In the New Accreditation Council for CME accreditation system, which aims to position CME as “a strategic asset to the quality improvement and patient safety imperatives of the U.S. healthcare systems,” the CME mission will take on a pivotal role. We believe that when the new processes are promulgated that give ACCME surveyors the metrics to evaluate self-studies (starting with those providers whose cycle ends in November 2008), the mission will be the foundation on which the self study will be built, with an emphasis on how it has influenced everything from content to measurement of results.

The “enhancement mission” — as the ACCME calls it — focuses on expected results, not just for the provider, but more importantly, for physicians and their patients. In fact, providers contemplating Level 3 accreditation will have to demonstrate how their program helps to narrow the quality gap and affects patient safety. So the emphasis — like every other part of the U.S. healthcare system — is on results as measured by CME's impact on physician competencies, the physician's performance-in-practice, and the physician's ability to improve the quality of care for his or her patients.

Become a Strategic Asset

While there has been an emphasis on measuring the outcomes of CME for several years, rudimentary self-reporting by learners will no longer be enough to demonstrate that CME is a “strategic asset.” To assist providers in assessing their current and future strategies, we offer the following suggestions:

  • Review the American Board of Medical Specialties' maintenance of certification information. Each ABMS member board (there is a board for each major specialty area) has or is developing lists of skills that their specialists are expected to possess. Review the lists for each content area in which you are providing CME activities. This can be used as one source of needs in the planning process. (Visit for the contact information for each board.)

  • Develop a toolbox of evaluation options. Measure multiple levels of evaluation results from your CME activities. To begin with, measure whether needs were met; use pre- and post-activity evaluations to measure immediate learning; and use more complex evaluation tools utilizing quality assurance data or hospital indicators to measure physician change or improved patient outcomes. Develop meaningful outcomes surveys that provide performance data. If you are with a medical education and communication company or specialty society, partner with clinical organizations that can determine the effect of education on patient care results.

  • Create noneducational interventions. Based on your needs assessment, pinpoint both educational and noneducational interventions that together will have a real impact on the gap in quality that your CME activity addresses. Don't be afraid to develop noneducational interventions such as sending reminders to participants after an activity to encourage behavior change, patient education materials, and initiatives to remove institutional barriers to change. Supporters look for this level of creativity.

  • Choose quality, not quantity. In the new CME paradigm, providers must carefully select activities based on their ability to improve physician competence and performance and to improve patient health. Go for quality, not quantity, and you will meet the new Level 3 criteria. This will position your organization as an exemplary CME provider, which will offer you more opportunities for funding for future activities.

This is the first in a series of three columns on the new accreditation criteria. The next articles will include strategies for achieving Level 2 (full accreditation) and Level 3 (accreditation with commendation).

Steve Passin and Susan O'Brien are, respectively, the president and senior associate of Steve Passin & Associates, a CME consulting company headquartered in Newtown Square, Pa. Reach Passin at; and O'Brien at