So much for good intentions. I ended up eating lunch at lunch, and not getting back to my room at breaks to catch up. So here I am, after a great dinner with even greater company at Finos, a nice Italian restaurant right around the corner from the hotel.
Anyway, to continue the post about this morning's plenary session on putting CME in a systems framework: Barbara Barnes, MD, with the University of Pittsburgh, said that while academia has the clinical care, research, and education components, the three have become more like separate systems than part of one organic whole over time. CME in particular has become marginalized from the rest of the research and care systems. She sees regularly scheduled conferences as one of the greatest opportunities for making change, and stressed the need for performing a more active role in quality improvement committees.
The session ended on a high note with Barbara Huffman, MEd, Carle Foundation Hospital, who was a hoot of a speaker. "The easy thing about hospitals is that we have the three Ds: Docs, diseases, and data," she said. "The problem is that patient care comes first, and everyone else takes a number—for CME, that number is usually in the double digits." And, she added, if your administration changes, your processes and culture change along with it. "Your system will always have an effect on you," she said.
In 2004, she was tasked with coming up with seven patient safety goals—things like making sure the right body parts are removed from the right body, and that one person's ID badge doesn't show up on someone else's meds.
In doing the needs assessment, they found that they had the 80/20 rule going: 80 percent of the admissions came from 20 percent of the doctors. "So we decided to concentrate on the big admitters. We designed our program for the high users by using them as instructors—what better way to get them to change than to put them on the spot?" she said. They did all kinds of interventions, including putting the seven patient safety goals on mouse pads. "But we didn't give them to the doctors, because they'd just take them home to give to their kids," she said, laughing. Instead, they gave the message mouse pads to those who check the patients in and out, so they could be sure the protocols were being followed. (Which is pretty smart, I may add.)
I'm losing steam for the night, seeing as it's about 1 a.m. where I come from and I have a very full belly that's making me sleepy. But I promise to write up some of the other sessions from today asap: The PACME followup session was pretty good, and the two sessions on preventing the appearance of commercial bias were terrific (basically, lots of cases we got to dissect). The session I went to on practical strategies for better outcomes also was really good—one person said it was the best session they went to all day, by far. And, of course, the free-for-all session where CME providers and pharma folks got to grill each other was really, really hot. They even gave out Web sites for grant proposals (I'm not sure if they want me to share those publicly, so I guess you probably had to be there for that part).
On my agenda tomorrow are sessions on the viability of speakers bureaus these days, the 2005 AMA PRA credit system update, and another as yet to be determined. If it didn't conflict with the AMA session, I'd love to go to the one on creating win-win joint/co-sponsorship relationships. I had the pleasure of meeting two of the three session leaders, Nathalie Harden and Ann Lichti, both with the Health Science Center for CME, last night, and they are just amazing. It will be one of the most dynamic and funniest sessions of the day, I guarantee it. Oh, and very educational.
So long for now, and please forgive any typos.