• • Mark Adams M.D. is our chief medical officer.  He and I met on a couple occasions, including the beginning of this month to try and clarify how CME can help the hospital get where they want to get.  He has mentioned clinical variation as a challenge to overcome.  I get the general idea of how that can be a problem but we discussed very few specifics.  He mentioned a bad outcome related to treatment of hyperkalemia in a patient with chronic renal disease and diabetes.
  • Mark also talked about making our hospital into an HRO, or High Reliability Organization to reduce the chance that human error would cause injury.
  • Apurva Marfatia MD is the current chief of staff.  He has discussed CME with me on a few occasions, but it mostly has to do with choosing my replacement.  It is important that he gets the connection between CME and quality improvement.
  • Sheetal Shah is director of risk management and patient safety.  Mark Adams suggested that discuss with her.  She is an attorney, and I know her from serving on our ethics committee.  I'm going to reach out to her shortly after sending this e-mail.
  • Jane Lombard will take over as CME chair in April 2021.  Jane is a cardiologist and was involved with CME when she worked at Kaiser.  I also work with her on the ethics committee.
  • Gloria Wu and Philip Ho (all physicians) weree considered as  candidates for taking over as CME chair.    Gloria Wu is an energetic ophthalmologist who has been director at CME at our Los Gatos campus.  She has some difficulties with CME planning process and cuts corners in the CME planning process, but loves to offer educational activities which are generally well received.  Philip Ho is an ENT physician who is also vice Chief of Staff at our Los Gatos campus.
  • Deborah Babcock MD, Christine Kilkenny RN, Donna Malhotra Garcia and Gretchen Suess NP are members of our CME committee who have worked particularly hard on their programs.  Debbie is a pediatrician, and has offered monthly educational activities for years.  Christine Kilkenny works in the stroke team, offers quarterly stroke dinners, gives us some performance and outcomes data.  Donna manages a cardiovascular/ cath lab RSS.  Gretchen is our palliative care manager and has offered activities in end-of-life care, palliative care, advanced directives.
  • Our Ethics committee used to offer lots of teaching activities in November, with Chrissy Hessler, Jennipher Owen, Ray Shaheen et al.
  • Barbi Phelps-Sandall and Bill Buchholz are at-large members of the committee.  
  • Lakshmi Myneni and Mariam Manoukian discussed an osteoporosis program but it hasn't materialized.
  • Elie Richa has shown an interest in oncology teaching programs, but not clear how deep the Cancer Center wants to get into this.  
  • There are scattered individuals who approach us to get their speakers on the schedule, basically to advertise the speaker.  
  • Ryan Nhan is our coordinator.  He has a background in public health.

• The next CMA conference on CME basics will be in April.  IMQ used to do all-day trainings, but everything's virtual now.  
• In order to offer CME compliantly, one needs to follow the rules.  Requirements are pretty simple, but difficult to explain simply.

The numbers here are intentional.  They correspond to ACCME criteria

1. Mission Statement:  We need to start with a mission statement, and follow it.
2. Address practice gaps:  figure out where you need to improve.  Have some rationale for determining practice gaps.  "It's interesting" doesn't cut it.
3. Create learning objectives designed to increase physician competence, physician performance, patient outcomes, or some combination of these.  Learning objectives should not simply increase knowledge.  This is a common mistake.
4. Choosing the target audience is no longer required.  But we keep it as part of the planning process.  
5. We should choose the appropriate teaching format, venue.  Lecture isn't always the best way to change how physicians practice.  Another common mistake.
6. Address "Desirable Physician Attributes".  Not everything is about patient care.  Sometimes it's about professionalism, sometimes just learning informatics.  Rarely a reason to fail an audit, it's usually where we spot the inexperienced CME providers.
7. Get financial disclosures from everybody in control of course content and resolve potential conflicts of interest before the educational activity.  Disclose to learners whether or not there was a relevant financial relationship.  Document that you did it.  This is a VERY common reason to fail an audit.
8. Follow our honorarium policy, and if you have commercial support, there's some rules to follow.
9. If you have commercial support, there are some rules to follow.
10. Make sure you are teaching medicine and not advertising a product.
11. Evaluate whether your teaching activities were successful.  Lotsa ways to do this.  Periodically review whether these learning activities are helping you meet your Mission Statement.
12. Periodically review whether your CME program is going the way you intended.  You can do this at midnight the weekend before your reapplication is due, or you can do it ahead of time.
13. Figure out how to adapt the CME program based on the lessons learned in step 12. 

•  The accreditation is for 4 years.  With "commendation criteria" it can be increased to 6 years.  Commendation criteria (criteria 23-39) are pretty straightforward, but need conscious planning.
• Cultural and Linguistic Competency (CLC) is a requirement for all CME accreditation originating in California.  The idea is to address disparities in health care related to culture and language.
• soon we will have the requirement to address "implicit bias".  Worthwhile, but not clear how we will do that.
• There is specific wording that should be followed when offering CME credit.  Best to have the phrase,   El Camino Hospital is accredited by the California Medical Association (CMA) to provide continuing medical education for physicians.  El Camino Hospital designates this live internet activity for a maximum of 1 AMA PRA Category 1 credit ^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

kept somewhere handy so you can cut and paste easily including italics and superscript.