We talked about learning activities for SVMD, and also for the urgent care clinics.  A challenge with CME is to go beyond the usual "interesting speaker" format and actually address the needs of the learners.  There are probably 100 things that we could think about when describing the needs of the learners.We talked about learning activities for SVMD, and also for the urgent care clinics.  A challenge with CME is to go beyond the usual "interesting speaker" format and actually address the needs of the learners.  There are probably 100 things that we could think about when describing the needs of the learners.

CME credits can be given in 15 min. increments.  So having a 10 min. discussion with questions and answers as part of a provider meeting, it can add up.

Dr. Jane Lombard is the medical director of the CME department for El Camino health.  She is also part of SVMD, and should be part of this discussion.

Here is some potential fodder for CME credit

• Any of our quality measures that we are not meeting
• Review of near misses.  I saw a patient this week, 95-year-old woman with influenza A.  If I have trusted the blood pressure cuff that indicated a heart rate of 65, we would have a problem.  Listening to the chest I could hear that the heart rate was well over 100.  In fact, it was 170-180.  Case reviews such as this can drive home the necessity of measuring heart rate in other ways besides trusting a blood pressure cuff.
• We see occasional peritonsillar abscess in urgent care.  This is potentially a threat to the airway and requires prompt intervention.  While trying to refer 1 of my patients to the El Camino Hospital emergency room, I was informed that getting an ENT consultant was difficult at best.  I ended up sending that patient to Stanford because of uncertainty over whether they would be treated at El Camino Hospital.  A discussion of management includes antibiotics, steroids and drainage.  We already know that.  What I need to know is, how should I administer the steroids and who can I call.
• We just saw a health stream video about active shooters.  Supplementing that with an active shooter drill might help us iron out logistics about how the front desk would alert the back rooms, escape routes and how to secure doors.
• By the way, why are we not giving ourselves credit for these health stream videos?
• N. 1st St. has a couple of ultrasound machines.  Dr. Subeh from the emergency room is willing to give us bedside ultrasound training.
• Informatics training can also merit CME credits.  I would not mind some brush up on creating order sets and learning from others what they use.
• Any discussion of how to manage a difficult clinical case is CME worthy.  Even if two people discuss it over the telephone, we could offer credit.  A summary could even be sent out to the group as a "lesson learned" for 15 min. worth of CME credit.
• An oncologist with Stanford used to receive quizzes on his phone.  He would answer them, read the discussion and collect 15 min. worth of credit.  The beauty of these quizzes is that we can measure what our doctors know and more importantly, what they don't know.
• As we all know, mass casualty events can quickly overload an emergency room.  Mass casualty drills are frequently performed by other hospitals with CME credit.  Learning objectives could include emergency bandaging, splinting, patient assessment, but other systemic things like incident command, storage of supplies, adapting to power outages.  N. 1st St. would be an excellent testing ground.
• Santa Clara County is organizing a diabetes prevention program.  I don't know whether El Camino health is involved with that.  We should be.

El Camino's CME accreditation can also be extended by a couple of years if we do certain sneaky tricks.  There are 16 of them, and some of the easier ones include:

• Educating teams rather than simply physicians.  Include nurses, medical assistants, call-center personnel
• Using support strategies (and documenting them) to make sure we get the results we want rather than hoping that the learners change practice based on a lecture.This is practically a giveaway.
• Addressing community health issues, whether it's diabetes, STDs, homelessness-related issues
• Demonstrating creativity or innervation in our educational program-this is practically a giveaway.
• Producing measurable change in physician performance or patient outcomes.  This takes a bit more work, but El Camino is already generating lots of data.  Besides, Kaiser does it all the time.
• Teaching communication or procedural skills.

I have an online page about basic CME planning.  It's at https://amicnow.org/260, and no, you don't need to read through it.

Mission: to patch up holes at SVMD

PPG:

• anxiety about new time schedule, 15/30
• inconsistent Rx practices
• patient experience
  • uncertainty about billing
  • lack of access
  •  communication with care team
• inadequate HTN and DM scores
• epidemiologic / new eyes on what's out there

learning objectives TBD, likely multidisciplinary

format

• 1 on 1
• live/lecture/Zoom
• hands-on (skin Bx, I&D, suturing, nails, bedside US)

DPA: pt care, informatics, MD QOL, 

 SCS: we're not getting commercial support, need a means of collecting FRs, not all topics are clinical.

Evaluation based on performance and outcomes

Comm Criteria - involve students, PAs MAs community, CME research, creativity, achieves outcomes, public health