Redesigning Continuing Education in the Health Professions (2010) / Chapter Skim
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4 Moving Toward a Continuing Professional Development System
4 Moving Toward a Continuing Professional Development System
Pages 79-92
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From page 79... ...
As detailed in the previous chapters, CE faces many problems, including: • The science underpinning CE for health professionals is fragmented and underdeveloped. The lack of a strong sci ence base makes it difficult if not impossible for health profes sionals to identify educational programs best suited to their needs, and the fragmentation of responsibility for research inhibits the establishment of a cohesive research agenda that can identify what works to best support continued learning.
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From page 80... ...
This chapter will focus on ways to implement such a system. ALTERNATIVES FOR REFORMING CONTINUING EDUCATION In considering the establishment of an institute such as the one proposed in the committee's statement of task, the committee identified alternative means of improving health professions learn
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From page 81... ...
There is no mechanism to ensure that continued learning is free from conflicts of interest. In addition, the status quo has limited capacity to promote widespread interprofessional learning opportunities.
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From page 82... ...
82 REDESIGNING CE IN THE HEALTH PROFESSIONS TABLE 4-1 Overview of the Alternatives Core Tasks Alternative Actors Research agenda Regulatory • o • o central Status quo Current N N stakeholders coordinated force to call research for regulatory agenda changes • unding from F potentially conflicted sources • ould • egulation not Program AHRQ C R within existing provide currently within government focused its authority • ensitivity agency investment S in CE about unilateral research and federal action to demonstration change state and projects professional roles • ould W promote close ties to QI • ould • egulation not HRSA C R invest in currently within research and its authority • ensitivity demonstration S projects about unilateral • ould W federal action to promote change state and close ties professional roles to research across education continuum • o central • ould develop Coalition Current N C stakeholders convener voluntary • ould raise and other C regulatory quality-focused money to standards organizations fund specific (e.g., NQF) research areas • ould C provide greater emphasis on QI
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From page 83... ...
83 TOWARD A CONTINUING PROFESSIONAL DEVELOPMENT SYSTEM Financing Conflict of interest Interprofessional care • o dedicated funding • ome actions to reduce • o incentives N S N sources COI to promote • 8 percent of funding 5 team-based for CE in medicine interprofessional from pharmaceutical care and medical device companies • ould require • acks authority to • ould promote W L C change in mission make widespread team-based to incorporate other impact on COI interprofessional sources of funding for care CE • istorically unstable H funding • ould require • acks authority to • ddresses W L A change in mission make widespread interprofessional to incorporate other impact on COI education through sources of funding for Titles VII and VIII, CE but inconsistently • ould result in more • ould develop • ould promote C C C consistent funding self-enforced COI interprofessional • ould develop self C guidelines learning, but enforced financing currently no strong regulations research capacity to do so continued
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From page 84... ...
But none of these private or public activities has resulted in documented widespread improvements in health professional practice and patient outcomes, in part due to the inadequacies of the science, regulation, and financing of continuing education. As to long-term costs, an important consideration that will help drive future CE efforts, there is no incentive under the status quo to reduce the costs or resources of CE activities and the overall CE system.
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From page 85... ...
The Agency for Healthcare Research and Quality funds research to improve health care quality, safety, efficiency, and effectiveness. Its work includes research on evidence-based practice, development of guidelines, technology assessments, and comparative
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From page 86... ...
This includes providing some funds for continuing education and professional development made available through Title VII and Title VIII of the Public Health Service Act. Specific to continuing education, Title VII provides money for the Area Health Education Center program that, among other things, trains health professionals working in underserved populations and local communities and supports interprofessional education and training.
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From page 87... ...
. Groups of this nature could be the basis for building a broader coalition, including organizations whose purposes are to improve health care quality and patient safety, such as the National Committee for Quality Assurance (NCQA)
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From page 88... ...
Because the committee believes that advancing the system in an effective manner will require strong leadership, this alternative was not recommended. Alternative 4: Creating a New, Private Structure In this scenario, the new structure would be operated by professional societies and organizations across all health professions.
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From page 89... ...
Stakeholders are all separated without an incentive to promote change. The development of a structure operated by professional societies shares some of the same benefits of the coalition alternative, perhaps the most important being the ability to explicitly seek input of those representing health professionals.
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From page 90... ...
For example, a model could be implemented that would enable states to provide input to the development of regulatory standards, but each state would retain authority to modify its laws, make any changes to its own regulatory processes, and find the resources needed to institute changes. A process could be established analogous to the National Association of Insurance Commissioners, which develops model laws that are then passed to the states to either adopt in their entirety or modify to meet the needs of the local circumstances.
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From page 91... ...
The NQF was developed by the 1998 President's Commission on Consumer Protection and Quality in the Health Care Industry. The commission recognized the need to develop standards for measuring health care quality and performance because of the promulgation of numerous highly varied sets of measures, resulting in unreliable data on which to base decisions.
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From page 92... ...
The institute, which the IOM committee has called the Continuing Professional Development Institute (CPDI) , should be designed as a neutral body that promotes and catalyzes collaboration.
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