Professional Education Matters | June 2014
News and Updates from the Office of Professional Education
Staff Chosen To Present At CME-Focused Conferences
Two Professional Education team members presented at three national conferences in May. Sarah Meadows, MS, CCMEP, Manager, Accreditation and Programs, presented a poster at the spring meeting of the Society for Academic Continuing Medical Education (SACME), in Cincinnati, OH. Meg Dingae, MSHA, CCMEP, Manager, Educational Grants and Collaboration, spoke at the West Coast Medical Education and Research Grants Breakthrough Summit in San Francisco, CA, and then two weeks later, at The Alliance for Continuing Education in the Health Professions Industry Summit in New Brunswick, NJ.
Society for Academic Continuing Medical Education
Earlier this year, Sarah’s 250-word abstract submission to SACME was selected for a poster presentation. The purpose of the poster was to inform attendees about the baseline/pre-assessment data conducted for the Wellbeing Campaign, which is a collaborative three-year weight management initiative funded by a grant from the Colorado Health Foundation. “The thorough baseline information is providing us the foundation for which we are building the interventional components of the initiative, as well as – ultimately – a sustainability plan for the two community primary care clinic networks with whom we are working,” she said.
The audience consisted of academic institution health care professionals in continuing education (CME, GME, and CE) and quality improvement departments. “They seemed most excited about the engagement of our team with this project at the patient level,” Sarah said. “As researchers and educators in CME/CE we tend to focus on the numbers and how they relate to health care providers who care for the patients. This project has given us the opportunity to really step into the work, which drew lots of interest and questions from the group.”
Sarah enjoys being part of initiatives that directly impact both health care provider practices and patient health. “Opportunities to present our work to a group like this let me reflect on the really amazing work we do here at National Jewish Health,” she said. “The more other organizations hear about the type of work we are engaging in, the more opportunities we have for really valuable collaborations and partnerships down the road.”
West Coast Medical Education and Research Grants Breakthrough Summit
Meg’s first presentation was selected by the Center for Business Intelligence (CBI) as part of an “Innovation Network Showcase,” which highlighted funded programs that delivered value and impact and are considered best practices from medical education providers.
“I gave a recap of our Atopic Dermatitis Performance Improvement and Quality Improvement Activity in collaboration with the Rocky Mountain Youth Clinics, The National Eczema Association, and HealthCare Research,” she said, explaining that she highlighted the design of the program, internal and external collaborations, quantitative outcomes and lessons learned. The program was funded by an educational grant from GlaxoSmithKline, and the faculty chair was Mark Boguniewicz, MD.
The audience included medical education providers, consulting companies, academics, researchers and pharmaceutical, biotechnology and medical device companies, from whom she received comments that the program was extremely impressive, as it combined multiple educational interventions and non-educational strategies to drive meaningful outcomes.
“The fact that we were able to pull off such a multifaceted program successfully gave hope to others who are intimidated by performance and quality improvement initiatives,” Meg said. “The presentation also helped to promote and disseminate the innovative things that we’re doing here at National Jewish Health to a broad audience.”
Pertaining to the overall conference, Meg said, “There was a lot of discussion about the patient’s voice in medical education programs, and I definitely left the conference thinking more about how we can incorporate the patient in program planning and implementation.”
The Alliance for Continuing Education in the Health Professions Industry Summit
Two weeks later and on the opposite coast, Meg presented a poster and spoke to an audience of medical education providers, consulting companies, academics, researchers and pharmaceutical, biotechnology and medical device companies. The topic of the overall summit was “Forces for Change: Shaping the Future to Improve Patient Care.” Meg presented during the “Outcomes Best Practices Session,” which included a lightning round of best outcomes along with an overview of how these are applicable to the audience.
Meg was invited to present after Kimberly Gregory, Director for the Center for Medical Education at GlaxoSmithKline, the commercial supporter of the program, nominated the Office of Professional Education for an award for the outcomes of the program Meeting the Needs of Rural Southern Colorado: Implementing Sustainable Evidence-Based Asthma Care. Lisa Cicutto, PhD, RN, and Esther Langmack, MD, served as faculty chairs for this program. Lisa also presented this project at the American Thoracic Society International Conference in San Diego during the poster session, Promoting Positive Outcomes in Respiratory Disease Management.
The nomination for Meg’s presentation asserted, “As a result of this initiative, not only did health care providers judge themselves to be better able to provide quality asthma care to their patients, but objective data demonstrated that this was the case. This asthma care-focused, multi-faceted, performance/quality improvement initiative was provided to rural primary health care teams and led to statistically significant and clinically meaningful improvements in all indicators of quality asthma care provision to adults and children with asthma.”
During the question and answer period of Meg’s presentation at the summit, attendees commented that the program was well thought-out, delivered and measured, and they were impressed by the overall outcomes in this rural population of Colorado. She said the session “reaffirmed that the types of quality and performance improvement initiatives that we are able to deliver are important, and that we are ahead of the game when it comes to high-impact outcomes.”
Patients Are Safer When Medications Are Checked
Keeping patients safe by keeping a current list of all the medicines they are taking is the main goal of a project at National Jewish Health.
“Medication regimens can be complicated, and change frequently,” said Elizabeth Kern, MD, MS, who with Gary Cott, MD, serves as lead faculty on the Medication Reconciliation Project.
“Medication errors represent the most common patient safety error,” said Dr. Cott. Studies have shown that more than 40% of medication errors are believed to result from inadequate reconciliation of medications in handoffs from one patient encounter to the next. Of these errors, 20% may result in harm to the patient. “An effective medication reconciliation process can significantly reduce these errors and, thus, enhance patient safety,” Dr. Cott said.
He pointed out that there has been considerable emphasis placed over the last several years on improving medication reconciliation processes in intensive care units, inpatient hospital wards, emergency rooms and other traditional hospital care centers. However, the majority of patient encounters occur in outpatient settings, and the diversity of outpatient practices makes it difficult to apply a uniform process to improve medication reconciliation in these settings. Dr. Cott said, “Our goal is to establish an efficient and effective team based medication reconciliation process tailored to each outpatient clinic specialty at National Jewish Health and hopefully provide a model that will work for other outpatient clinics.”
When patients arrive for an appointment at National Jewish Health, clinic staff will get their medication history. This will be recorded electronically and printed in a clinical summary that includes the complete medication list. This will then be handed to the patient before they leave their appointment. “Updating and correcting the lists at each clinic visit promotes patients’ understanding of their medications, and prevents potentially dangerous drug interactions,” said Dr. Kern. “The medication reconciliation process at National Jewish Health aims to make sure that all of our patients take the right drugs in the right doses all the time.”
The program continues what National Jewish Health was in the process of doing as a requirement of the Joint Commission, the nation's oldest and largest standards-setting and accrediting body in health care. The Joint Commission defines medication reconciliation as “the process of comparing a patient’s medication orders to all of the medications that the patient has been taking. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors or drug interactions.”
It also plays a role in meeting conditions for a federal program called Meaningful Use (MU). While the Joint commission and MU only require medication reconciliation when patients come to National Jewish Health from other clinics, National Jewish Health has chosen to have the process at every visit to ensure clinical excellence.
This project is made possible through an educational grant from GlaxoSmithKline (GSK) and is overseen by the Quality Improvement Committee and the Office of Professional Education.
Lung Cancer Care Is Focus Of Quality Improvement / Performance Improvement Initiative
The overall goal of this initiative is to improve the quality of care for patients visiting National Jewish Health’s Lung Cancer Center and to extend the best practices from this effort to those who treat lung cancer throughout the United States via high impact enduring materials. The program is titled “To Measure is to Know: Making the Most of the Latest Evidence and Electronic Data Systems to Enhance the Quality and Patient-Centeredness of Lung Cancer Care.”
Facilitated by the Office of Professional Education at National Jewish Health with lead faculty Elizabeth Kern, MD, MS, and Laurie Carr, MD, the program addresses gaps in lung cancer treatment as well as in patient education and communication. The program is funded by educational grants from Genentech and Lilly.
“Understanding, and improving the process and outcomes of our care fulfills our mission to discover and to heal,” said Dr. Kern. “Disseminating our findings fulfills the third arm of our mission, which is to educate.”
Since the Lung Cancer Center opened at National Jewish Health in 2010, approximately 100 patients are served each year with 250 chemotherapy treatments administered annually. While ongoing Performance Improvement (PI) and Quality Improvement (QI) activities exist, as well as an innovative lung cancer registry for tracking patient clinical features, several gaps for improvement have been identified by a “practice redesign” team at National Jewish Health. Made up of providers, administrators, educators and QI staff, the team has assessed the current Lung Cancer Center practices related to quality indicators for best practices.
Quality indicators to be measured include the numbers of qualified patients receiving chemotherapy for cancer care, and the percentage who receive more than 80% of the planned therapy. Among patients receiving chemotherapy to improve symptoms of cancer, the frequency and reasons for dose reductions will be studied. The team will use the electronic lung cancer registry to create a comprehensive synopsis of care that patients can easily access and understand. This is expected to result in improved continuity of care with referring physicians and other institutions.
“A systematic approach to measuring care as it is delivered is a critical first step to understanding how to improve health care quality,” said Dr. Kern. “Our project will refine our methods to measure care in an unobtrusive and sustainable manner.”
In addition to internal collaborations, National Jewish Health has partnered with PeerView Institute for Medical Education (PVI) to develop and disseminate a robust web-based CME activity. This will allow those who treat lung cancer across the U.S. to learn about the successful quality and performance transformations within the NJH Lung Cancer Center, as well as access to tools and strategies that proved most useful and effective.
The program commenced in January of 2014 and will end in June of 2015. For more information, please contact Medical Education Project Specialist Kelli Windlan, MSHA, at X6508.
Still a Big Draw: What Is the Denver TB Course?
A rendition of one of the longest running television game shows played out at one of the longest running tuberculosis (TB) education courses. Jeopardy – sans Alex Trebek – closed the Wednesday and Friday sessions of the 51st Annual Denver TB Course at National Jewish Health in early April. Attendees assumed the roles of both audience and contestants as National Jewish Health faculty Charles Daley, MD, and Shannon Kasperbauer, MD, facilitated the game via PowerPoint that consisted of questions relating to TB.
“The Jeopardy game was a terrific addition to the course this year,” said Dr. Kasperbauer. “The questions were designed to solidify knowledge we had presented earlier in the course. The game added a dimension of engagement that brought out a competitive spirit within the group which made it a lot of fun. We are looking forward to continuing this program in future courses.”
The TB Course provided a broad overview of active and latent TB including its epidemiology, transmission, pathogenesis, diagnosis, treatment and management. As in years past, participants came from all over the world, including those who specialize in a broad range of disciplines, public health, infectious diseases, pulmonary and critical care, preventive medicine and epidemiology. This year, 66 attendees came from 27 states, Canada, and Holland.
One of the course highlights is the Contact Investigation Workshop led by physicians, TB nurses, and outreach workers from the Denver TB Clinic at Denver Health Medical Center. The course also addresses the needs of special populations of patients, such as children and those with HIV. The attendees are split into groups and work together to answer case-based questions.
The Denver TB Course is an interactive event, featuring case-based learning and participation through an audience response system (ARS), added in recent years. Participants are able to answer questions during the pre/posttest as well as during many lectures by using the ARS keypads. The faculty are able to use this as a teaching tool and show/talk about the correct answer and why.
Professional Education Programs Coordinator Mandy Comeau shared why the course still attracts an audience – with minimal marketing – into its 51st year. “Many of our attendees found out about the conference from a colleague, boss or past attendee. I think the draw is the faculty and their expertise,” she said. “Our faculty consists of National Jewish Health Infectious Disease physicians, as well as many others from the Denver TB Clinic at Denver Health and University of Colorado.”
The next Denver TB course is set for October 15-18, 2014. More details and registration information can be found at njhealth.org/TBcourse.
Current Educational Activities Include Smoking Cessation
This spring, the Office of Professional Education launched a free online CME/CE course: Beyond the 5 A’s: What You Can Do for Smoking Cessation in Your Practice. To date, 95% of those who have completed the course said they plan to make changes in their practices from what they learned about smoking cessation interventions with patients. Participants noted that the course helped them become better equipped to educate their patients on quitting tobacco products. To get more information or to register for the course, please go to www.beyondthe5as.org or go to www.njhealth.org/CME where it is listed with other learning opportunities provided by the Office of Professional Education at National Jewish Health.