How is our learning environment? We’ll find out soon
UMHS will soon be visited by representatives from the Accreditation Council for Graduate Medical Education (ACGME) to conduct a Clinical Learning Environment Review (CLER) site visit. This type of site visit has been established to assess the graduate medical education (GME) learning environment of each sponsoring institution and its participating sites.
CLER emphasizes the responsibility of the institution for the quality and safety of the environment for learning and patient care. This is an opportunity for UMHS to demonstrate leadership in patient safety, quality improvement and reduction in health care disparities.
Although the precise date of the CLER visit cannot be predicted, it is important for all UMHS house officers, faculty members and staff to be prepared to provide assistance to any site visitor.
What is known is that the CLER visit will cover a 3-4 day span and is expected to occur in 2016. The ACGME will provide a 10-day notice before their arrival.
CLER assesses institutions in the following six focus areas:
• Patient Safety: This includes opportunities for residents to report errors, unsafe conditions and near misses and to participate in inter-professional teams to promote and enhance safe care.
• Quality Improvement: This includes how sponsoring institutions engage residents in the use of data to improve systems of care, reduce health care disparities and improve patient outcomes.
• Transitions in Care: This includes how sponsoring institutions demonstrate effective standardization and oversight of transitions of care.
• Supervision: This includes how sponsoring institutions maintain and oversee policies of supervision concordant with ACGME requirements in an environment at both the institutional and program level that assures the absence of retribution.
• Duty Hours Oversight, Fatigue Management and Mitigation: This includes how sponsoring institutions: (i) demonstrate effective and meaningful oversight of duty hours across all residency programs; (ii) design systems and provide settings that facilitate fatigue management and mitigation; and (iii) provide effective education of faculty members and residents in sleep, fatigue recognition and fatigue mitigation.
• Professionalism: This includes factors in how sponsoring institutions educate for a professional workplace, monitor behavior on the part of residents and faculty and respond to issues concerning accurate reporting of program information, integrity in fulfilling educational and professional responsibilities and veracity in scholarly pursuits.
The CLER site visitors will seek answers to questions such as:
• What organizational structures and administrative and clinical processes do the sponsoring institution and its major sites have in place to support GME learning in each of the six focus areas?
• What is the role of GME leadership and faculty to support resident and fellow learning in each of the six areas?
• How comprehensive is the involvement of residents and fellows in using these structures and processes to support their learning in each of the six areas?
• From the perspective of the sponsoring institution and its major participating sites, what are the measures of success in using this infrastructure and what was the level of success?
• From the perspective of the sponsoring institution and its major participating sites, what are seen as the opportunities for improving the quality and value of the current clinical learning environment infrastructure to support the six focus areas?
Hosting a CLER site visit is a positive step toward improving the clinical learning environment for our patients and our resident and fellow physicians. Thank you for your help and cooperation!