CLER on WIHI

Madge Kaplan writes:

The next WIHI broadcast — September 24, 2014: From Here to CLER: Graduate Medical Education and the Clinical Learning Environment Review (CLER)  — will take place on Wednesday, September 24, from 2 to 3 PM ET, and I hope you'll tune in.

Our guests will include:

• Kevin B. Weiss, MD, MPH, Senior Vice President, Institutional Accreditation, Accreditation Council for Graduate Medical Education (ACGME)
• Robin Wagner, RN, MHSA, Vice President, Clinical Learning Environment Review, ACGME
• Maren Batalden, MD, Medical Director of Hospital Quality, Associate Director of Graduate Medical Education for Quality and Safety, Cambridge Health Alliance (CHA)
• James Moses, MD, MPH, Medical Director of Quality Improvement, Boston Medical Center; Academic Advisor, IHI Open School for Health Professions

A new IOM report released over the summer has reignited debate and discussion about the financing and goals of graduate medical education (GME) in the US. Given that Medicare is the primary funder, to the tune of $15 billion per year, the report’s authors call for greater accountability for all the government support, along with a change in priorities. For example, the IOM committee points to a disconnect between what the health care system desperately needs right now — more cost-conscious doctors capable of improving patient care, managing population health, and committed to primary care — and residency programs that remain overwhelmingly hospital-based and focused on medical specialties.

This is not the first time we’ve heard calls to reform GME, or the first time we’ve seen efforts to respond by the accrediting body itself, the Accreditation Council for Graduate Medical Education (ACGME). They’re in the midst of rolling out a new set of residency training expectations that are more aligned with delivering value and helping patients achieve optimal health. The program is called the Clinical Learning Environment Review — CLER for short. On the September 24 WIHI we’re going to explore the potential for CLER to bring about the most dramatic changes yet for medical residents, and we hope you’ll tune in.

ACGME’s Dr. Kevin Weiss and Robin Wagner will explain the goals of CLER and some of the specific ways residents are being asked to contribute to progress in six areas: Patient Safety, Quality Improvement, Transitions in Care, Supervision, Duty Hours Oversight (including Fatigue Management and Mitigation), and Professionalism. Dr. Maren Batalden from the Cambridge Health Alliance (CHA) now has a CLER site visit under her belt, and she’s plenty excited about the potential for the program to better align residency training with an organization’s overall safety and quality improvement agenda. Finally, we welcome Dr. James Moses from Boston Medical Center, who has been in the trenches of helping to steer residency training in a new direction for years and also serves as academic advisor for IHI’s Open School.

Whether or not you are directly involved in GME, its priorities have implications for all of health care. WIHI Host Madge Kaplan looks forward to your participation and your comments on the September 24 WIHI. To get ready for the program, we invite you to check out this blog post by IHI’s Dr. Goldmann about the IOM report on GME.

We hope you will tune in and learn more with us! You can enroll for the broadcast here.