ACGME to judge doc-training programs based on outcomes

NEJM: New process aims to foster innovation

Topics: Academic Medical Centers, Strategy

February 27, 2012

The Accreditation Council for Graduate Medical Education (ACGME) is introducing a new accreditation process for residency programs that focuses on educational outcomes, according to a new report in NEJM.

The new process, called the Next Accreditation System (NAS), will be launched in two phases. The first phase begins in July 2013 and will implement the new system in seven of ACGME's core specialties: diagnostic radiology, emergency medicine, internal medicine, neurologic surgery, orthopedic surgery, pediatrics, and urology. The remaining 19 specialties will adopt the process by July 2014.

According to the authors of the report, a "key element" of the NAS will be reporting residents' milestones. Specifically, residents must demonstrate competency in patient care, medical knowledge, professionalism, and communication, among other metrics.

"Over time, we envision that the NAS will allow the ACGME to create an accreditation system that focuses less on the identification of problems and more on the success of programs and institutions in addressing them," says Thomas Nasca, CEO of ACGME and co-author of the report

Other changes associated with the NAS include:

  • Ongoing data collection and trend analysis;
  • Intermittent site visits to examine residents' learning environment; and
  • Extending the period between accreditation visits from five years to 10 years.

In addition, programs with high-quality outcomes will be afforded more flexibility to explore innovative learning practices. "By encouraging high-performing programs to innovate, the system will open the quality ceiling and produce new learning," the researchers say. "Simultaneously, an ongoing process-based approach for programs with less-than-optimal performance will continue to raise the floor for all programs" (Bankhead, MedPage Today, 2/22; Robeznieks, Modern Healthcare, 2/22 [subscription required]).

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