Quality assessment and improvement of post graduate family medicine training in the USA

Hoekzema, Grant; Maxwell, Lisa; Gravel, Joseph; Mills, Walter W.; Geiger, William; Honeycutt, James David

doi:10.1080/14739879.2016.1218299

Cited by 2 publications

(2 citation statements)

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“…A convention of red, yellow, and green was chosen for the RPI, with green representing achievement of excellence in quality targets; yellow denoting adequate program quality for accreditation purposes but with room for improvement or caution; and red indicating metrics below accreditation standards, national norms, or targets promoted by family medicine professional organizations, based on published requirements or literature (Table 1). 13,14 Analysis of the aggregate data for the 6 years (2012-2017) that the survey was active revealed that 646 program-years of data from 248 unique FM residency programs could be reliably extracted. Adjusting for minor variations in the wording of survey questions over the years, the data can be grouped into categories of questions: (1) program accreditation and program leadership status, (2) family medicine center (FMC) resident clinical experience, (3) hospitalbased resident clinical experience, (4) procedural training, (5) residency program scholarship, and (6) graduate scope of practice.…”

Section: Methodsmentioning

confidence: 99%

“…11,12 We have previously described the process to develop this tool and its initial successes and challenges. 13,14 In 2018, the AFMRD Board made the decision to sunset the RPI due to insufficient return on investment as demonstrated by increasing software costs and staff time coupled with lack of growth in participation and only modest improvement in quality. This paper describes the lessons learned from an analysis of 6 years of data collected while the RPI was in use that can inform future quality and accreditation efforts implemented on a national level.…”

Section: Original Articlesmentioning

confidence: 99%

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Six Years’ Experience Using Specialty National Residency Index: An Early Dashboard to Document Change Over Time

Hoekzema

Mills

Maxwell

et al. 2021

Fam Med

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Background and Objectives: A decade ago, the Association of Family Medicine Residency Directors developed the Residency Performance Index (RPI) as a novel dashboard of metrics to support residency programs’ quality improvement efforts. Although the RPI has since been discontinued, we sought to identify lessons learned from an analysis of 6 years of data collected while the RPI was in use to inform future quality and accreditation efforts implemented at the national level. Methods: The RPI collected data from 2012-2017 for nearly 250 distinct family medicine residency programs, identifying strengths and areas for improvement. Eighty-two programs provided data for 3 or more years of measures allowing analysis of improvement trends. Results: For participating programs, aggregate data over 6 years indicated the majority had stable leadership and accreditation. Total family medicine center (FMC) visits by graduates and resident visit demographics were robust. Graduate scope of practice was consistent with nationally publicized trends. Programs hit most aspirational targets more than 40% of the time. However, analysis for those programs with 3 or more years of data revealed that the tool did not result in significant changes for most metrics. Linear regression analysis showed improvements in total patient visits, visits under 10 years of age, and certain procedural competencies for those programs with 3 or more years of data. Conclusions: The RPI was the first and only nationally utilized family medicine graduate medical education quality improvement tool. Individual programs did not show substantial change in quantifiable metrics over time despite limited evidence of select programmatic improvements. Nationally, aggregated data provided insight into scope of practice and other areas of interest in residency training. Further efforts in provision of residency improvement tools are important to support programs given the increasing complexity and high stakes of family medicine residency education.

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Section: Methodsmentioning

confidence: 99%

Section: Original Articlesmentioning

confidence: 99%

Six Years’ Experience Using Specialty National Residency Index: An Early Dashboard to Document Change Over Time

Hoekzema

Mills

Maxwell

et al. 2021

Fam Med

Self Cite

View full text Add to dashboard Cite

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Annual program review process: an enhanced process with outcomes

Wiemers¹,

Nadeau²,

Tysinger³

et al. 2018

Medical Education Online

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The Accreditation Council for Graduate Medical Education’s required Annual Program Review of Educational Effectiveness (APREE) has helped us improve our program and change its culture to one of continuous quality improvement. This report outlines our systematic process and describes specific outcomes it has produced over a 10-year period. We identified ways to enhance our APREE after reading articles that described various ways to conduct the process found in a PubMed and OvidSP search and relevant policies from our local Graduate Medical Education Office. After discussing options, we incorporated new ideas into our APREE and tasked our Program Evaluation Committee to track outcomes from objectives developed by faculty and residents during each APREE. Objectives from faculty and residents in 10 years of our APREE led to major improvements (e.g., increased board pass rate) in our program. In addition, the enhanced APREE process gradually changed our residency’s culture to one that embraces continuous quality improvement. A systematic APREE process can engage residents and faculty in improving specific components of a residency. Besides providing outcomes for Web Ads and Self-Study items, the APREE models quality improvement techniques to residents, involves a wide array of stakeholders, and helps program stakeholders embrace continuous quality improvement.

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Quality assessment and improvement of post graduate family medicine training in the USA

Cited by 2 publications

References 14 publications

Six Years’ Experience Using Specialty National Residency Index: An Early Dashboard to Document Change Over Time

Six Years’ Experience Using Specialty National Residency Index: An Early Dashboard to Document Change Over Time

Annual program review process: an enhanced process with outcomes

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