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Cytotherapy Jul 2024Cell and gene therapy poses evolving challenges. The current article summarizes the discussions held by European Regional Committee of the International Society for Cell... (Review)
Review
Current challenges in cell and gene therapy: a joint view from the European Committee of the International Society for Cell & Gene Therapy (ISCT) and the European Society for Blood and Marrow Transplantation (EBMT).
Cell and gene therapy poses evolving challenges. The current article summarizes the discussions held by European Regional Committee of the International Society for Cell & Gene Therapy and the European Society for Blood and Marrow Transplantation (EBMT) on the current challenges in this field, focusing on the European setting. This article emphasizes the imperative assessment of real-world cell and gene therapy activity, advocating for expanded registries beyond hematopoietic transplantation and chimeric antigen receptor-T-cell therapy. Accreditation's role in ensuring standardized procedures, as exemplified by JACIE (The Joint Accreditation Committee of ISCT-Europe and EBMT), is crucial for safety. Access to commercial products and reimbursement variations among countries underscore the need for uniform access to advanced therapy medical products (ATMPs). Academic product development and point-of-care manufacturing face barriers to patient access. Hospital Exemption's potential, demonstrated by some initial experiences, may increase patient accessibility in individual situations. Regulatory challenges, including the ongoing European ATMPs legislation review, necessitate standardized criteria for Hospital Exemption and mandatory reporting within registries. Efforts to combat unproven therapies and fraud involve collaboration between scientific societies, regulatory bodies and patient groups. Finally, is important to highlight the vital role of education and workforce development in meeting the escalating demand for specialized professionals in the ATMP field. Collaboration among scientific societies, academic institutions, industry, regulatory bodies and patient groups is crucial for overcoming all these challenges to increase gene and cell therapy activity in Europe.
Topics: Humans; Genetic Therapy; Europe; Cell- and Tissue-Based Therapy; Registries; Societies, Medical; Accreditation
PubMed: 38416085
DOI: 10.1016/j.jcyt.2024.02.007 -
Journal of Graduate Medical Education Feb 2024The field of health care simulation continues to grow, accompanied by a proliferation of fellowship programs, leading to fellowship accreditation efforts. There is...
The field of health care simulation continues to grow, accompanied by a proliferation of fellowship programs, leading to fellowship accreditation efforts. There is controversy around the best approach to accreditation. The authors sought to understand perspectives of simulation leaders on fellowship accreditation to best inform the growth and maturation of fellowship accreditation. In 2020, simulation leaders identified through snowball sampling were invited to participate in a qualitative study. During one-on-one semistructured interviews, participants were asked about experiences as simulation leaders and their perspective on the purpose and impact of accreditation. The interviews were audio recorded and transcribed. Thematic analysis informed by a phenomenology framework was performed using a masked open coding technique with iterative refinement. The resulting codes were organized into themes and subthemes. A total of 45 simulation experts participated in interviews ranging from 25 to 67 minutes. Participants described discord and lack of consensus regarding simulation fellowship accreditation, which included a spectrum of opinions ranging from readiness for accreditation pathways to concern and avoidance. Participants also highlighted how context drove the perception of accreditation value for programs and individuals, including access to resources and capital. Finally, potential impacts from accreditation included standardization of training programs, workforce concerns, and implications for professional societies. Simulation leaders underscored how the value of accreditation is dependent on context. Additional subthemes included reputation and resource variability, balancing standardization with flexibility and innovation, and implications for professional societies.
Topics: Humans; Internship and Residency; Fellowships and Scholarships; Accreditation; Qualitative Research; Delivery of Health Care
PubMed: 38304604
DOI: 10.4300/JGME-D-23-00388.1 -
Quality Management in Health CareThe quality of health care relies on achieving the best quality and patient safety goals, and accreditation plays a fundamental role in achieving these goals through...
BACKGROUND AND OBJECTIVES
The quality of health care relies on achieving the best quality and patient safety goals, and accreditation plays a fundamental role in achieving these goals through compliance with standards that guide excellence. Accreditation also helps streamline operations and supports evidence-based quality improvement plans. This study aims to evaluate the perception of health care professionals on the accreditation process and its impact on the quality of health care and patient safety.
METHODS
This is a cross-sectional questionnaire survey distributed via the SuccessFactors website and made accessible to all hospital staff.
RESULTS
The online questionnaire was completed by 2047 participants, representing 51% of the entire hospital staff at Johns Hopkins Aramco Healthcare (JHAH). Overall analysis indicated a positive perception of accreditation benefits among health care employees (as indicated by participation in accreditation activities and/or preparation for the survey visits) and reflected on patient health care quality and safety dimensions, with an overall Likert median score of 4.0 (interquartile range = 3.7-5.0; P < .05).
CONCLUSION
The outcomes of our study confirm that JHAH employees perceived a positive impact of accreditation on health care quality improvement and patient safety. Also, the study supports considering accreditation as a fundamental requirement to improve health care system processes. However, it is critical to sustain quality of services over time during accreditation cycles.
Topics: Humans; Cross-Sectional Studies; Hospitals; Accreditation; Personnel, Hospital; Delivery of Health Care; Perception
PubMed: 37651601
DOI: 10.1097/QMH.0000000000000405 -
Journal of Korean Medical Science Jun 2024The recent debate surrounding the expansion of enrollment in Korean medical schools has reignited interest in the Flexner Report, published in the United States in 1910.... (Review)
Review
The recent debate surrounding the expansion of enrollment in Korean medical schools has reignited interest in the Flexner Report, published in the United States in 1910. Historically, medical education in the United States transitioned from small proprietary schools to university-affiliated institutions, emphasizing basic science and clinical experience. The Flexner Report advocated for scientific medicine and led to significant reforms in medical education, including standardization of curricula and strengthened admission requirements. The influence of this report extended to Korean medical education, shaping its curriculum, accreditation system, and emphasis on academic excellence. The expansion of medical school enrollment has led to a crucial dilemma. Should we prioritize the training of physicians who provide practical medical services or continue to emphasize academic medicine as we do now? There has been insufficient discussion of the individualized curricula, necessary investments, and societal efforts to accommodate these changes. It is imperative to move beyond mere enrollment expansion debates and collectively determine the future trajectory of Korean medical education, devising actionable plans to achieve overarching goals.
Topics: Republic of Korea; Education, Medical; Schools, Medical; Curriculum; Humans; Accreditation; United States
PubMed: 38859740
DOI: 10.3346/jkms.2024.39.e182 -
Cureus May 2024Equitable health manpower distribution is essential for the successful implementation of the Universal Health Care (UHC) program by the Philippine Department of Health....
BACKGROUND
Equitable health manpower distribution is essential for the successful implementation of the Universal Health Care (UHC) program by the Philippine Department of Health. Mapping the distribution and profile of dermatologists in the Philippines can improve Filipinos' access to skin disease treatment.
METHODS
A review of the database of dermatologists from the Philippine Dermatological Society (PDS) members' directory (as of November 2023), as well as the Philippine Health Insurance Corporation (PhilHealth) database (as of July 2023), was conducted. The distribution of PDS-accredited dermatologists was analyzed by geographic location, demographic profile (age and sex), density (per 100,000 people), and the dermatologist-to-general practitioner (GP) ratio. Heatmaps illustrating the distribution of dermatologists in the Philippines and the ratio of PhilHealth-accredited PDS board-certified dermatologists to GPs were created.
RESULTS
Out of 1389 PDS board-certified dermatologists, 1345 resided in the Philippines. The majority were women (1221/1345, 90.78%), with a median age of 47 years (range: 23 to 85). More than half were practicing in the National Capital Region (NCR) (684/1345, 50.86%). The overall dermatologist density was approximately 1 per 100,000 people (1.19); it was highest for the Luzon Island group (1.54) (NCR, 4.80) and lowest for the Mindanao Island group (0.27; the Bangsamoro Autonomous Region of Muslim Mindanao or BARMM, 0.04). Less than one-third (396/1345, 29.44%) of dermatologists were PhilHealth-accredited, with a density of 0.35 dermatologists per 100,000 people. Out of 45218 PhilHealth-accredited physicians, 396 (0.88%) were dermatologists while 11748 (25.98%) were GPs. The overall dermatologist-to-GP ratio among PhilHealth-accredited physicians was 1:30; it was highest in the Luzon Island group (1:20) and lowest in the Mindanao Island group (1:118).
CONCLUSION
The Philippines lacks dermatologists in regions outside the NCR. The majority are women, and few are PhilHealth-accredited. The dermatologist-to-GP ratio among PhilHealth-accredited physicians is low. Dermatology training programs should encourage more applicants, especially men, and prioritize applicants from underserved regions.
PubMed: 38883103
DOI: 10.7759/cureus.60402 -
Abdominal Radiology (New York) Sep 2023The National Accreditation Program for Rectal Cancer (NAPRC) was established by the American College of Surgeons with the goal of standardizing care of rectal cancer... (Review)
Review
The National Accreditation Program for Rectal Cancer (NAPRC) was established by the American College of Surgeons with the goal of standardizing care of rectal cancer patients in order to improve outcomes. NAPRC accreditation requires compliance with an established set of standards, many of which are directly related to radiology participation in multidisciplinary conference, rectal MR image acquisition, interpretation and reporting, and radiologist education. This paper outlines the pertinent standards/requirements for radiologists as part of the Rectal Cancer Multidisciplinary Team in the NAPRC guidelines, with proposed methods and tips for implementation of these standards from the perspective of the radiologist.
Topics: Humans; Rectal Neoplasms; Radiology; Accreditation; Radiologists
PubMed: 37160474
DOI: 10.1007/s00261-023-03919-9 -
Medical Education Dec 2023The COVID-19 pandemic had significant impacts on many aspects of health care and education, including the accreditation of medical education programmes. As a community...
INTRODUCTION
The COVID-19 pandemic had significant impacts on many aspects of health care and education, including the accreditation of medical education programmes. As a community of international educators, it is important that we study changes that resulted from the pandemic to help us understand educational processes more broadly. As COVID-19 unfolded in Canada, a revised format of undergraduate medical accreditation was implemented, including a shift to virtual site visits, a two-stage visit schedule, a focused approach to reviewing standards and the addition of a field secretary to the visit team. Our case study research aimed to evaluate the sociomaterial implications of these changes in format on the process of accreditation at two schools.
METHODS
We interviewed key informants to understand the impacts, strengths and limitations of changes made to the accreditation format. We used an abductive approach to analyse transcripts and applied a sociomaterial lens in looking for interconnections between the material and social changes that were experienced within the accreditation system.
RESULTS
Stakeholders within the accreditation system did not anticipate that changes to the accreditation format would have significant impacts on how accreditation functioned or on its overall outcomes. However, key informants described how the revised format of accreditation reconstructed how power was distributed and how knowledge was produced. The revised format contributed to changes in who held power within each of the programmes, within each of the visiting teams and between site members and visiting team members. As power shifted across stakeholders in response to material changes to the accreditation format, key informants described changes in how knowledge was produced.
CONCLUSIONS
Our findings suggest that the most powerful knowledge about any given programme might best be obtained through individualised tools, technologies and voices that are most meaningful to the unique context of each programme. Deliberate attention to how knowledge and power are influenced by the interactions between material and social processes within accreditation may help educators and leaders see the effects of change.
Topics: Humans; Pandemics; Schools, Medical; COVID-19; Education, Medical; Accreditation
PubMed: 37264487
DOI: 10.1111/medu.15143 -
Human Resources For Health Aug 2023The World Federation for Medical Education (WFME) defines accreditation as 'certification of the suitability of medical education programs, and of…competence…in the...
Consistency and quality in written accreditation protocols for pediatrician training programs: a mixed-methods analysis of a global sample, and directions for improvement.
BACKGROUND
The World Federation for Medical Education (WFME) defines accreditation as 'certification of the suitability of medical education programs, and of…competence…in the delivery of medical education.' Accreditation bodies function at national, regional and global levels. In 2015, WFME published quality standards for accreditation of postgraduate medical education (PGME). We compared accreditation of pediatric PGME programs to these standards to understand variability in accreditation and areas for improvement.
METHODS
We examined 19 accreditation protocols representing all country income levels and world regions. For each, two raters assessed 36 WFME-defined accreditation sub-areas as present, partially present, or absent. When rating "partially present" or "absent", raters noted the rationale for the rating. Using an inductive approach, authors qualitatively analyzed notes, generating themes in reasons for divergence from the benchmark.
RESULTS
A median of 56% (IQR 43-77%) of WFME sub-areas were present in individual protocols; 22% (IQR 15-39%) were partially present; and 8.3% (IQR 5.5-21%) were absent. Inter-rater agreement was 74% (SD 11%). Sub-areas least addressed included number of trainees, educational expertise, and performance of qualified doctors. Qualitative themes of divergence included (1) variation in protocols related to heterogeneity in program structure; (2) limited engagement with stakeholders, especially regarding educational outcomes and community/health system needs; (3) a trainee-centered approach, including equity considerations, was not universal; and (4) less emphasis on quality of education, particularly faculty development in teaching.
CONCLUSIONS
Heterogeneity in accreditation can be appropriate, considering cultural or regulatory context. However, we identified broadly applicable areas for improvement: ensuring equitable access to training, taking a trainee-centered approach, emphasizing quality of teaching, and ensuring diverse stakeholder feedback.
Topics: Humans; Child; Educational Status; Pediatricians; Accreditation; Physicians
PubMed: 37592365
DOI: 10.1186/s12960-023-00852-2 -
Journal of Applied Clinical Medical... Oct 2023Northwest Medical Physics Center (NMPC) is a nonprofit organization that provides clinical physics support to over 35 radiation therapy facilities concentrated in the... (Review)
Review
Northwest Medical Physics Center (NMPC) is a nonprofit organization that provides clinical physics support to over 35 radiation therapy facilities concentrated in the Pacific Northwest. Although clinical service is the primary function of NMPC, the diverse array of clinical sites and physics expertise has allowed for the establishment of structured education and research programs, which are complementary to the organization's clinical mission. Three clinical training programs have been developed at NMPC: a therapy medical physics residency program accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), an Applied Physics Technologist (APT) program, and a summer undergraduate internship program. A partnership has also been established with a major radiation oncology clinical vendor for the purposes of validating and testing new clinical devices across multiple facilities. These programs are managed by a dedicated education and research team at NMPC, made up of four qualified medical physicists (QMPs). The education and research work has made a significant contribution to the organization's clinical mission, and it has provided new training opportunities for early-career physicists across many different clinical environments. Education and research can be incorporated into nonacademic clinical environments, improving the quality of patient care, and increasing the number and type of training opportunities available for medical physicists.
Topics: Humans; Clinical Competence; Curriculum; Education, Medical; Health Physics; Internship and Residency; Radiation Oncology
PubMed: 37602785
DOI: 10.1002/acm2.14124 -
American Journal of Clinical Pathology Mar 2024To evaluate the gender composition of departmental chairs and program leadership of Accreditation Council for Graduate Medical Education-accredited pathology residencies...
OBJECTIVES
To evaluate the gender composition of departmental chairs and program leadership of Accreditation Council for Graduate Medical Education-accredited pathology residencies and American Board of Pathology-certified subspecialty fellowships across the United States.
METHODS
In this cross-sectional analysis, we examined the gender of individuals holding leadership positions in academic pathology in the United States. Using publicly available online data, 2 authors independently coded perceived gender (ie, man/woman/other) with 100% concordance.
RESULTS
In 144 pathology residency programs, more women hold residency program director positions (52.1% [75/144]). Among 11 pathology subspecialties, women overall hold fewer fellowship program director positions (45.0% [212/471]). Among the residency-associated pathology department chair positions identified, women hold fewer positions (31.8% [42/132]). There is some geographic variation in pathology leadership gender composition when stratified using US Census regions.
CONCLUSIONS
Women in academic pathology departments are well represented in residency and overall fellowship program leadership but are underrepresented in department chair and certain pathology subspecialty leadership positions. The disproportionate number of women in department chair positions is observed across medical specialties, highlighting the need for improved gender equity among high-level academic medicine positions.
Topics: Male; Humans; Female; Physicians, Women; Cross-Sectional Studies; Leadership; Accreditation; Certification
PubMed: 37961931
DOI: 10.1093/ajcp/aqad151