Anesthesiology Training Program Accreditation Challenges

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Anesthesiology Training ProgramAccreditation
Challenges

• AAPD/SAAC
• November 2005

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Why the Question

• A large portion of our training programs are on
  probation or on short review cycles
• Are there lessons learned from our successes and
  shortfalls?
• Are there some things we can do or should be
  doing?
• Can the RRC review/report provide leverage in Med
  School/Hospital negotiations?

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Survey

• Relationship with Institution
• Private vs Public Non-Profit vs For-Profit
• Other GME programs in your hospital
• Department Make-Up
• Faculty mix (generalist specialist)
• Administrative help (non-billing staff)
• Size of residency (Is larger or smaller better)
• Use of mid level providers (CRNA AA)
• Estimate of clinical workload deterrents

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Survey

• Teaching Environment
• Work hours Work hour violations
• Lectures Mentoring for underperformance
• Faculty to Resident ratios
• Training Tests Mock Oral Exams
• Outside meetings (Dept Support)
• Academic Enhancement
• Fellowships Offered
• Funding (NIH Industry)
• School of Medicine and Hospital Support

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Survey

• Citations (Number Type)
• Relationship to Evaluation, Review Cycle and ??
  Probation??

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N36 Progs 28 Resp
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NONE ON Probation
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N36 Progs 28 Resp
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N36 Progs
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Department Make-Up

• Faculty mix (generalist specialist)
• Administrative help (non-billing staff)
• Size of residency (Is larger or smaller better)
• Use of mid level providers (CRNA AA)
• Estimate of clinical workload deterrents

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AVG 10,760
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Teaching Aides

• 35 of 36 Sent residents to meetings
• 33 of 36 from Dept, 2 shared, 1 resident
• 35 of 36 Provide Mock Oral Exams
• 36 of 36 Use In-Service Training Exam

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Academic Exposure

• 35 of 36 Advanced Clinical Track
• 28 of 36 Advanced Scientist Track
• 19 of 36 NIH Funding
• 30 of 36 Industry Funding

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N3
N9
N6
N17
27
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Citations 2 Year Review Programs

• Inadeq scholarly act (3)
• Too many residents (2)
• No res/post op notes (2)
• Low ABA cert rate (2)
• No QA involvement (2)
• ICU exper inadequate (2)

• Low blocks for Ca pain
• Low case diversity
• More 12 res coverage
• Prog Dir qualifications
• No neuroanesth fac
• Inadequate library
• Core competencies not incorporated
• Affil sites not registered

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Citations 3 Year Review Programs

• Low scholarly act (3)
• Low ABA cert rate (3)
• Too many residents (2)
• Poor specialty experience
• Poor ICU involv (2)
• Poor pain curriculum
• Low Nerve blocks
• Low trauma
• Poor PACU (in OR)
• Poor evoked potent.
• low ACLS cert rate

• Low fac non-clin time
• 66 Fac ABA cert rate
• Low Inst support MLPs
• Acting chair
• CBY curric violation
• Low res/post op notes

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Citations 4 Year Review Programs

• Too many residents (2)
• Excess service demands
• Low ABA cert pass rate
• Poor Specialty Experience
• low block numbers
• pain/OB only in CA3
• limited ICU rotations
• NO chronic pain program
• Little research

• CBY curric violation
• Acting chairperson
• Core competency not documented
• Confusion about GOs
• ResFellow designation
• Inadequate off space
• Inadequate locker room

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Citations 5 Year Review Programs

• Affiliate program form clarification (2)
• Low post op notes
• Poor case lot entries
• Poor Specialty experience
• low specialty cases
• low OB minimums
• low pain procedures
• low Crit Care teaching
• low FOB experience

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Conclusions

• Small sample size conclusions limited
• Further information
• Apparent association - Short Review Cycle
• Lower resident number
• Lower admin staff number
• Reduced fellowship offering
• Reduced specialty faculty
• Reduced specialty experience