Nogle refleksioner fra ACGME, Orlando

Transkript

1 Nogle refleksioner fra ACGME, Orlando Berit Bjerre Handberg Sekretariatschef, Videreuddannelsessekretariatet Stolt over danske sundheds- og uddannelsessystem...

2 American Council of Graduate Medical Education (ACGME) Mission: We improve health care and population health by assessing and advancing the quality of resident physicians' education through accreditation. Responsible to the public...

3 ACGME VISION We imagine a world characterized by: A structured approach to evaluating the competency of all residents and fellows, Motivated physician role models leading all GME programs, High-quality, supervised, humanistic, clinical educational experience, with customized formative feedback, Clinical learning environments characterized by excellence in clinical care, safety, and professionalism, Residents and fellows achieving specialty specific proficiency prior to graduation, Residents and fellows prepared to become Virtuous Physicians who place the needs and well-being of patients first.

4 ACGME: Private, not-for-profit organization that sets standards for US graduate medical education (residency and fellowship) programs and the institutions that sponsors them and renders accreditation decisions based on compliance with these standards. 800 ACGME-accredited institutions sponsoring 10,000 residency and fellowship programs positions in 150 specialties and subspecialties.

5 Accreditation is achieved through a voluntary process of evaluation and review ACGME accreditation provides assurance that a Sponsoring Institution and program meets the quality standards of the specialty or subspecialty practice(s) for which it prepares its graduates. ACGME accreditation is overseen by a Review Committee made up of volunteer specialty experts from the field that set accreditation standards and provide peer evaluation

6 Akkreditering er IKKE certificering Programmer (uddannelsesforløb) bliver akkrediteret (ACGME) Individuelle læger bliver certificeret (American Board of Medical Specialties, ABMS)

7 Terminologi Designated Institutional Officials (DIO) ~ UKO Program Directors ~ PKL. Primære opgave: maintain accreditation Ass. Program Directors, local site PDs UAO Program Coordinators ~ VUS (står for alle indberetningerne og en stor del af dokumentationen, næsten en til hver PD)

8 Voluntary? License gn National Board of Health (SST) efter USMLE efter gennemført akkrediteret uddannelsesforløb er lægen eligible for board examination Certificate as board specialist (lign speciallægeanerkendelse af LVS) Recertificeres hver 5 år Meget varieret og fragmenteret sundhedssystem (offentligt, semioffentligt, universiteter, semiprivat, privat, forsvaret, kirken, forsikringsselskaber) Ingen daglig fuldtidsledelser

9 Akkrediteringen (godkendelsen): Institutional requirements (Universitet/hospital) Programme requirements Annual report 10 årig sitevisit Annual report: screening pba (gamle) data og indberetningerne Skriverier og handleplan evt ekstra besøg godkendt, advarsel, frakendt (uhyre sjældent)

10 Elementer i årlige rapport board pass rate faculty scholarly activity resident scholarly activity faculty hours faculty resident /ratio resident hours (ACGME har bestemt 80 timer pr uge, PD skal monitorere det) response to citation (bemærkninger)

11 Elementer i årlige rapport arbejdsskema resident case log resident survey (evaluer.dk) faculty survey milestones outcomes Virkelig meget dokumentation...

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13 Hvem gør noget lign. i DK? NRLV SST DRRLV - bla. gennem godkendelse af uddannelsesprogrammer PKL, PUF Specialespecifikke uddannelsesudvalg Videnskabelige selskaber Inspektorordningen Evaluer.dk - begge metoder vurderer afdelingen. Ikke hospitalet, den enkelte overlæge eller det samlede uddannelsesforløb

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15 Funding? Mange økonomiske overvejelser... Medicaid, betaler løn til ud af Besluttes af kongressen Resten fra hospitaler, universiteter, private, fonde, kirker, (nonner) forsikringsselskaber... Trump???? Forventer nedskæringer More reliance om hospital clinical dollars Vores sundhedssystem er meget, meget stabilt...

16 Overordnet planlægning og koordinering? We don t!! Usikkert arbejdsmarked.. Hvis stedet vurderes til at kunne uddanne et vist antal uddannelseslæger af gangen af ACGME - så må du uddanne det antal af gangen (eller lade være...) Samme for universiteter Visse stater kun halvt så mange videreuddannelsespladser som der uddannes på medicinstudierne

17 Anvendelsen af tests Uoverensstemmelse mellem vurdering af klinisk arbejde og testresultater? kursus i at lære at gå til test!!! træne testevnen

18 Recertificering, Maintenance Of Certification (MOC) Hvad betyder det at hold the certificate at have speciallægeanerkendelse?? Are they staying current? Burde DK også gøre det? svar på sp Fordi vi skal!! De fik os altså ikke overbevist...

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