This is the second in a three-part series on the ACCME accreditation process for CME providers. The first details the ACCME's accreditation process; and the third shows how to bounce back after being placed on probation or receiving a progress report requirement.

In a video on the ACCME’s Web site, Kopelow calls the set of criteria with which providers must comply to achieve accreditation with commendation “a set of values or attributes that ACCME believes are the ones that can have the highest impact on healthcare, patient outcomes, and physician practice.” It also can seem out of reach for CME providers who don’t provide patient care services or have clinical and patient data. As an audience member at a session on achieving accreditation with commendation at the 2012 ACEHP conference said, “If we’re not a hospital or a medical school, how can we comply with things like Criteria 21 [which requires providers to participate ‘within an institutional or system framework for quality improvement.’]?”

To answer this question, the Accreditation Council for Continuing Medical Education has created the following example, putting itself in the role of an accredited provider. In this example, the ACCME’s CME mission is to enhance the competence and performance of CME professionals with respect to the ACCME requirements and in turn to enhance the competence, performance, or patient outcomes of their learners. The ACCME will seek to do this through its online resources, its live educational events, and its focused webconferences.

Criterion 16: The provider operates in a manner that integrates CME into the process for improving professional practice.

➽ The ACCME has reached out to numerous government and health system organizations to facilitate the inclusion of accredited CME as a “bridge to quality” and as a strategic asset to their initiatives to improve physician practice. For example, the ACCME has worked with the Office of National Drug Control Policy and the Food and Drug Administration to position accredited CME as a strategic partner in their initiatives to improve prescriber practice in the area of substance abuse prevention, detection, and treatment.

➽ The ACCME produced the booklet and presentation, called “CME as a Bridge to Quality,” to encourage CME providers to demonstrate to their stakeholders how accredited CME supports improvements in physician practice and patient care.

Criterion 17: The provider utilizes non-education strategies to enhance change as an adjunct to its activities/educational interventions (e.g., reminders, patient feedback).

As adjuncts to its Bridge to Quality™ accreditation workshops:
➽ The ACCME has published a compendium of compliance and noncompliance case examples drawn from the accreditation review process. This compendium is designed to help CME providers learn from each other and understand how the ACCME evaluates compliance.

➽ The ACCME publishes data about accreditation outcomes that shows providers that compliance is achievable and alerts them to potential risk areas for noncompliance.

➽ The ACCME facilitates the dissemination of best practices by producing video interviews with CME and other healthcare system leaders who share their innovative approaches to planning effective education, including strategies they use to overcome challenges and build bridges with other healthcare stakeholders.

➽ The ACCME uses organizational and administrative tools and processes to support providers in successfully achieving reaccreditation. For example, the ACCME publishes guides to the reaccreditation process and sends reaccreditation timeline reminders.

Criterion 18: The provider identifies
factors outside the provider’s control that affect patient outcomes.

The ACCME has identified the following factors, outside of its control, that affect the ability of its providers to comply with accreditation requirements and offer effective CME that improves physician competence, performance, and patient outcomes:
➽ There is a range of expertise among CME

➽ Commitment to change varies among learners.

➽ Some executives are not committed to the success of their CME program. They may not allocate appropriate funding or resources, and they may not demand or expect that the CME program demonstrate change and improvement.

Criterion 19: The provider implements educational strategies to remove, overcome, or address barriers to physician change.

The ACCME’s educational strategies relate to physicians as clinicians or CME professionals.

➽ The ACCME clarifies the accreditation requirements to ensure they are understandable to clinicians who may not be involved in CME as well as to physicians who are CME professionals.

➽ The ACCME holds special educational sessions for providers at risk of losing their accreditation. These providers must bring their physician leaders to the sessions. ACCME’s chief executive talks one-on-one with the physician leaders to help them understand the accreditation requirements, the ACCME’s expectations, and the relevancy of the educational requirements.

➽ The ACCME produces video interviews with physician leaders discussing how they have overcome barriers to physician change and facilitated physician commitment to learning and change through CME.

Criterion 20: The provider builds bridges with other stakeholders through collaboration and cooperation.

➽ The ACCME has built bridges with numerous organizations in the CME and healthcare environment. Through these connections, the ACCME has the opportunity to communicate the value of CME and facilitate the integration of CME in healthcare improvement initiatives. For example, the ACCME is an associate member of the American Board of Medical Specialties and the Council of Medical Specialty Societies.

➽ The ACCME participates regularly in the American Medical Association’s Council on Medical Education meetings to discuss issues of importance to both the accreditation and credit systems.

➽ The ACCME participates in the annual conference and initiatives of the Association of Independent Academic Medical Centers focused on all components of medical education as it relates to quality and improved patient care.

➽ The ACCME exchanges information about its systems, requirements, and strategic planning/directions with the Accreditation Council for Graduate Medical Education.

➽ The ACCME collaborates with the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education on the process for Joint Accreditation for the Provider of Interprofessional Continuing Education.

➽ The ACCME builds bridges with organizations that are outside the CME environment. For example, the ACCME participated in the Centers for Disease Control and Prevention Editorial Summit: Advancing Public Health Globally, held in September 2011 in Atlanta. The goal of the summit was to establish a sustainable, collaborative forum to facilitate the dissemination of scientific information to healthcare practitioners, policymakers, and the public. ACCME’s chief executive Kopelow discussed how CME can support the translation of new science into physician practice and improved patient care. In January, the ACCME convened a follow-up meeting to further the forum’s goals.

➽ The ACCME reaches out to organizations outside the CME/healthcare systems to build awareness of accredited CME. For example, the ACCME was invited to participate in the first U.S.-India Higher Education Summit, held in Washington, D.C., in October 2011. Hosted by the U.S. and Indian governments, the summit brought together international leaders in government, business, and academia to discuss their strategic vision for building collaboration between the U.S. and India in the area of higher education. Kopelow offered his perspective about how continuing professional education can contribute to this initiative.

➽ The ACCME provides speakers for numerous educational and professional development events held by recognized accreditors, member organizations, CME organizations, and other stakeholder groups.

Criterion 21: The provider participates within an institutional or system framework for quality improvement.

➽ The ACCME operates within the healthcare system to integrate accredited CME into quality improvement efforts.

➽ The ACCME encourages CME providers to position their programs as strategic assets to their institution’s and system’s quality-improvement efforts.

➽ Government agencies have approached the ACCME to discuss how CME can help drive quality efforts.

➽ The ACCME provides ongoing support for the American Board of Medical Specialties Maintenance of Certification® initiative.

➽ The ACCME is collaborating with the FDA to support the participation of accredited CME in the Risk Evaluation and Mitigation Strategy (REMS) for long-acting and extended-release opioids.

➽ The ACCME collaborates with the nursing and pharmacy accreditors to offer Joint Accreditation for those organizations that provide education by the healthcare team for the healthcare team.

Criterion 22: The provider is positioned to influence the scope and content of activities/educational interventions.

➽ The ACCME accreditation requirements influence the education offered by CME providers in that the activities must be based on educational needs and the learners’ professional practice gaps.

➽ By creating these rules and teaching providers how to implement them, the ACCME influences the scope and content of CME activities.

➽ The ACCME tailors its own educational offerings to the needs of its learners.

This is the second in a three-part series on the ACCME accreditation process for CME providers. The first details the ACCME's accreditation process; and the third shows how to bounce back after being placed on probation or receiving a progress report requirement.

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