Performance/Quality Improvement

Performance/Quality Improvement

Office of Continuous Professional Learning MSC09 5370, 1 University of New Mexico Albuquerque, NM 87131 (505) 272-3942 https://hsc.unm.edu/medicine/education/cpl/

Name of Participant(s)*

Email Addresses*

Department*

Select

Division (If applicable)

Title of P/QI Activity*

Proposed start date for P/QI CME*

1. Purpose of P/QI Activity

Specify the objectives of your P/QI activity in terms of changes in competence, performance in practice, and/or patient outcomes that you will measure/assess.*

2. Which of these competencies will be addressed in your P/QI activity?

At least one competency needs to be selected.

ABMS/ACGME Competencies:*

Institute of Medicine Competencies:*

Interprofessional Education Collaborative Competencies:*

Values/Ethics for Interprofessional Practice

Roles/Responsibilities

Interprofessional Communication

Teams and Teamwork

3. What is your anticipated timeline?

Specify below the number of weeks or months you anticipate taking to conduct each P/QI stage you intend to complete (the 3 stages are described on the procedure cover page and in subsequent pages of form).

Stage A, Current Performance Assessment*

Stage B, Application of P/QI to Patient Care*

Stage C, Evaluation of P/QI Effort*

4. Design Criteria

Designed to change competence*

(learners’ strategies and/or skills)

Yes

Designed to change performance*

(what learners actually do in practice)

Yes

Designed to change patient outcomes*

(impact on the patient or on the care delivered)

Yes

5. Evaluation Criteria

You must evaluate changes in learner competence, performance, patient outcomes. You must respond positively to at least one of these three questions and explain your evaluation process.

Changes in competence evaluated*

Yes

Changes in performance evaluated*

Yes

Changes in patient outcomes evaluated*

Yes

If yes, how will you evaluate the competency, performance or patient outcomes?

6. Disclosure and Relevant Financial Relationship Form

Complete and submit the Disclosure and Relevant Financial Relationship (one form for each participant).

7. Description of P/QI CME Stages

Stage A: Learning from current practice performance assessment (5 AMA PRA Category 1 Credits upon completion). Stage A requires learning from current practice performance assessment and recognition of practice-based need. Needs are determined from an assessment of current practice, using selected performance measures, such as chart review, patient safety reports, or other appropriate mechanism. Participants are actively involved in the data collection /analysis process

Stage B: Learning from the application of P/QI to patient care (5 additional AMA PRA Category 1 Credits upon completion) In Stage B, the participants identify and implement an intervention(s) that that is indicated by the Stage A analysis. A detailed description of the intervention is required along with the rationale for the intervention design.

Stage C: Learning from the evaluation of the P/QI CME effort (10 additional AMA PRA Category 1 Credits upon completion) Reassess and reflect on performance in practice measured after the implementation of the intervention(s), by comparing to the original assessment and using the same performance measures. Summarize all practice, process and/or outcome changes that resulted from conducting the P/QI activity any practice based on pre/post intervention analysis.

Today's Date

Send me a copy of my responses

Privacy Notice|Report Abuse