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Congregation of Christian Brothers ​hi i'm steve singer i'm the director of education and outreach at the Accreditation Council for continuing medical education my name is Kathy Marion I'm the manager of standards and outcomes at the American Academy of Family Physicians hi Kathy welcome thank you Steve how are you I'm good good good glad to have you here and I think what we're going to talk about today is flipping the flipping our assumptions about overall program sort of reflection evaluation improvement as part of our ACCME requirements we have requirements that organizations is sort of a value of accreditation that they're reflective and they learn and they improve over time so that plan do study act and they're also process parts of that there's a self-study process there's education and resources that we provide to providers sort of at a midpoint within their accreditation term to say okay it's time to start thinking about re-accreditation and those sorts of things but I think that a sort of a consequence perhaps of those rules is a perspective that that reflection and improvement is in ACCME requirements as opposed to an organizational value so I'd like to have a conversation with you and and sort of learn from your experience about what you've seen and what you're seeing now and whether or not we can sort of flip that assumption around so do me a favor tell me tell me what you're doing now okay where you work and then we're gonna roll back the clock a little bit and look at where you came from I'm the manager of standards and outcomes at the American Academy of Family Physicians and in that role I oversee the AFP credit system as well as our educational design and delivery and the associated accreditation with the ACCME to be able to award PA are a category one credit okay and before that give give us a little history of Cathy okay prior to coming to the American Academy of Family Physicians I was in higher ed for about 12 years working with adult students so I would work with students who had returned to earn bachelor's and master's degrees at several different universities okay and as an educator within sort of a formal educational system that was also the system that was accredited right hiring different accreditation right exactly higher education does have accrediting bodies where you have to demonstrate your programs compliance in order to continue to be an accredited institution okay so similar similar kind of sort of regulatory okay so relative to that because we were talking before before the interview about the comparison what you did there and what you do now so tell us about how what you did for that organizational accreditation with regard to the program level you know so this high level how is the program evolving and improving over time okay historically in higher education the cycle of accreditation was ten years if you were found compliant and so about two years before that you would start gathering documentation identifying report writers and gathering the data you needed to demonstrate why you're making your case making your case prior probably about three to five years before I left higher ed they started a new program called a quip which was an annual of RIA credit a ssin cycle and so for a three year plan you would write your your goals your strategies and your plan and then annually you would provide an update of what you were doing to demonstrate that you were aligned on that quality improvement plan and if you ran into problems and you hadn't reached some of those goals you explained why but your focus might have been on a higher priority that your business identified as you were going through the process and so as long as you continued in that cycle and demonstrated that you were making progress and you were aligning with the guidelines and policy around higher education you were able to remain a credit and an accredited institution of higher ed okay okay so the so that perspective informs an approach that you've brought to your role at the aafp right so tell us tell us what what you're doing or your involvement with your sort of organizational review at the AAFP and then we'll we'll sort of connect that back to ACCME requirements on this question about whether there's more than one way to to do this when I came to the Academy almost five years ago they had just received accreditation with commendation and everyone was really excited because that meant we had six years before we went through the process again and so but also you know it's also a value it's a very much that's interesting that's exactly sort of to our to the points right the value of being an accredited provider is the core of our missionary and our drive so right that's not in question of course it was more the process of the what was needed to gather the information and the documentation and the preparation successfully navigating that and then successfully being able to say hey we've got commendation which provided value not only to our learners but to others that we worked with within the cme environment right and as a credit system it's very important that we show adherence to the highest level of commendation that we can achieve for our credit system okay so after I when I arrived coming from a different environment it took me a couple of years to understand CME understand processes I attended many of the ACCME bridges to quality as the role of our Credit System and listened to the presentation several times and began to think

well how can we adapt and adopt all of these systems that we put in place but use those to tell our story so halfway through our react red adacia n-- cycle i decided that we would pull a team together and we would look at what we've done so far let's outline where we are in the process based on what we said we were going to do for improvement and then write a mini mock self-study to address all the criteria that were expected and then do our own random audit of files and determine where are the gaps in those files and what training we need to be able to because for our CME Department quality being able to be support the needs of our learners and be relevant being able to train our staff on how to comply and then the process behind that is how we have to come up with tactical decisions to address the strategy of being an ACCME certified provider okay so you've described sort of what I seen sort of is two domains you're sort of defining this in sort of a broad context so you you talked about this this institutional reviewer sort of an interim review that you did internally that looked at the materials and and files and stuff like that looking for from an administrative standpoint do we have what we need or what we will need for accreditation purposes going forward sort of does it take a look at that in an interim fashion as opposed to sort of all in a big cramming rush you know before the deadline but in the midst of describing those administrative things you also sort of moved over and you were starting to talk about things that didn't sound like accreditation requirements you were talking about value and relevance to your learner's you're talking about I think faculty and the support that you give to them so in in these sort of two areas and and now I'm going to reflect back to your academic background that you had when you did that sort of yearly review was it also sort of across two areas both looking at sort of administrative have we crossed the T's and dotted the eyes as well as these sort of points of value I think so I think strategy drives tactic so if our strategy is to be an ACC accredited provider with commendation for the value that's providing what are the strategies around doing that what are the goals and metrics we need to put into place so those metrics and help to buy drive policy help drive vision help drive direction and then the file pull the tactics the pieces that have to be there to demonstrate that competency at that detail level need to be outlined more importantly to that organizationally with education being one of our core pillars that is an organizational goal every year we set metrics around education for competence for demonstrating accreditation being engaged in the external environment and so as those goals are set those are woven into the various rules that govern see me and then it's our job to filter those into the fabric of what we're doing yeah that's that's a it's a nice way of describing it because I think that you you've described sort of the intersection between accreditations public trust in as you described being responsive to what medicine and patience and and the public needs and bringing that into our requirements so that by satisfying our requirements we are helping to sort of bring the system toward what the public and what medicine are are looking for and then you describe that that your organization's view of accreditation as a value is is a way a marker of your organization's alignment with those same external sort of goals okay so in in a more tactical setting one of the things I'm wondering is the the you know you mentioned that you've come several ACCME workshops and and as we provide materials and resources and education to help providers successfully navigate let's say the self-study process and all the things that we need to have and all the things that need to be brought forward one of our goals has been to try to simplify and evolve those processes and our hope is to find a middle ground where it becomes more difficult to tell the difference between your own narrative your own sort of telling your story about how your organization is striving towards those values and what we are looking for it accreditation in terms of what we are what we need to see sort of the evidence that we need to look at so my question is is that as your as your processes have devolved at the devil AFP have you found a way to simplify that process and evolve that process do you feel that it's been taken on as a value or not there yet I believe that it's been taken on as a value but I also see it's an evolutionary process I think that it's a continuation you never really get to the endpoint you're constantly looking to say how can I ensure the education is unbiased how can I ensure that it has the highest quality that it's a relevant education that's aligning with the changes in MOC mo l so as those become important components of CME we need to work to make sure that our story that you mentioned in engulfs that information and then as we're telling our story we need to look around at the realm of compliance to say are we compliant in the processes we have a place to do that so we can demonstrate to our learners to the community and to legislative bodies that the CME knows how to manage education to improve the health of the public in the institutional or the organizational review that you do how is it structured on an annual basis we our board approves an organizational level of metrics around each of our four pillars practice advancement education health of the public and advocacy and through those metrics they filter down to our vice-president level to our division level to our Park Department level and then ultimately our staff level and so as those metrics are written there aligning with the different strategies to support the vision of the organization and within education specifically CME providing the education meeting educational needs of our members and to improve the health of the public their families in the community is a key goal for us and it but that's it's sort of a long side so I understand now better that that sits alongside the goal of

maintain our accreditation correct and and and pursue excellence and codes right okay so but do you do you find that the I understand that the the the definition of having to be prepared and and sort of maintain what you need for accreditation is sort of an essential goal at its level but do you find that because you have this organizational framework which is bigger and broader does that organizational narrative help you to tell your story to the ACCME Oh most definitely I think when we look at the categories of 16 to 22 we we can pull so many different examples of how our organization is demonstrating and embracing within itself those qualities and those those criteria I think in my opinion if we're doing that well the tactics of the rest of the criteria and the standards of support commercial support follow in the process of the steps you have to do so they're woven into our educational design and development process they're not there because they have to be there they're there because our members and our learners and our organization expects that we provide education that has that level of quality and rigor right and I would suppose that it's also it's it's possible there are other organizations that are there other CME professionals that are watching this and it's sort of thinking what does this mean or how do I apply this in my organization you can also consider this idea that the the definition or the I mean the distinction between organizational mission and these you know four pillars that you talked about and CMU mission can can sort of dissolve a little bit that that you can look at your that that one of the roles that you have is to support the overall organization's mission and therefore as you're reflective about how to improve you're certainly looking at your educational program you know the things that you're doing that are part of the educational function but if that educational function is a core aspect of which organization does then the sort of a delineation between the CME program sort of in a box as opposed to the broader organization is not necessarily a distinction that that that we from accreditation need to you know that we don't require or you know so that's sort of an opportunity and I think one of the ways that we've really helped integrate not just policy within the CME department or process is we formed a CME Strategy Group which includes executives from around the organization and our different areas where we talk about education first of all in general how we use CME to support members needs and address the gaps that they have but also what other tools are a roundel organization that we can refer our learners to either through patient education or tools to support the enhancement of patient-centered medical home or practice advancement right so we're them together as a community and see the learner as an entity that we want to support with the various things that the Academy does interesting so you're really sort of in viewing that strategic asset yes kind of approach Thank You Kathy thank you appreciate your coming CUNY William E. Macaulay Honors College.