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The Pan African Medical Journal 2023accreditation is the most effective approach to ensure the quality of services. Laboratory performance can be evaluated using the World Health Organization (WHO)-SLIPTA...
Accreditation of a molecular HIV diagnostic laboratory following the Strengthening Laboratory Management Towards Accreditation (SLMTA)-Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach in Kenya: an implementation science study.
INTRODUCTION
accreditation is the most effective approach to ensure the quality of services. Laboratory performance can be evaluated using the World Health Organization (WHO)-SLIPTA checklist, which checks a laboratory´s compliance with ISO 15189 on a five-star score scale and improved using the SLMTA approach. Compliance is assessed by an external body and can result in accreditation. In this paper, we describe the steps taken by the Kenya Medical Research Institute (KEMRI) HIV Laboratory, Alupe, a resource-limited public entity, towards accreditation, and discuss the lessons learned.
METHODS
the laboratory adopted a SLMTA-SLIPTA approach that included targeted mentorship, on-site workshops, and training. Mentorship-based interventions were used to establish a robust quality management system. Targeted mentorship, on-site workshops, and training were conducted between September 2015 and July 2016. Audits used the SLIPTA checklist to detect gaps in 12 quality system essentials. Performance indicators including turnaround time, external quality assurance, sample rejection rates, and corrective actions were tracked. An external assessment by the national accreditation body was conducted between September 2016 and November 2016.
RESULTS
training and mentorship-based interventions were successfully conducted. Quality management systems aligned with ISO 15189 were established. Baseline, midterm, and exit audits yielded scores of 47%, 75%, and 94% respectively. Early infant diagnosis external quality assurance scores were 100% in 2014-2016, while average viral load scores were at 60%, 70% and 90% during the same period. Turnaround time from September 2015 surpassed the 80% target. Accreditation was awarded in March 2017.
CONCLUSION
the SLMTA-SLIPTA approach is suitable for quality improvement in resource-limited laboratories.
Topics: Humans; Laboratories; Quality Control; Kenya; Quality Improvement; Implementation Science; Accreditation; HIV Infections
PubMed: 38223876
DOI: 10.11604/pamj.2023.46.60.39549 -
Current Opinion in Pulmonary Medicine Mar 2024This review holds significant relevance and is timely; as of June 2022, the United States Accreditation Council of Graduate Medical Education (ACGME) formally recognized... (Review)
Review
PURPOSE OF REVIEW
This review holds significant relevance and is timely; as of June 2022, the United States Accreditation Council of Graduate Medical Education (ACGME) formally recognized interventional pulmonary medicine as a novel subspecialty with a unique fellowship training program pathway beyond Pulmonary and Critical Care Medicine. This recognition stands as a culmination of extensive efforts spanning decades, aimed at establishing a specialized training program for interventional pulmonary medicine beyond traditional Pulmonary and Critical Care Fellowship in the United States. Globally, there are apprenticeship models in non-US programs with ongoing efforts to further standardize training in interventional pulmonary medicine. It underscores the progressive evolution and innovative nature inherent to this subspecialty, signifying a distinctive leap forward in medical education and practice, which calls for further inventive development of training tools and standardized educational delivery.
RECENT FINDINGS
Newly discovered insights from the recent literature review will highlight methodologies of procedural education and innovative training approaches. These findings will underscore the significance of standardized curriculum development within the field as well as ongoing challenges.
SUMMARY
Identifying and addressing future challenges in integrating new technologies into clinical education and broadening the educational scope of trainees in this newly recognized subspecialty is crucial for enhancing competency. The implications of moving toward a more standardized process, creating new clinical pathways with research, and adopting emerging minimally invasive technologies aim to impact patient outcomes in both nonmalignant and malignant thoracic diseases. This progressive shift is redefining the specialty, moving beyond specific procedures, and pivoting towards a more distinct educational pathway. Such a transformation will lead to more diverse, comprehensive, and evidence-based driven patient care delivery.
Topics: Humans; United States; Pulmonary Medicine; Clinical Competence; Accreditation; Education, Medical, Graduate; Fellowships and Scholarships
PubMed: 38197436
DOI: 10.1097/MCP.0000000000001049 -
Journal of the American Medical... Sep 2023Foundational domains are the building blocks of educational programs. The lack of foundational domains in undergraduate health informatics (HI) education can adversely...
BACKGROUND
Foundational domains are the building blocks of educational programs. The lack of foundational domains in undergraduate health informatics (HI) education can adversely affect the development of rigorous curricula and may impede the attainment of CAHIIM accreditation of academic programs.
OBJECTIVE
This White Paper presents foundational domains developed by AMIA's Academic Forum Baccalaureate Education Committee (BEC) which include corresponding competencies (knowledge, skills, and attitudes) that are intended for curriculum development and CAHIIM accreditation quality assessment for undergraduate education in applied health informatics.
METHODS
The AMIA BEC used the previously published master's foundational domains as a guide to creating a set of competencies for health informatics at the undergraduate level to assess graduates from undergraduate health informatics programs for competence at graduation. A consensus method was used to adapt the domains for undergraduate level course work and harmonize the foundational domains with the currently adapted domains for HI master's education.
RESULTS
Ten foundational domains were developed to support the development and evaluation of baccalaureate health informatics education.
DISCUSSION
This article will inform future work towards building CAHIIM accreditation standards to ensure that higher education institutions meet acceptable levels of quality for undergraduate health informatics education.
Topics: Curriculum; Medical Informatics; Health Education; Educational Status; Accreditation; Nursing Informatics
PubMed: 37561427
DOI: 10.1093/jamia/ocad147 -
Journal of Educational Evaluation For... 2024Despite explicit expectations and accreditation requirements for integrated curriculum, there needs to be more clarity around an accepted common definition, best... (Review)
Review
Despite explicit expectations and accreditation requirements for integrated curriculum, there needs to be more clarity around an accepted common definition, best practices for implementation, and criteria for successful curriculum integration. To address the lack of consensus surrounding integration, we reviewed the literature and herein propose a definition for curriculum integration for the health professions education audience. We further believe that health professions education is ready to move beyond "horizontal" (one-dimensional) and "vertical" (two-dimensional) integration and propose a model of "six degrees of curriculum integration" to expand the two-dimensional concept for future designs of health professions programs and best prepare learners to meet the needs of patients. These six degrees include: interdisciplinary, timing and sequencing, instruction and assessment, incorporation of basic and clinical sciences, knowledge and skills-based competency progression, and graduated responsibilities in patient care. We encourage medical educators to look beyond two-dimensional integration to best prepare physicians of the future.
Topics: Curriculum; Humans; Education, Medical; Clinical Competence; Accreditation; Models, Educational
PubMed: 38872249
DOI: 10.3352/jeehp.2024.21.15 -
Cureus Aug 2023Objective YouTube (YouTube LLC, San Bruno, California, United States) is used as a primary resource for many patients looking to gain healthcare knowledge. Recently,...
Objective YouTube (YouTube LLC, San Bruno, California, United States) is used as a primary resource for many patients looking to gain healthcare knowledge. Recently, YouTube made efforts to increase the quality of posted content by accrediting trusted healthcare sources. With an increasing emphasis being placed on minimally invasive options, this study was done to investigate the quality of YouTube videos on MitraClip™ (Abbott Laboratories, Chicago, Illinois, United States) with respect to patient education. Methods YouTube was searched using the keyword "MitraClip". A total of 66 videos were evaluated, with 32 of those videos being included for final analysis after applying exclusionary criteria. Three independent reviewers separately scored the videos using the Global Quality Scale. Likes, dislikes, views, comments, and dates of upload were also recorded. Two-tailed t-tests were used to determine statistical significance. Results MitraClip videos on YouTube proved to be of medium quality, receiving an average Global Quality Scale score of 3.39. When stratified by the new YouTube accreditation process, those with accreditation had a significantly higher Global Quality Scale score of 4.11, while non-accredited videos had an average Global Quality Scale score of 3.12 (p<0.01). Shorter and more patient-friendly videos were also significantly lower in quality (p<0.05). Conclusion The YouTube accreditation process has demonstrated initial success at regulating the quality of MitraClip content, thereby reducing the spread of misinformation. However, this progress is undermined by the lack of unique videos present on the platform. Increasing the amount of original content about MitraClip may allow viewers to diversify their educational sources and ultimately gain a better understanding of the procedure.
PubMed: 37614823
DOI: 10.7759/cureus.43881 -
BMJ (Clinical Research Ed.) Nov 2023
Topics: Humans; Education, Medical, Graduate; Clinical Competence; Accreditation; Internship and Residency
PubMed: 37977574
DOI: 10.1136/bmj.p2610 -
Journal of the American Association of... Sep 2023Many organizations, foundational documents, and structures guide nurse practitioner (NP) educators. The number can be overwhelming for nurse practitioner faculty and...
Many organizations, foundational documents, and structures guide nurse practitioner (NP) educators. The number can be overwhelming for nurse practitioner faculty and administrators, but awareness and understanding are essential for developing high-quality NP programs. A set of five key questions is a starting place for NP faculty to identify documents that guide their NP program development and curricula. (1) Which states does your program meet state educational requirements for professional licensure or certification? (2) Which accreditor is your program accredited by? (3) Which certification examinations are your students prepared to take? (4) Which educational competencies/standards apply to your program? (5) Which professional or practice organizations might be influential to your program? The development of high-quality NP programs advances the protection of the public and upholds the reputation of the profession. Organizations, components of licensure, accreditation, certification, education, and practice (LACEP), and key documents from national organizations will be reviewed, including how each of these are complementary and different.
Topics: Humans; Curriculum; Educational Status; Certification; Nurse Practitioners; Physical Examination
PubMed: 37589749
DOI: 10.1097/JXX.0000000000000933 -
Neuromodulation : Journal of the... Aug 2023Intrathecal drug delivery systems (IDDSs) are used for the treatment of pain and spasticity. A wide range of educational criteria exist for these devices. The North... (Review)
Review
OBJECTIVES
Intrathecal drug delivery systems (IDDSs) are used for the treatment of pain and spasticity. A wide range of educational criteria exist for these devices. The North American Neuromodulation Society (NANS) Education Committee developed a comprehensive IDDS curriculum to function as a standard for physician graduate education and assessment through training and into practice.
MATERIAL AND METHODS
A multidisciplinary and diverse task force gathered by the NANS Education Committee met in person and virtually over several sessions and developed an IDDS curriculum modeling their previous work on spinal cord stimulation and following the Accreditation Council for Graduate Medical Education (ACGME) Milestones. There were iterative revisions and adaptations to the curriculum, and the final version was approved by the NANS Board of Directors.
RESULTS
The curriculum was developed with distinction between implanting physicians and managing physician and physicians who perform both tasks. There is a lateral temporal progression from early learner to practitioner, with advanced learner in the middle. In addition, there is a modular vertical organization that divides the curriculum into the six educational competencies outlined by the ACGME.
CONCLUSION
A comprehensive, modular, graduated, and segmented educational curriculum for IDDSs was developed by NANS. We propose the curriculum to be the standard for guidance and assessment of trainees and physicians pursuing training in implanting or managing IDDSs.
Topics: Humans; Curriculum; Education, Medical, Graduate; Accreditation; Drug Delivery Systems; North America
PubMed: 35088723
DOI: 10.1016/j.neurom.2021.11.012 -
The Journal of Hand Surgery Oct 2023Milestones have been in effect for Accreditation Council for Graduate Medical Education-accredited hand surgery fellowships since 2015. In 2016, the Accreditation... (Review)
Review
Accreditation Council for Graduate Medical Education Hand Surgery Milestones V2.0 Development and Implementation: What Fellowship Directors, Faculty, and Fellows Need to Know.
Milestones have been in effect for Accreditation Council for Graduate Medical Education-accredited hand surgery fellowships since 2015. In 2016, the Accreditation Council for Graduate Medical Education began an improvement process to make the milestones easier to read, understand, and assess. This article looks at the process used for hand surgery, makes comparisons between the two versions, and discusses the resulting changes. A representative group of hand surgery faculty and fellows worked together to review the milestones data and identify necessary changes. Working iteratively in large and small groups, the milestones were edited, and a supplemental guide was developed. The new hand surgery milestones have fewer patient care subcompetencies, yet include the same overarching themes. The medical knowledge subcompetencies have been reduced to four, and they now focus on key dimensions of knowledge development instead of pure anatomical knowledge. Systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills include subcompetencies harmonized with all other accredited programs. Finally, the supplemental guide was created as an aid to clinical competency committees to provide clear understanding of the intent of the milestones. The guide includes examples for individual milestones, ideas for how to assess each subcompetency, and resources for faculty and fellows alike. The new hand surgery milestones were designed to be clearer and easier for clinical competency committees to evaluate and for faculty and fellows to understand. The accompanying supplemental guide is a new addition that will help individual programs better understand how to implement these changes. The new hand surgery milestones can be found at https://www.acgme.org/globalassets/pdfs/milestones/handsurgerymilestones.pdf.
Topics: Humans; Internship and Residency; Fellowships and Scholarships; Hand; Education, Medical, Graduate; Clinical Competence; Faculty; Accreditation
PubMed: 37462592
DOI: 10.1016/j.jhsa.2023.05.021 -
Surgery For Obesity and Related... Mar 2024Clinical calculators can provide patient-personalized estimates of treatment risks and health outcomes. The American College of Surgeons Metabolic and Bariatric Surgery...
BACKGROUND
Clinical calculators can provide patient-personalized estimates of treatment risks and health outcomes. The American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) set out to create a publicly available tool to assess both short-term postoperative risk and long-term benefits for prospective adult patients eligible for 1 of 4 primary bariatric procedures. The calculator is comprised of multiple prediction elements: (1) 30-day postoperative risk, (2) 1-year body mass index projections, and (3) 1-year comorbidity remission.
OBJECTIVES
To assess the performance of the 1-year comorbidity remission prediction feature of the calculator.
SETTING
Not-for-profit organization clinical data registry.
METHODS
MBSAQIP data across 4.5 years from 240,227 total patients indicating at least 1 comorbidity of interest present preoperatively and who had a 1-year follow-up record documenting their comorbidity status were included. Six models were constructed, stratified by the presence of the respective preoperative comorbidity: hypertension, hyperlipidemia, gastroesophageal reflux disease, sleep apnea, non-insulin-dependent diabetes, and insulin-dependent diabetes. A multinomial logistic regression model was used to predict 1-year remission (total, partial, or no remission) of insulin-dependent diabetes. All other outcomes were binary (yes or no at 1 yr), and ordinary logistic regression models were used.
RESULTS
All models showed adequate discrimination (C statistics ranging from .58 to .68). Plots of observed versus predicted remission (%) showed excellent calibration across all models.
CONCLUSION
All remission models were well calibrated with sufficient discrimination. The MBSAQIP Bariatric Surgical Risk/Benefit Calculator is a publicly available tool intended for integration into clinical practice to enhance patient-clinician discussions and informed consent.
Topics: Adult; Humans; Quality Improvement; Prospective Studies; Postoperative Complications; Retrospective Studies; Bariatric Surgery; Comorbidity; Diabetes Mellitus, Type 2; Gastrectomy; Accreditation; Insulins; Treatment Outcome; Obesity, Morbid
PubMed: 37867047
DOI: 10.1016/j.soard.2023.09.020