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ABEM Maintenance of Certification Instructions

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  1. 1. ABEM EMCC What you need to do.Generally your certificate will expire 10 years after initial or re- certification.
  2. 2. Turns out Obama will not help you.
  3. 3. ABEM EMCC ( Emergency Medicine Continuous Certification )Four Components: 1-3 Implemented in 2004. 1.Professional Standing You must hold at least one medical license. 2.LLSA (Lifelong Learning and Self Assessment) 8 completed out of the ten years between certification/renewal or renewal/renewal. Exceptions: renew 2011 6, renew 2012 7 needed.The primary goal of LLSA is to promote continuous learning by diplomates. ABEM facilitates this learning by identifying an annual setof LLSA readings to guide diplomates in self-study of recent EM literature. Readings are intended to address issues of relevance tocurrent clinical practice at the time they are posted. ABEM recognizes that EM is an ever-evolving science and that new knowledgebecomes available on a continual basis.LLSA readings are designed as study tools and should be read critically. They are not intended to be all-inclusive and are not meantto define the standard of care for the clinical practice of EM. ABEM does not endorse a specific research finding or treatment modalityby virtue of its being the subject of a selected LLSA reading.
  4. 4. LLSA into CME @ EMedHome.com$99 per year to join. $85 this year for up to 25 CME credits (less this year due to less articles). 20 CME credits for completing the test (has been 25 in the past).
  5. 5. 3. Concert: Assessment of Cognitive ExpertiseComponent three of the EMCC program, the Continuous Certification (ConCert)examination, is available annually. Like the previous recertification examination, itmeasures the knowledge base for the practice of Emergency Medicine (EM). The ConCert examination is a comprehensive examination based on the EMModel. ConCert will typically occur in the tenth year of each diplomate’s EMCC cycle. ConCert is a half-day examination. ConCert is administered at computer-based testing centers around the country
  6. 6. 4. Assessment of Practice Performance"Assessment of Practice Performance (APP) is the fourth component of EMCC. Clinically active diplomates assess the quality of carethey provide compared to peers and then apply the best evidence or consensus recommendations to maintain or improve that care.APP focuses on practice-based learning and improvement, particularly in the competencies of patient care, interpersonal andcommunication skills, and professionalism. APP is based on diplomates’ involvement in a national, regional, or local practice A specific goal of the APP program is toimprovement plan of their choice that meets ABEM’s basic requirements.recognize quality improvement activities in which most diplomates are alreadyparticipating."Started 2010.First Attestations are required 2011 for 2013 certificates.Two components:1.Communication/Professionalism (CP) Activity2. Patient Care Practice Improvement (PI) Activity
  7. 7. Communication / Professionalism (CP)"Communication / Professionalism (CP) feedback program, such as thepatient surveys used by most hospitals, in years one through eight."MAPPS will cover this.Chief of the department will be the attestor.Not able/need to attest to yet, starts for certificates expiring in 2017.
  8. 8. Patient Care Practice Improvement (PI)"A PI activity must include the following four steps:1. Review patient clinical care data from ten of your patients. The data must be related to a singlepresentation, disease, or clinical care process that is part of the Model of the Clinical Practice ofEmergency Medicine (EM Model) for example • clinical care processes • feedback from patients that relates to the clinical care given • outcomes of clinical care • access to care such as time for through-put, left without being seen, etc.Group data and data collected through a national, regional, or local practice improvement program in whichyou participate is acceptable.2. Compare the data to evidence-based guidelines. Evidence-based guidelines are based on publishedresearch subject to peer-review. Only if such guidelines are not available, you may use guidelines set byexpert consensus or comparable peer data. Guidelines set by expert consensus are published, accepted,national standards, and guidelines set by peer data are set by individuals who practice in like or similarcircumstances.3. Develop and implement a plan to improve the practice issue measured in Step #1. You may plan for anindividual or group improvement effort.4. After implementing the improvement plan, review patient clinical care data from ten additional patientswith the same presentation, disease, or clinical process as the first patient data review. Use this data toevaluate whether clinical performance has been improved or maintained."
  9. 9. Acceptable Types of Patient CarePractice Improvement Activity ABMS Patient Safety Module Core Measureso Acute Myocardial Infarction: aspirin on arrivalo Acute Myocardial Infarction: ACE inhibitor or ARB given for LVSDo Acute Myocardial Infarction: Beta-blocker within 24 hours of arrivalo Acute Myocardial Infarction: Fibrinolytic within 30 minutes of arrivalo Acute Myocardial Infarction: PCI within 90 minutes of arrivalo Pneumonia: Oxygenation assessmento Pneumonia: Blood cultures for ICUo Pneumonia: Blood culture before first antibiotico Pneumonia: Antibiotic timing (within 4 hours; within 8 hours) PQRS Measureso Aspirin at arrival for acute myocardial infarction.o Stroke and stroke rehabilitation: deep vein thrombosis prophylaxis (DVT) for stroke or intracranial hemorrhage.o 12-lead electrocardiogram (ECG) performed for non-traumatic chest pain.o 12-lead electrocardiogram (ECG) performed for syncope.o Community-acquired pneumonia (CAP): vital signs.o Community-acquired pneumonia (CAP): assessment of oxygen saturation.o Community-acquired pneumonia (CAP): assessment of mental status.o Community-acquired pneumonia (CAP): empiric antibiotic.o Prevention of catheter-related bloodstream infections (CRBSI): CVP insertion protocol Door to Balloon Time Sepsis Pathways Stroke Protocol/Pathways Activation Asthma Pathways Throughput Time Measures Door to Doctor Times Left without Being Seen Unscheduled Return Visits Patient Call Back Program: Assessment of Clinical Care Given (not a satisfaction survey) atient Care Practice Improvement  P
  10. 10. Paulo the Attestor
  11. 11. When to attestOne required year in year 1-4 and one in years 5-8.For those required (year 2013 and on) one one PI done andattested to in 2010 through 2013.Stroke care pathway will cover initially until we need a newproject 2015.I would recommend everyone attest to completing the projectthis year.
  12. 12. Year LLSA PI activity year range.2011 6 none2012 7 none2013 8 2010 through 20112014 8 2010 through 20122015 8 2010 through 20132016 8 2011 through 2014 ***2017 8 *cp starts 2010 through 2011 and 2012 through 20152018 8 cp 2010 through 2012 and 2013 through 20162019 8 cp 2010 through 2013 and 2014 through 20172020 8 cp 2010 through 2014 and 2015 through 2018
  13. 13. Bottom Line this will not impact you. You must go online and attest only.
  14. 14. Activity DetailsActivity Local ActivityActivity / Program Name Acute Stroke Care Activity Location / Organization Name San Diego Medical Center/Kaiser Foundation Hospital Dates you performed the activity:04/01/2010-04/18/2011Step 1. My program included reviewing the following patient care data from at least ten of mypatients:Clinical care processesOutcomes of clinical careStep 2. I compared my data to the following clinical standards:Evidence-based guidelinesExpert consensusComparable peer dataStep 3. I developed and implemented a PI plan, either individually or as part of a group, in thefollowing areas:Clinical remindersPersonal educationChange in systems or processClinical pathwayStep 4. Using patient care clinical data from at least ten additional patients of mine, with the samepresentation, disease or clinical process as the first patient data review, I re-measured my clinicalperformance:YesMy clinical performance improved or maintained the standard I used in Step 2:Yes
  15. 15. Step by Step Instruction for AttestationAfter signing into ABEM.org, click on EMCC Online
  16. 16. Step by Step Instruction for AttestationClick on Assessment of Practice
  17. 17. Step by Step Instruction for Attestation Click on Attest for PI
  18. 18. Step by Step Instruction for Attestation Click on Update License(s)
  19. 19. Step by Step Instruction for Attestation After updating License Info, Select Stroke Protocol/Pathways
  20. 20. Step by Step Instruction for AttestationFill out section as noted above and then click Continue
  21. 21. Step by Step Instruction for AttestationConfirm information and Check box and Click on Save andContinue
  22. 22. Step by Step Instruction for AttestationFill out Verifier Info as above and Click on Save andSubmit
  23. 23. Step by Step Instruction for Attestation Click on Attest for Communication and Professionalism
  24. 24. Step by Step Instruction for AttestationSelect MAPPS for Communication and ProfessionalismActivity
  25. 25. Step by Step Instruction for AttestationFill out Attestation as noted above and ClickContinue
  26. 26. Step by Step Instruction for AttestationVerify info, Check box and Click Save andContinue
  27. 27. Step by Step Instruction for AttestationFill out Verifier Info as above and Click on Save and Submit
  28. 28. Questions?