Development of Entrustable Professional Activities for Hospice and Palliative Medicine Fellowship Training in the United States.
*Education; *Entrustable Professional Activities; *fellowship; *graduate medical education; *hospice; *Hospice Care; *palliative care; *Palliative Care; Adult; Aged; Delphi Technique; Education; Female; Graduate/methods; Hospice Care; Human; Humans; Male; Medical; Middle Age; Middle Aged; Palliative Care; Palliative Medicine/*education; Surveys and Questionnaires; United States; Young Adult
CONTEXT: Entrustable Professional Activities (EPAs) represent the key physician tasks of a specialty. Once a trainee demonstrates competence in an activity, they can then be "entrusted" to practice without supervision. A physician workgroup of the American Academy of Hospice and Palliative Medicine sought to define Hospice and Palliative Medicine (HPM) EPAs. OBJECTIVE: The objective of this study was to describe the development of a set of consensus EPAs for HPM fellowship training in the United States. METHODS: A set of HPM EPAs was developed through an iterative consensus process involving an expert workgroup, vetting at a national meeting with HPM educators, and an electronic survey from a national registry of 3550 HPM physicians. Vetting feedback was reviewed, and survey data were statistically analyzed. Final EPA revisions followed from the multisource feedback. RESULTS: Through the iterative consensus process, a set of 17 HPM EPAs was created, detailed, and revised. In the national survey, 362 HPM specialists responded (10%), including 58 of 126 fellowship program directors (46%). Respondents indicated that the set of 17 EPAs well represented the core activities of HPM physician practice (mean 4.72 on a five-point Likert scale) and considered all EPAs to either be "essential" or "important" with none of the EPAs ranking "neither essential, nor important." CONCLUSIONS: A set of 17 EPAs was developed using national input of practicing physicians and program directors and an iterative expert workgroup consensus process. The workgroup anticipates that EPAs can assist fellowship directors with strengthening competency-based training curricula.
Landzaat Lindy H; Barnett Michael D; Buckholz Gary T; Gustin Jillian L; Hwang Jennifer M; Levine Stacie K; Okon Tomasz R; Radwany Steven M; Yang Holly B; Encandela John; Morrison Laura J
Journal of pain and symptom management
2017
2017-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jpainsymman.2017.07.003" target="_blank" rel="noreferrer noopener">10.1016/j.jpainsymman.2017.07.003</a>
Quality Metrics in Neonatal and Pediatric Critical Care Transport: A National Delphi Project.
*Delphi Technique; Airway Management – Standards; Airway Management/standards; Benchmarking; Clinical Indicators; Critical Care – Standards; Critical Care Family Needs Inventory; Critical Care/*standards; Delphi Technique; Health Care; Hospitals; Humans; Multidisciplinary Care Team – Standards; Ohio; Outcome and Process Assessment (Health Care); Outcomes (Health Care); Patient Care Team/standards; Patient Safety – Standards; Patient Safety/standards; Pediatrics – Standards; Pediatrics/*standards; Quality Indicators; Quality of Health Care – Standards; Quality of Health Care/*standards; Special; Tertiary Care Centers; Time Factors; Transportation of Patients – Standards; Transportation of Patients/*standards
OBJECTIVES: The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics. DESIGN: Modified Delphi technique. SETTING: The first round of consensus determination was via electronic mail survey, followed by rounds of consensus determination in-person at the American Academy of Pediatrics Section on Transport Medicine's 2012 Quality Metrics Summit. SUBJECTS: All attendees of the American Academy of Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted on October 21-23, 2012, in New Orleans, LA, were eligible to participate. MEASUREMENTS AND MAIN RESULTS: Candidate quality metrics were identified through literature review and those metrics currently tracked by participating programs. Participants were asked in a series of rounds to identify "very important" quality metrics for transport. It was determined a priori that consensus on a metric's importance was achieved when at least 70% of respondents were in agreement. This is consistent with other Delphi studies. Eighty-two candidate metrics were considered initially. Ultimately, 12 metrics achieved consensus as "very important" to transport. These include metrics related to airway management, team mobilization time, patient and crew injuries, and adverse patient care events. Definitions were assigned to the 12 metrics to facilitate uniform data tracking among programs. CONCLUSIONS: The authors succeeded in achieving consensus among a diverse group of national transport experts on 12 core neonatal and pediatric transport quality metrics. We propose that transport teams across the country use these metrics to benchmark and guide their quality improvement activities.
Schwartz Hamilton P; Bigham Michael T; Schoettker Pamela J; Meyer Keith; Trautman Michael S; Insoft Robert M
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
2015
2015-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/PCC.0000000000000477" target="_blank" rel="noreferrer noopener">10.1097/PCC.0000000000000477</a>