"Continuous Professional Development in Patient Safety" - Erik ...

CONTINUOUS PROFESSIONAL DEVELOPMENT IN
PATIENT SAFETY
Erik Langenau, DO, FAAP, FACOP,
Vice President for Continuous Professional Development & Innovations
Melissa Turner, MS
Senior Quality and Patient Safety Officer
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Continuous Professional Development in Patient Safety
• Disclosures
– None
• Agenda
– What are the elements of Patient Safety? (Melissa Turner)
– What continuous professional development programs
address Patient Safety? (Erik Langenau)
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Continuous Professional Development in Patient Safety
Medical Error and Patient Safety
• 1 in 25 hospital patients sustains injury related to
medical error
• Medical errors account for 44,000-98,000 deaths
per year
• By low US mortality estimates, medical error is
the 8 th leading cause of death
The Institute of Medicine: Achieving a New Standard for Care (2004). IOM; 2010. Available at
http://www.nap.edu/openbook.php?record_id=10863&page=30. Last accessed December 2012.
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Continuous Professional Development in Patient Safety
Medical Error and Healthcare Costs
• Medical errors cost $17-29 billion per year in
expense, lost worker productivity and disability
• US healthcare expense rising 7% per year,
patient safety improving by 1% per year
Reducing Errors in Healthcare: Translating Research Into Practice (2000). The Agency for Healthcare
Research and Quality (AHRQ); 2000. Available at http://www.ahrq.gov/qual/errors.htm. Last accessed
December 2012.
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Continuous Professional Development in Patient Safety
Types of medical error
• Diagnostic process error resulting in
– near miss, misdiagnosis, harm
• Diagnostic error resulting in
– Misdiagnosis, missed diagnosis, delayed diagnosis
• Adverse outcome
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Continuous Professional Development in Patient Safety
• How do we know?
• Why do we measure?
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QUALITY: PATIENT-CENTERED, TIMELY CARE
Doctor–Patient Communication: Doctor Listened Carefully,
Explained Things Clearly, Respected What They Had to Say,
and Spent Enough Time with Them
Percent of adults age 18 and older reported “always”
100
U.S. average
75
54
57 57 57 58 57
50
25
0
2002^ 2003 2004^ 2005 2006 2007
^ Denotes years in 2006 and 2008 National Scorecards.
Data: U.S. average—Medical Expenditure Panel Survey (AHRQ 2010)
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Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2011. 7

Continuous Professional Development in Patient Safety
Continuous Professional Development Programs
Best Practices
Patient Safety
Continuous Professional Development
(CPD) Programs
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Continuous Professional Development in Patient Safety
Board Certified Physicians:
Osteopathic Continuous Certification (OCC)
Maintenance of Certification (MOC)
FSMB-MOL AOA-OCC ABMS-MOC
1. Unrestricted Licensure 1. Licensure & Professional Standing
1. Reflective Lifelong
Learning
2. The assessment of
knowledge & skills
2. Lifelong Learning/CME 2. Lifelong Learning & Selfassessment
3. Cognitive Assessment 3. Cognitive Expertise
3. Performance in Practice 4. Practice Performance
Assessment & Improvement
4. Practice Performance Assessment
5. AOA Membership
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Continuous Professional Development in Patient Safety
Board Certified Physicians:
Osteopathic Continuous Certification (OCC)
Maintenance of Certification (MOC)
FSMB-MOL AOA-OCC ABMS-MOC
1. Unrestricted Licensure 1. Licensure & Professional Standing
1. Reflective Lifelong
Learning
2. The assessment of
knowledge & skills
2. Lifelong Learning/CME 2. Lifelong Learning & Selfassessment
3. Cognitive Assessment 3. Cognitive Expertise
3. Performance in Practice 4. Practice Performance
Assessment & Improvement
4. Practice Performance Assessment
5. AOA Membership
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Continuous Professional Development in Patient Safety
Examples of CME programs
• Conferences
– Annual Health Care Quality & Patient Safety Conference
– Annual National Patient Safety Foundation (NPSF)
Patient Safety Congress
• Knowledge examinations
– Pediatrics Review and Education Program (PREP)
– Continuous Osteopathic Learning Assessment (COLA)
• Online courses
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Continuous Professional Development in Patient Safety
Examples of Practice Improvement Programs
• Simulation
– Practical Exam / Standardized Patients
• AOBNMM Oral and Practical Exam
– Simulations (Mannequin, Part-task)
• ACLS / BLS
• ABA (Anesthesiology) Simulation Exams
• Fundamentals of Laparoscopic Surgery (FLS)
– Computer–Based Simulation
• ABFM Self-Assessment Module (SAM)
http://www.wiser.pitt.edu/sites/wiser/moca
www.sciencedirect.com
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Continuous Professional Development in Patient Safety
Examples of Practice Improvement Programs
• Practice Improvement Modules
– ABMS: Patient Safety Improvement Program (PSIP)
– ABFP: Performance in Practice Module (PPM)
– ABIM: Practice Improvement Modules (PIM)
– AOA: Clinical Assessment Program (CAP)
– NBOME: Osteopathic Performance Assessment and
Improvement Module (OPAIM TM )
• Emerging Programs
– Virtual Environments
– Web-Based Communication Assessment
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Continuous Professional Development in Patient Safety
• Clinical Assessment Program (CAP)
– CAP for PQRI (Physician Quality Reporting Initiative)
– “Improves patient outcomes by providing valid assessments
of current clinical practices in osteopathic residency
programs and physician practices”
– “CAP is a Web-based performance measurement program
which analyzes data taken directly from patient medical
records”
– “Demonstrates the osteopathic profession's commitment to
continuous quality improvement”
Reference: McGill SL. Using AOA’s Clinical Assessment Program in Performance Improvement
CME. Available at http://www.osteopathic.org/inside-aoa/events/Documents/cme-and-usingaoa-clinical-assessment-program.pdf
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Continuous Professional Development in Patient Safety
• Osteopathic Performance Assessment and
Improvement Module (OPAIM ® )
– Web-based asynchronous platform
– Formative assessment
– Practice assessment
– Educational components: journal club, video demonstrations,
screencasts, etc
– Self reflection
– Individualized Learning Plan
– Pre and post knowledge assessment
– Pre and post performance assessment
– Osteopathically distinct
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Continuous Professional Development in Patient Safety
• Sample
MOC
Program
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Continuous Professional Development in Patient Safety
Meaningful opportunities to improve patient care and safety
FSMB-MOL AOA-OCC ABMS-MOC
1. Unrestricted Licensure 1. Licensure & Professional Standing
1. Reflective Lifelong
Learning
2. Lifelong Learning/CME 2. Lifelong Learning & Selfassessment
2. The assessment of
knowledge & skills
3. Cognitive Assessment 3. Cognitive Expertise
3. Performance in Practice 4. Practice Performance
Assessment & Improvement
5. AOA Membership
4. Practice Performance Assessment
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Continuous Professional Development in Patient Safety
References
• Agency for Healthcare Research and Quality (AHRQ). Reducing Errors in Healthcare:
Translating Research Into Practice. 2000. Available at http://www.ahrq.gov/qual/errors.htm.
• Institute of Medicine. The Institute of Medicine: Achieving a New Standard for Care (2004).
IOM; 2010. Available at http://www.nap.edu/openbook.php?record_id=10863&page=30.
• Langenau EE, Gimpel JR. The Challenges for Physicians of Demonstrating Continuing
Competence in the Changing World of Medical Regulation: Osteopathic Pediatrician Case
Report. J Med Reg. 2012;97(4): 14-20.
• Levine AI, Schwartz AD, Bryson EO, Demaria S Jr. Role of simulation in U.S. physician
licensure and certification. Mt Sinai J Med. 2012;79(1):140-53.
• McGill SL. Using AOA’s Clinical Assessment Program in Performance Improvement CME.
Available at http://www.osteopathic.org/inside-aoa/events/Documents/cme-and-using-aoaclinical-assessment-program.pdf
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THANK YOU
Any Questions?
The NBOME’s vision is to be the global leader in assessment for
osteopathic medicine and related health care professions.
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