IOM MEETING PUSHES FOR TEAM-CENTERED CME

The Institute of Medicine brought approximately 160 national experts to Washington, D.C., this summer. Their mission was to explore ways to restructure health profession education to better prepare health care professionals to practice in a world that has shifted from acute to chronic care; evidence-based practice; increasing interdisciplinary team health care; and changing patient-clinician relations.

“It was exciting to be there with colleagues who represented schools of medicine, dentistry, pharmacy, accrediting, credentialing and licensing organizations, health care specialties, government agencies, foundations, and integrated health care systems,” says Bruce Bellande, PhD., executive director of the Alliance for CME in Birmingham, Ala.

The idea behind the meeting was to develop strategies to move forward on the five core areas addressed in IOM's previously released “Crossing the Quality Chasm” and “To Err is Human” reports — patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics.

Working in small groups, the interdisciplinary teams tackled an overarching objective: “How do we educate health care professionals to provide evidence-based, patient-centered care, delivered by interdisciplinary teams using quality improvement and informatics as a foundation?” They developed action plans that the groups and participating individuals would move forward with after the meeting.

In all, there were more than 200 action plans generated; a report on the action plans, and possibly further developments that may come out of individual and groups continuing work on the action plans, is expected to be released by the end of 2002.

Next Step: More Patient-Driven CME

“The main thing that I think will come out of this for CME providers is that CME will be taking a more patient-centered approach,” says Bellande. “Evidenced-based medicine and quality improvement also will be even more clearly on the radar screen.”

But while strides have already been taken on most of the five core steps, he thinks the idea of multidisciplinary teams might prove to be the most problematic to implement. “Typically, the main focus in CME is on one health care professional group. A major implication for us is to find ways to incorporate some kind of interdisciplinary team approach in CME and many of the related educational activities we engage in,” he says.

While some CME providers do offer nursing credit and pharmacy credit in addition to Category 1 AMA PRA credit for activities, most of these programs focus on what's new in a specific area that applies to different types of health care professionals, he says, rather than on fostering teamwork. “The question is: To what degree can interdisciplinary education be integrated into the current system? Or would it require a mild to major — if not drastic — reform of the health care profession curriculum?”

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