at the AAP NCE meeting

Yesterday was a day of uneventful travel from Roanoke to San Francisco.

Today I started performing the "work" of attending this meeting.  At 7:30 am I was among a small group of  pediatric subspecialists that met with the leadership of the American Board of Pediatrics to discuss issues related to maintenance of certification in the pediatric subspecialties.

The American Board of Pediatrics (ABP) is the organization responsible for certifying individual pediatricians as being qualified to practice--either general pediatrics, or a particular subspecialty such as critical care, cardiology, neonatology, gastroenterology, and so on.  Before one becomes certified in one of the subspecialties, one must already be certified in general pediatrics. The initial certification requires training in an accredited training program and satisfactorily completing a certifying examination. Maintenance of certification requires that a physician be licensed, show evidence of professionalism, show evidence that he or she remains knowlegeable in the field by passing another exam, and show evidence that he or she engages in quality improvement activities within his or her practice or institution. Many of the steps of maintenance of certification have been determined only in the last few years. That is the case of what is known as "part 4" which is the part that evaluates the pediatrician's engagement in quality improvement activities.

So, what we did this morning was meet with the ABP leaders to help them understand what subspecialty pediatricians who typically work in hospitals are already doing in this regard, and by what means the ABP can determine that such activity meets certain requirements. This process is all intended to make certain that any general or subspecialty pediatrician who maintains certification, is in fact practicing state-of-the art pediatrics.

At this meeting, an example was shared with the group of a pediatric organization that has had a long history of requiring their members to participate in quality improvement projects in order to remain employed. That is the Pediatrix Medical Group--which happens to be employers of the neonatologists who work in and provide medical direction of the neonatal intensive care unit (NICU) at Carilion Clinic Children's Hospital. I have been impressed with the quality of care these physicians bring to our most vulnerable patients, and delighted that their dedication to continual improvement of care is recognized on a national level.

I am also delighted to be able to report that each and every group of Carilion pediatric physicians is actively involved in assessing the quality of their care and working to improve outcomes, and eliminate waste. Over the course of the next weeks and months I look forward to sharing some of our quality improvement projects on this blog, as well as outcomes that have been achieved.

The rest of the day was spent attending the Section of Critical Care (SOCC) executive committee meeting. In this meeting, our group of elected representatives reviewed activities of the past 6 months, made decisions regarding how to proceed with new actions, and discussed the plan for next year's conference--what continuing medical education topics will be offered to our membership next year, who the speakers will be, and so on. Yes, it takes at least a year to plan this kind of national educational offering. In a few months, we will start thinking in earnest about the conference in 2012.

All in all I put in about a 10 hour day, but did have an hour and a half for lunch. I am looking forward to having a pleasant dinner with the group this evening, and to attending the scientific and educational presentations tomorrow.

Comments

At the Carilion Clinic Children's Hospital, through a coordinated multidisciplinary approach involving dedicated respiratory therapists, NICU RNs, Neonatal NNPs, & neonatologists, we have been able to decrease the incidence of Retinopathy of Prematurity requiring laser treatment - a serious illness which can cause blindness and/or significant visual impairment to essentially 0% in our at risk preemies. Our program which involves the comprehensive management of oxygen administration was developed by the national Pediatrix Medical Group.

Building on the success of this effort & utilizing a similar, literature based approach, amongst other initiatives, we have been able to develop a program to decrease our central catheter association blood stream infections to < 1/1000 lines days. Decreasing hospital acquired infections is of course one of several goals recently announced by the director of the CDC.

All Pediatrix Medical Group physicians are required to attend regular Continous Quality Improvement (CQI) Summits in order to learn about Quality Improvement methodology and share successes.

These quality improvement methodologies work best when there is a strong administrative support such as we enjoy at Carilion Clinic.

Many thanks to Manny for taking the time to add important information about our NICU and the wonderful job done by the whole team there to ensure our precious neonates (premies) get the best possible care. This is one of the reasons I am so proud to be a part of the Carilion Clinic Children's Hospital

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