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MOC Tip of the Month
By Edmund Kwok

It’s there for the taking! How data can fuel self/team assessment

MOC Tip of the Month - By Dr. Edmund Kwok

Hospitals collect and report all kinds of metrics for accreditation and quality improvement. Did you know that you can take advantage of this treasure trove of data for your own continuing professional development?

Here’s how my colleagues and I are improving our individual and group performance in patient flow by analyzing metrics at The Ottawa Hospital, where we work as emergency physicians. I’ll leave you with several ideas for how you can implement a similar model — no matter your specialty or subspecialty. I’ll also highlight opportunities for claiming MOC Program credits (including in Section 3: Assessment).

First things first: uncover existing data collection systems

Whether you work in a hospital or a group practice, you’ll be surprised by the amount of data that’s available to you — it usually takes just one conversation to find out!

We met with our hospital administrators and told them we were interested in analyzing our performance as a group. We discussed what kinds of data they collected that might be relevant to our scope of practice. We were able to capture various emergency room metrics related to patient flow:

  • the number of patients seen per day,
  • the time spent seeing a patient,
  • CT scan and imaging ordering rates,
  • the length of stay for patients, and
  • wait time for patients before receiving pain control.

Note: While these metrics are specific to Emergency Medicine, your hospital is probably also collecting metrics that are relevant to your discipline. Talk to your hospital administrators and find out what kinds of data they could pull for you and your team!

Data + feedback = MOC Section 3!

The emergency physicians on our team received a scorecard showing where each of us was on the bell curve for each metric we analyzed. We were able to see and reflect on how we performed relative to our peers in the same environment. For example, comparing the number of patients we each see per day. Our department head then reviewed the scorecards and gave us all individual feedback as part of our annual reappointment assessment process. This exercise provided an excellent opportunity for us to claim MOC Section 3 Practice Assessment credits by recording the activity and our learning outcomes in MAINPORT ePortfolio.

Make the data work for you: turn assessment into improvement

We noticed that in our department, there was wide variation in patient flow efficiency among individual physicians. Individually reflecting on this data was helpful to know where we stand compared to each other — there were some really high performers and also some lower performers on that distribution curve. Now that we have a better idea of where to focus our efforts, we’re trying to tighten that variation with a combination of interventions. These include individual coaching and tailored educational workshops. The workshops are particularly interesting because they are hosted by our high performers who showcase their best practices as examples to help others improve.

Learning together for extra MOC credit

All the physicians who attended our educational workshop on patient flow could claim Section 1 Unaccredited Group Learning MOC credits. The workshop presenters could also report the new learning they acquired while researching and preparing their teaching session as a Personal Learning Project (Section 2 Self-Learning MOC credits).

Note: Individual and practice improvement is sometimes uncomfortable. We were lucky that everyone on our team was equally committed to the process. This helped ease some of the inevitable discomfort that comes from comparing individual data for the betterment of the team. It’s important to set parameters and level expectations before getting started.

Don’t stop there! Repeat the process to put the “continuing” in CPD

We started our quality improvement process last year and expect our next round of data this summer. Our physicians will get scorecards every year on the metrics we’re monitoring. This means we’ll have the opportunity to compare our scorecards year after year and look for continuous improvement. Over time, we’re hoping to see that improvement in the form of less variation in the flow numbers between individual physicians.

Assess annually for continuous Section 3 credits

Because we’ll be repeating this process annually, our physicians will be able to claim additional MOC Section 3 Assessment credits each year after reflecting and receiving feedback on whether the changes they have made to their practice are making a difference.

Your turn! Start small on a metric that matters …

Our group has the advantage of having a quality improvement unit within our department and a coordinator to help us run our projects. That set-up enabled us to look at a broad spectrum of metrics, from patient flow to ordering rates to patient satisfaction. However, for smaller groups or private practitioners with limited time and resources, I recommend you start by focusing on just one or two metrics that matter to your practice. Once you decide, pull some data and get started!

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