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Clinical Competency Committees

Clinical Competency Committees. What Faculty need to know Academic Affairs Committee ACEP,JMTF, CORD . WHAT…are Clinical Competency Committees (CCC’S)? . A group of faculty members tasked with Assessing resident performance and progress based on multi-source data

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Clinical Competency Committees

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  1. Clinical Competency Committees What Faculty need to know Academic Affairs Committee ACEP,JMTF, CORD

  2. WHAT…are Clinical Competency Committees (CCC’S)? • A group of faculty members tasked with • Assessing resident performance and progress based on multi-source data • Determining individual resident’s level on Milestones • Making formal recommendations to the PD regarding remediation, promotion and graduation

  3. WHAT...are the (EM) Milestones? • 23 (core) SKILLS, KNOWLEDGE AREAS, ATTITUDES • Specific to the 6 CORE COMPETENCIES FOR EM • (PC, MK, PROF, ICS, PBLI, SBP) • Organized in developmental framework of levels 1-5 • 1—entry level • 2-3 mid level resident advancing appropriately • 4 target for graduation • 5 expert level • Descriptors of levels

  4. EM MILESTONES • (pc-1) Resuscitation • (pc-2) H&P • (pc-3) Labs/Studies • (pc-4) DDx • (pc-5) Pharmacotherapy • (pc-6) Reassessment, F/U • (pc-7) Disposition 8. (pc-8) Multi-tasking 9. (pc-9) Procedures 10. (pc-10) Airway 11. (pc-11) Pain management/sedation 12. (pc-12) ED Ultrasound 13. (pc-13) Wound manage 14. (pc-14) Vascular Access

  5. EM Milestones continued… 15. (mk-1) Medical knowledge 16. (prof-1) Compassion, Integrity, Respect, Ethics 17. (prof-2) Accountability to society, patients, profession and self. 18. (ics-1) Patient centered communication 19. (ics-10) Team Managment 20. (pbli-1) Follow up, CQI, EBM 21. (sbp-1) Patient safety—SBAR, handoffs, checklists… 22. (sbp-2) Efficiency, flow 23. (sbp-3) Technology (EMR), data and information access

  6. WHY… is my program initiating CCC’s? • ACGME mandate: ALL programs must have CCC’s up and running by July 2013 as part of the Next Accreditation System (NAS). • All programs begin reporting aggregate data on residents’ milestone achievement by December 2013. • In NAS, CCC’s are integral in the process of interpreting data and assigning milestone levels.

  7. WHAT FOR? • What purpose does the ACGME hope to accomplish by requiring programs to establish CCC’s? • Increase the validity and accuracy of program assessment of resident competence throughout training and at graduation. • Provide the benefit of “the insight and perspective of a group” to the resident evaluation process. • Assure that programs detect resident deficiencies EARLY and provide meaningful recommendations for remediation. • Ultimately assure the competence of graduates to practice independently.

  8. WHO…comprises the CCC? • The ACGME allows programs flexibility. • Some parameters: • 5-7 members • MUST include clinically active core faculty “dedicated to resident education.” • MAY include non MD medical educators • Suggestions: • PD,APD, core faculty • Faculty who primarily supervise in clinical setting • Site directors • Involved nursing staff

  9. HOW will the CCC’s function? • Meet quarterly, biannually, or more frequently as necessary to allow semi-annual evaluation of each resident • Review multi-source data (previously compiled) for each resident. • Come to consensus on resident’s achievement of milestone level (possible milestone level 1-5). • Generate report with competency determination for each resident with recommendation for advancement, graduation or remediation.

  10. HOW…will CCC’s function? • CCC Chair (Ideally NOT PD) directs process • Members must maintain confidentiality of proceedings • Deliberations, decisions and reports may be protected (not discoverable) under peer-review confidentiality depending on state laws. • Ongoing evaluationof CCC process to allow recommendations for continued improvement of process regarding activities of CCC

  11. WHAT…are examples of data CCC may use in resident assessment? • In-Service Scores • Rotation/shift evaluations • Patient satisfaction data • Procedure logs • 360 evaluations • Scholarly work • Oral board performance • Direct observation data • Self evaluations/reflection • Adverse information (complaints, misconduct) • Administrative compliance • Structured chart review • Core measures • Provider Reports

  12. How will CCC’s compile data? • Programs are free to develop Assessment Tools for compiled data or use one already made. • Consistency of approach will increase accuracy even for un-validated assessment tools.

  13. WHAT…is the role of the PD? • Receives report/consensus determinations with recommendations of CCC. • Includes report in resident record. • Carries responsibility of ultimate decision making with regard to advancement, remediation, graduation.

  14. DATA Sources • FAQs ACGME Website: • www.acgme-nas.org/assets/pdf/NASFAQs.pdf • www.acgme-nas.org/assets/pdf/Milestones/EmergencyMedicineMilestones.pdf

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