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Accreditation – Learning from Each Other. Jane C.K. Fitch, MD John L. Plewes Professor & Chair University of Oklahoma. Summary. ACGME/RRC info Data from ACGME website and Grogono’s 13 th annual anesthesiology NRMP report Survey info Example Discussion/ discussion / discussion. ACGME.

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accreditation learning from each other

Accreditation – Learning from Each Other

Jane C.K. Fitch, MD

John L. Plewes Professor & Chair

University of Oklahoma

summary
Summary
  • ACGME/RRC info
    • Data from ACGME website and Grogono’s 13th annual anesthesiology NRMP report
  • Survey info
  • Example
  • Discussion/discussion/discussion
acgme
ACGME
  • 7,800 GME programs
  • 118 specialty programs
  • 27 RRCs
  • RRCs include AMA (CME), ABMS (ABA), and academic specialty organization (ASA)
acgme4
ACGME
  • 3 basic functions of accreditation:
    • Establishment and periodic revision of publicly available accreditation standards
    • Measure compliance by program with accreditation standards
    • Notify the general public of a program’s accreditation status
accreditation actions
Accreditation Actions
  • Withheld Accreditation**
  • Initial Accreditation
  • Continued Accreditation
  • Probationary Accreditation**
  • Withdrawal of Accreditation**

(** indicates adverse actions)

anesthesiology notification letter
Anesthesiology Notification Letter
  • Accreditation Status
  • Length of Training
  • Maximum Number of Residents
  • Notification Letter
  • Effective Date
  • Next Site Visit
  • Program Listing
acgme rrc anesthesiolgy staff
ACGME RRCAnesthesiolgy Staff
  • Judith Armbruster, PhD, Executive Director
  • Linda Thorsen, MA, Associate Executive Director
  • Norma R. DeYagcier, Accreditation Administrator
  • Denise Braun, Accreditation Assistant
rrc anesthesiology committee members
RRC Anesthesiology Committee Members
  • J. Jeffrey Andrews, M.D. ASA
  • Audree A. Bendo, M.D. ASA
  • Philip D. Lumb, MB, BS ASA
  • Lois L. Bready, M.D. CME
  • David L. Brown, M.D. CME
  • Jeffrey R. Kirsch, M.D. CME
  • Steven C. Hall, M.D. ABA
  • Mark A. Rockoff, M.D. ABA
  • Mark A. Warner, M.D. ABA
  • Corey E. Collins, D.O Resident
anesthesiology rrc
Anesthesiology RRC
  • Average accreditation length is 3.7 years (range of 1 to 5 years)
  • Longer accreditation (4 or 5 years) indicates the ACGME and RRCs are more confident about a program’s ability to provide quality education.
acgme11
ACGME
  • Field staff (FS) vs Specialist Site Visitor (SSV)
    • FS if cycle is 4 or 5 years
    • SSV if cycle is 1 to 3 years
slide14
Withdrawn Programs by Academic Year (Voluntary Withdrawal, Accreditation Withdrawn, or Administrative Withdrawal)
positions matched by state
Positions Matched by State
  • 1999 - 2005
    • NY, CA, MA, PA, TX, IL
  • 24 % top 2 states
  • 44 % top 5 states
  • 64 % top 10 states
positions matched per million population
Positions Matched per Million Population
  • Avg 30 matched per 6.6 million
    • 4.37 matched/million
  • Range 1.1 – 20.98 matched/million
2005 nrmp
2005 NRMP
  • 2.5 % incr recruitment (1200 to 1230)
  • 0.5 % decr positions offered (1289 to 1283)
  • 83 % programs filled (89 to 53)
  • 6.22 % NRMP students match into anesthesiology
accreditation decisions in 2004 05 for all core anesthesiology programs
Accreditation Decisions in 2004-05 for All Core Anesthesiology Programs
  • 132 Total programs
  • 33 Reviewed
  • 28 Cited
  • 1 Full Accreditation
  • 27 Continued Full Accreditation
frequent anesthesiology citations
Frequent Anesthesiology Citations
  • Evaluations
    • None by resident, faculty
  • Scholarly Activity
    • Few pubs, little or no ADs
  • PACU
    • Little organized teaching, other duties, not contiguous
  • Critical Care
    • No anesthesiology involvement
  • Resident Complement
    • Exceeded without approval
frequent anesthesiology citations con t
Frequent Anesthesiology Citations (con’t)
  • Clinical Experience (logs)
    • Uneven distribution, lack minimum requirement, not regularly monitored by PD
  • Goals and Objectives
    • Not detailed, not developed for all rotations, not distributed
  • Affiliation Agreements
    • Not signed, not updated, not all with PIF, integrated agreements not specify PD to make all appointments
  • Competencies
    • Not incorporated into curriculum, not familiar with Outcomes initiative
frequent anesthesiology citations con t24
Frequent Anesthesiology Citations (con’t) *
  • Poor board scores
  • Continual faculty turnover
  • Inadequate supervision
  • Excess number of residents
  • Inadequate scholarly activity
  • Inadequate institutional support

* JSA

states with no anesthesiology residency programs
AK – West

HI - West

ID - West

MT – West

NV - West

WY - West

DE – NE

RI – NE

ND - Central

SD - Central

States with No Anesthesiology Residency Programs
states with only one anesthesiology residency program
AL - South

AR – South

MS – South

OK – South

SC – South

WV – South

AZ - West

CO – West

NM - West

OR - West

UT - West

IN - Central

IA – Central

NE – Central

NH - NE

VT – NE

ME - NE

States with Only One Anesthesiology Residency Program
slide30
OU
  • Nov 2000 “The Scarlet P”, 11 citations
  • Nov 2001
  • Site visit 3/02
    • See you in 2 years!
  • Site visit 5/04
    • 4 year review cycle, no citations
slide31
OU
  • 3 areas:
    • ICU
    • Board scores
    • Scholarly activity
slide32
OU
  • 3 areas:
    • ICU
      • Then
        • Pulm/med ICU & PICU
        • No anesthesiology intensivists
      • Now
        • NICU, PICU, Surgery/trauma
        • 3 intensivists
      • Future
        • Multidisciplinary fellowship
slide33
OU
  • 3 areas:
    • Board scores
      • Then
        • 1 year curriculum, 6 AM lectures, ITE, AKT pre, no mock orals, no review course program, 65 %
      • Now
        • 3 yr curriculum, WEB 3 – 5 PM, ITE, AKT pre/post/6/18, mock orals, $ and time for one review course/yr/resident, 83 %
      • Future
        • 100 % pass rate
slide34
OU
  • 3 areas:
    • Scholarly activity
      • Then
        • No clinical or basic research, no infrastructure, no ADs
      • Now
        • Both clinical and basic research, infrastructure, CST last 2 years, ADs
      • Future
        • PhD, peer reviewed funding
slide35
OU
  • Support (aka $$$)
    • Dean, COM
    • CEO, Hospital (HCA)
  • OK Board of Health
    • Conrad 30 plan
    • HPSA, MUA, MUP
summary36
Summary
  • ACGME/RRC info
    • Data from ACGME website and Grogono’s 13th annual anesthesiology NRMP report
  • Survey info
  • Example
  • Discussion/discussion/discussion
ad