniques, a quiet environment, nutritional support, and caregiver comfort to improve newborn care.
He is also pleased that Christiana Care’s Multi-Specialty Portfolio Program helped him submit his work on the neonatal improvement project in 2017 to maintain his certified status with the American Board of Pediatrics. Other pediatric team members, who contribute to the neonatal project, have also submitted the quality improvement project for maintenance of certification.
“For physicians, who are busy attending to daily details of a practice, the Portfolio Program recognizes the work already being done to advance the care of patients and eases some of the burdens associated with submitting a quality improvement project,” said David Paul, M.D., chair of the Department of Pediatrics and clinical leader of the Women and Children’s Service Line. “It’s a helpful program for Christiana Care to provide.”
Recognizing that Christiana Care and other health care organizations have meaningful improvement projects under way, the American Board of Medical Specialties has allowed qualified institutions to launch Multi-Specialty Portfolio Programs through which improvement projects can be submitted by physicians for maintenance of certification. The Portfolio Program is designed to continue the high standards for improvement projects and to make it easier for physicians to meet all the requirements for a project submission.
In late 2015, Christiana Care was named a sponsor of the program, and in February 2018 the hospital system renewed its participation. In Dr. Soykan’s view, the program deserves to be widely used, as it helps physicians highlight key data-driven elements of quality improvement, such as safety, efficiency and effectiveness. The program is the only one of its kind in Delaware.
Today before designing a quality improvement project, physicians can consult with the Multi-Specialty Portfolio Program to make sure a potential investigation has the necessary data-driven protocols for maintenance of certification, said T. Sheron Smith, MHA, LNHA, PCMH, CCE, director, Continuing Medical Education and Physician Professional Development. She is one of 10 members of a multidisciplinary committee from various service lines within Christiana Care that oversees the Portfolio Program.
Smith is also part of a committee working group that reviews maintenance of certification applications and consults with physicians on how to improve their projects prior to formal submission.Other working group members are Loretta Consiglio-Ward, MSN, RN, education specialist, Quality and Safety, Institute for Learning, Leadership and Development (iLEAD); and Portfolio Program Committee Chair Robert Dressler, M.D., MBA, quality and safety officer, Academic and Medical Affairs.
“Over the last several years Christiana Care has increasingly asked clinicians to give their time for process improvements across the organization,” said Dr. Dressler. “One way that we can be supportive of these essential efforts to create more innovative, effective and affordable systems of care is to be active partners in the maintenance of certification process.”
Using the Multi-Specialty Portfolio Program
The American Board of Medical Specialties’ Multi-Specialty Portfolio Program, sponsored by Christiana Care, streamlines Part 4 of Maintenance of Certification dealing with the requirement to submit a quality improvement effort application. In planning a submission, physicians can contact the Portfolio Program Committee’s working group for advice on project selection, data collection and other matrices. A physician must have participated in an approved quality improvement effort and have satisfied all of the participation requirements. An attestation must also be “cosigned” (an electronic form is provided for this purpose) by the project leader.
For maintenance of certification renewals due in December 2018, the working group will take electronic submissions until November. Once data has been properly collected by a physician, forms are filled out and the project is submitted via the Christiana Care portal.
At that time, the working group reviews the application and asks a physician for additional information, if needed. When all data is supplied, the completed forms are shared with the entire 10-member committee for final approval. The whole submission effort typically takes 30 days when all the forms are complete.