Exploring a Business Case for High-Value Continuing Professional Development Proceedings of a Workshop (2018) / Chapter Skim
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3 Putting the Value in High-Value CPD
3 Putting the Value in High-Value CPD
Pages 19-32
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From page 19... ...
, it is critical to understand how CPD aligns with value-based purchasing as it takes hold in the United States and in other international markets as well. In the view of Paul Mazmanian, associate dean for assessment and evaluation studies at Virginia Commonwealth University, those responsible for managing professional development will likely face pressure to restructure the CPD enterprise to meet the demands of reorganizing health systems.
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Less frequently reported outcomes include immunization rates, mortality, morbidity, and other community health indicators. Box 3-1 outlines evaluation perspectives of Moore, Green, and Gallis with tools for achieving desired results and improved outcomes (Moore et al., 2009)
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PUTTING THE VALUE IN HIGH-VALUE CPD 21 BOX 3-1 Evaluation Outcomes and Tools Level 1: Participation Description: Number of learners who participate in the educational activity Tools: Attendance records Level 2: Satisfaction D escription: The degree to which expectations of participants were met regarding the setting and delivery of the educational activity T ools: Questionnaires or surveys completed by attendees after an educa tional activity Level 3A: Declarative knowledge escription: The degree to which participants state what the educational D activity intended them to know Tools: Pre- and posttests of knowledge or self-reported gain in knowledge Level 3B: Procedural knowledge escription: The degree to which participants state how to do what the edu D cational activity intended them to know how to do Tools: Pre- and posttests of knowledge or self-reported gain in knowledge Level 3C: Dispositional knowledge escription: The degree to which participants demonstrate intentionality, D consistent with values, attitudes, and norms T ools: Valid and reliable tests of psychological constructs or statements of commitment to change Level 4: Competence escription: The degree to which participants show in an educational set D ting how to do what the educational activity intended them to be able to do T ools: Observation in an educational setting or self-report of competence or intention to change Level 5: Performance escription: The degree to which participants do what the educational activ D ity intended them to be able to do in their practices T ools: Observed performance in clinical settings, patient charts, administra tive databases, self-reports of performance Level 6: Patient health D escription: The degree to which the health status of patients improves because of changes in the practice behavior of participants T ools: Health status measures recorded in patient charts or administrative databases or patient self-report of health status Level 7: Community health D escription: The degree to which the health status of a community of patients changes because of changes in the practice behavior of participants Tools: Incidence and prevalence reports or community self-reports SOURCE: Adapted from Moore et al., 2009.
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TABLE 3-1 Educational Interventions and Their Effectiveness Effectiveness for Intervention Definition Behavior Change Educational material Printed/published and distributed Little or no effect recommendations for clinical care Conferences Conferences, workshops, lectures Mixed effectiveness outside practice setting
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Multifaceted Select combinations of the previous More consistent interventions seven interventions, such as outreach effectiveness visits, clinical information from patients, or computer reminders to counsel patients about specific disorders Interprofessional Two or more health and social care Mixed effectiveness education professionals learning interactively in educational sessions Interprofessional Interventions in health care settings Mixed effectiveness collaboration to improve care provided by two or more health professionals SOURCE: Presented by Paul Mazmanian, April 6, 2017.
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PATIENT PERSPECTIVE AND NONECONOMIC VALUES Andrew Spiegel, International Alliance of Patient Organizations Spiegel, director of the International Alliance of Patient Organizations, told workshop participants that although much of the attention is focused on the economic benefits of CPD, CPD can also contribute to important noneconomic benefits for the patient. Spiegel has been a leader in the patient advocacy community for more than 20 years, after his parents died 2 days apart from two different cancers.
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• Management and leadership would learn how to inspire their workers to go forward with a vision. Table 3 respondent: A While the costs for the • Health care providers, theoretical CPD activity program are uncertain, prescribers, and dispensers for training health care there were theorized would feel more confident workers to combat the financial gains through in their skills, their opioid epidemic reduced public health decision making, and their costs and improved public approach to dealing with safety.
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Table 5 respondent: A Costs involve a simple • Payers would have fewer theoretical CPD activity metric of calculating the costs with care outside of using TeamSTEPPS as cost of care in the hospital the hospital. applied to palliative care in versus the cost of care in • The family/caregivers the home the home.
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unmet patient needs. He noted that in the patient advocacy community the issue of CPD is not "ever discussed or published" despite the self-evident link between health care provider skills and knowledge and the patient experience.
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Spiegel said that, despite efforts by the patient advocacy community to educate patients outside the clinic setting, patients still tend to get most of their information from their doc tors and follow their doctors' recommendations. For this reason, it is essential that CPD helps providers effectively convey and trans late information about disease management to their patients.
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. birthing experience," and asked Spiegel how CPD can help providers understand and acknowledge the centrality of the patient in making informed decisions about disease management.
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This kind of assessment inevitably denies treatment to some patients, he remarked, before wondering aloud, "Should every patient have access to every therapy no matter where they are in the world? " The International Alliance of Patient Organizations advocates for universal quality health care in every country in the world, but Spiegel admits that achieving this goal is enormously difficult and not getting any easier.
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2009. Continuing medical education costs and benefits: Lessons for compet ing in a changing health care economy.
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2017. Continuing professional development in medicine and health care: Better education, better patient outcomes.
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