Meeting ACGME and ABMS Quality Improvement Requirements in a Sleep Medicine Fellowship Program

Abstract

Study Objectives: To describe a sustainable program of teaching and implementing quality improvement (QI) in a 12-month sleep medicine fellowship. Methods: We created a QI curriculum based on Accreditation Council for Graduate Medical Education (ACGME) and American Board of Medical Specialty (ABMS) Part IV Maintenance of Certification (MOC) requirements for QI. Two program faculty with prior QI training volunteered to mentor fellows. Our institution's central QI office houses QI experts who teach QI across the health system. One of these experts, referred to as the "QI consultant," helped us adapt QI teaching materials to include 4 online modules and 5 group sessions. Fellows worked in teams to complete 2 data-guided QI cycles. Results: The curriculum required 29 hours for fellows, 18 hours for faculty, and 55 hours for the QI consultant; now that teaching materials have been created, the QI consultant's involvement will decrease over time. Post-curriculum surveys showed that fellows' knowledge of QI concepts increased, as did their confidence performing QI activities. Fellows' QI projects objectively improved timeliness and quality of care for patients. Sleep medicine fellows and QI faculty mentors evaluated the curriculum positively. The curriculum met ACGME requirements for QI, and fellows and mentoring faculty received ABMS Part IV MOC credit upon completion of the curriculum. Conclusions: A QI curriculum can successfully be implemented into a 12-month sleep medicine fellowship to increase sleep medicine fellows' QI knowledge and confidence, meet ACGME and MOC requirements, and contribute to care of patients with sleep disorders. Keywords: education, fellowship, maintenance of certification, quality improvement, sleep disorders Citation: Shelgikar AV, Priddy C, Van Harrison R. Meeting ACGME and ABMS quality improvement requirements in a sleep medicine fellowship program.

Virtual adaptation of healthcare quality improvement training programmes in response to COVID-19: A rapid narrative review

“…Customizing didactic materials to suit programme and participant needs is a time intensive task [28]. Developing an online site can be resource-intensive and lead to functional problems [19].…”

“…Studies used various evaluation methods; some focused on programme level factors such as course completion rates [16,27], learner reaction to training [14,17,25,32], engagement level of participants [14,28,33], participant perceptions of the online module content and quality [20], preferred training delivery mode [16,22,27] and document and report submission by participating teams [32]. Another area of outcome evaluation was improvement in participant knowledge.…”

“…Another area of outcome evaluation was improvement in participant knowledge. Studies evaluated improved participant comfort [31] and con dence [20,28]in using QI. Many studies also assessed participants' QI knowledge, skills, attitudes and behaviours [14-17, 23-25, 27, 31, 34].…”

“…How participants implemented QI skills and knowledge also constituted a part of outcome evaluation in various studies. This included development of action and improvement plans [18], number of QI projects developed [20] and completed [28] and results attained from these projects [19]. Improved results for the patients were also used as a proxy for outcome evaluation [14, 15, 17-19, 27, 30, 32].…”

“…Most of the included studies reported achieving desired outcomes such as increased QI knowledge & skills [14,24,25,27,28,34,35], positive reaction from participants towards the training [17,19,20,32], implementation of QI knowledge by participants [18,29] and con dence to use the learned skills in future [22,28]. One study reported no improvement in the measure being tracked [32].…”