ABIM Foundation Focus – Winter 2017

Cultivating Physician Engagement in Performance Improvement

In November 2016, the American Board of Internal Medicine and the ABIM Foundation convened a group of stakeholders—including physicians from varying practice settings and other opinion leaders—for a two-day meeting to discuss what physicians need to know and do to improve quality and how certifying boards, specialty societies and other organizations can foster physician engagement and skills development in performance improvement. Among the meeting highlights:

• A panel of patient advocates discussed which quality improvement efforts resonated most with patients.
• In his keynote address, Dr. Jeffrey Wiese, Senior Associate Dean for Graduate Medical Education at Tulane University and Chair of the ABIM Internal Medicine Specialty Board, traced the modern history of the intersection between payment and quality.
• Tom Granatir, Senior Vice President for Policy and External Relations at the American Board of Medical Specialties (ABMS), updated the group on the ABMS’s recent report of a Board Task Force on Improvement in Medical Practice.
• Chuck Kilo, MD, Vice President and Chief Medical Officer at Oregon Health & Science University, spoke about the skills and competencies physicians need to engage in performance improvement activities.
• Small-group discussions focused on drivers, barriers and solutions related to physician engagement and attempted to define the attributes of meaningful activities in performance improvement.

A summary of the meeting provides additional insight on the discussions and panels.

Establishing Priorities to Develop Patient-Centered Metrics for Low-Value Care

In February 2017, AcademyHealth and the ABIM Foundation convened leading physicians, health researchers, system administrators, health plan representatives and others to attempt to define priorities for the development of patient-centered measures in the area of overuse. The meeting was funded by the Patient-Centered Outcomes Research Institute (PCORI).

Over the course of the one-day meeting:

Susan Edgman-Levitan, the Executive Director of the John D. Stoeckle Center for Primary Care Innovation, gave a presentation about the issues raised in her commissioned paper “Defining Patient-Centered Metrics for Low Value Care: What Matters to Me?”

• Physician-researchers Sameer Saini, MD, MS, and Eve Kerr, MD, MPH, presented their findings about the current state of the research about measures used to assess the impact of interventions to reduce low-value care.
• Attendees worked in small groups and then together using crowd-sourcing and a rank-order tool to set priorities among potential measurement concepts.

Charter on Professionalism for Healthcare Organizations

The “Charter on Professionalism for Health Care Organizations,” featured in the January 11, 2017, issue of Academic Medicine, is a new set of professionalism-based metrics for model hospitals and hospital systems intended to create more healing environments, alleviate workforce burnout and provide ethical guidelines for hospital operations.

The Charter was funded by the Commonwealth Fund, the ABIM Foundation, the American Hospital Association, the Federation of American Hospitals and Northwell Health. It extends the commitments and principles articulated in the Physician Charter—which focuses on the responsibilities of individual physicians—to health care delivery systems. Its authors include health care professionals, patients and community advocates.

Focusing on behavioral change, the new Charter addresses four main areas, including:

• Patient Partnership: By involving patients more fully in their care and in hospital strategies, a more patient-centered approach to health care can be achieved. Although patients clearly benefit from such partnerships, organizations can improve their performance and increase public trust.
• Organizational Culture: Attention to the environment of the health care workforce can reduce burnout among all health care professionals, which now affects more than half of physicians. When health care workers’ well-being is attended to, they can in turn provide better care for patients.
• Community Partnership: Population health requires collaboration among all the entities that can affect the social determinants of health: hospitals, government, and community organizations.
• Operations and Business Practices: Ethical business practices improve access, the quality of patient care, and hospital financial performance.

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