see a system of interprofessional, team-based learning that focuses on the delivery of evidence-based health care. Health professionals themselves, as well as teachers of CPD and other stakeholders, will need to reorient their ideas of the necessity and purpose for CPD activities and the roles they will have to play as continuous learners in order to consistently deliver the best possible care.

Concentrated efforts to begin this movement are needed to prevent further delays in improving health care quality and safety. To this end, the planning committee should cultivate relationships with relevant stakeholders, who in turn need to consider how they can best support the continuous development of the health care workforce. The scope of relevant stakeholders is broader than those directly involved in the learning of the U.S. health professions workforce. The United States can learn from the positive and negative experiences of other countries (e.g., Canada, European Union, United Kingdom) that have systems and structures in place to direct professional development, thus shortening the lead time needed to implement a U.S. CPD system (see Appendix C). International cooperation is a source of mutual learning, and initially the CPDI would likely learn from the best practices of other countries. Once a comprehensive CPD system is in place in the United States, the CPDI would be able to be an active member of the global CPD community by sharing its lessons learned.

Best practices could also be learned from and shared with other industries, such as engineering and teaching, which also require continuing education to assure the public of professionals’ competence (see Appendix D). While the content must reflect the needs of the different industries, strategies for encouraging behavior change and learning are applicable across industries. The CPDI could benefit itself and others by being an active part of a continued learning community that spans all industries for which continued learning and development are critical.

Development of the CPDI is an important step toward ensuring health professionals’ capacity to provide high quality care, but it is only one part of improving the quality and safety of the larger health care system. A strong connection needs to be created between CPD for clinicians and quality improvement at the micro-, meso-, and macrosystem levels. The microsystem refers to the front line of care, the network of interdependent people, information, and technology working together to accomplish a specific aim (e.g., ambulatory pediatric clinic, labor and delivery room, inpatient unit). The mesosystem creates the environment for transformation and includes the resources, strategies, and measures to guide and track



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