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MAINTENANCE OF CERTIFICATION Part IV Practice Performance and Improvement
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  1. MAINTENANCE OF CERTIFICATIONPart IV Practice Performance and Improvement David L. Gillespie MD, FACS Professor of Surgery University of Rochester School of Medicine and Dentistry Rochester, NY

  2. Maintenance of Certification • ongoing process • continuous improvement • Surgeons must demonstrate a program of • ongoing learning • professional assessment • self improvement • Facilitates maintaining expertise within specialty The American Board of Surgery

  3. Maintenance of Certification • patient centered initiative • demonstrate high degree of professionalism • improve patient care • address concerns of public about quality • will strengthen the value of Board certification   The American Board of Surgery

  4. Maintenance of Certification (“MOC”):      • 1) Demonstration of Current Professional Standing • every 3 years, unrestricted License, privileges to practice, letter of attestation • 2) Demonstration of Lifelong Learning and Self Assessment • 50 CME credits per year, demonstrate self assessment • 3) Demonstration of Cognitive Expertise • recertification examination, once every TEN (10) years. • 4) Evaluation and Improvement of Performance in Practice The American Board of Surgery

  5. Maintenance of Certification (“MOC”):      • 1) Demonstration of Current Professional Standing • every 3 years, unrestricted License, privileges to practice, letter of attestation • 2) Demonstration of Lifelong Learning and Self Assessment • 50 CME credits per year, demonstrate self assessment • 3) Demonstration of Cognitive Expertise • recertification examination, once every TEN (10) years. • 4) Evaluation and Improvement of Performance in Practice The American Board of Surgery

  6. Maintenance of Certification (“MOC”):      • 1) Demonstration of Current Professional Standing • every 3 years, unrestricted License, privileges to practice, letter of attestation • 2) Demonstration of Lifelong Learning and Self Assessment • 50 CME credits per year, demonstrate self assessment • 3) Demonstration of Cognitive Expertise • recertification examination, once every TEN (10) years. • 4) Evaluation and Improvement of Performance in Practice The American Board of Surgery

  7. Maintenance of Certification (“MOC”):      • 1) Demonstration of Current Professional Standing • every 3 years, unrestricted License, privileges to practice, letter of attestation • 2) Demonstration of Lifelong Learning and Self Assessment • 50 CME credits per year, demonstrate self assessment • 3) Demonstration of Cognitive Expertise • recertification examination, once every TEN (10) years. • 4) Evaluation / Improvement of PracticePerformance The American Board of Surgery

  8. Part IV MOCPractice Performance and Improvement • Verification required every three (3) years • involved in one or more assessment programs • focus on analysis of practice performance • quantitative assessment • Use info gained for performance improvement The American Board of Surgery

  9. Part IV MOCPractice Performance and Improvement • Requirements are subject of active discussion • by the ABS, ACS, SVS, SCVS • unclear what programs will qualify • To show Performance Evaluation/Improvement • will be more than participation in M&M The American Board of Surgery

  10. Part IV MOC- Practice Performance and Improvement – • Some examples which might apply include • participation in Quality Outcome projects such as • National Surgical Quality Improvement Project (NSQIP), • Surgical Care Improvement Project (SCIP) • practice databases such as those being developed through • the ACS web portal • the SVS carotid database The American Board of Surgery

  11. Part IV MOC- Practice Performance and Improvement – • Participation in NSQIP (National Surgery Quality Improvement Program) The American Board of Surgery

  12. Part IV MOC- Practice Performance and Improvement – • NSQIP (National Surgery Quality Improvement Program) • Grew out of the National VA Surgical Risk Study 1991 • now offered to all interested hospitals • 2004 ACS began enrolling • new private sector hospitals into the ACS NSQIP The American Board of Surgery

  13. Part IV MOC- Practice Performance and Improvement – • NSQIP (National Surgery Quality Improvement Program) • The ACS NSQIP is available to all private sector hospitals that • meet the minimum participation requirements, • complete a hospital agreement, • pay an annual fee of $35,000. • Many benefits by participating • most importantly reduction of surgical morbidity and mortality • VA NSQIP will continue in parallel system • will compare its results against the ACS NSQIP private sector data The American Board of Surgery

  14. Part IV MOC- Practice Performance and Improvement – • Participation in SCIP (Surgical Care Improvement Project) The American Board of Surgery

  15. Part IV MOC- Practice Performance and Improvement – • SCIP (Surgical Care Improvement Project) • A national quality partnership of organizations • improving surgical care by reducing surgical complications • Steering committee ACS, CMS, AHA, ASA, AORN, CDC, AHRQ • Goal: reduce preventable surgical M&M by 25 % by the 2010 • Hospitals can join SCIP to collect and submit data • Hospitals that wish to sign up to participate in SCIP • complete Hospital Letter of Participation and fax it The American Board of Surgery

  16. Part IV MOC- Practice Performance and Improvement – • SCIP has four modules • Infection • 7 Infection Prevention Process Measures • Venous Thromboembolus (VTE) • 2 VTE Prevention Process Measures • Cardiac Prevention Module • 1 Cardiovascular Prevention Measure • Respiratory • Delayed implementation to use these measure in expanding the ICU Core Measure Set The American Board of Surgery

  17. Part IV MOC- Practice Performance and Improvement – • Some examples which might apply include • participation in Quality Outcome projects such as • National Surgical Quality Improvement Project (NSQIP), • Surgical Care Improvement Project (SCIP) • practice databases such as those being developed through • the ACS web portal • the SVS carotid database. The American Board of Surgery

  18. Part IV MOC- Practice Performance and Improvement – • ACS Practice Based Learning System (case log system) The American Board of Surgery

  19. Part IV MOC- Practice Performance and Improvement – • ACS case log system • allows surgeons to track their cases and outcomes • convenient easy-to-use. • Can compare personal outcomes to others confidentially • opportunities for training from learning modules The American Board of Surgery

  20. Part IV MOC- Practice Performance and Improvement – • ACS case log system • The American Board of Surgery has • identified Practice Based Learning and Improvement as a core competency. • in the future the case logging system could support • submission of case logs for maintenance of certification (MOC). • open only to members of the American College of Surgeons. • To register for the system you will need to log in to the ACS Web site. The American Board of Surgery

  21. Part IV MOC- Practice Performance and Improvement – • SVS carotid database The American Board of Surgery

  22. Part IV MOC- Practice Performance and Improvement – • SVS carotid database • ensures eligibility for CAS reimbursement. • CMSrequire data collection on CAS for reimbursement • offers confidential benchmarking reports • Site-specific CEA vs. CAS baseline risk factors and complications • over time in your facility. • to other institutions • by individual provider • "Real time" access to all your data for analysis. The American Board of Surgery

  23. Part IV MOC- Practice Performance and Improvement – • SVS carotid database • Facility benefits • available now • easy-to-use • cost-effective way to meet CMS regulations for CAS • downloadable database • Collection of ongoing follow-up • Collects both stenting and open repair data for comparison. • Real-time comparative reports. • one-time enrollment fee of $1,000 • annual subscription fee of $3,000 The American Board of Surgery

  24. Part IV MOC- Practice Performance and Improvement – • The ABS is investigating other data systems • Personal • national, • regional, • hospital-specific • and is soliciting input • e-mail at mocpart4@absurgery.org The American Board of Surgery

  25. Thank you The American Board of Surgery