The Healthcare Improvement Skills Center v. 3.0
A Warmer Welcome to Quality Improvement in Healthcare

Please click the following links to access the desired CME/CE Information:

CME Accreditation Statement
ACCME/AMA Accreditation
CME Credit
How to Receive CME Credit
CME Planning Committee
Disclosure Statements (Commercial Support/Conflicts of Interest)
Media
Target Audience
Practice Gap/Goal Statement
Learning Objectives
Policy on Privacy & Confidentiality
Medical Disclaimer
Time, Equipment, & Software Required
Acknowledgments of Financial & In-Kind Support
Contact Information

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The activities on this website have been planned and implemented in accordance with the Essentials Areas and Policies of the Accreditation Council for CME (ACCME) through the joint sponsorship of Case Western Reserve University (CWRU) School of Medicine and Improvement Learning. Case Western Reserve University School of Medicine is accredited by the Accreditation Council for CME to provide continuing medical education for physicians.

Completion of the two part QI Skills Self-Assessment and Summary:	3 credits
Completion of the QI Skill Development Plan:	1 credit
Completion of each of the 6 HISC QI Skills "Learning Modules": Successful completion of all six modules could add up to a maximum of 6 category 1 credits.	1 credit each, for up to 6 credits
Completion of the QI Project Plan, a QI project off line, and the QI Project Assessment	15 credits*

*Please note, this block of 15 credits will only be awarded
  if all other activities on this website have also been completed.

If you are completing these activities in order to meet a Part 2 Maintenance of Certification (MOC) requirement, as a medical specialty board diplomate, you must complete all activities on this site in order to receive credit for meeting the MOC Part 2 requirement. ABIM Diplomates must enter this site via their personal ABIM website portal (go to www.abim.org) in order to get MOC credit from ABIM. American Board of Pediatrics Diplomates must enter this site via their personal ABP website portfolio portal by clicking on the link to this site to be found there (go to www.abp.org) in order to receive credit from ABP.

Current Accreditation Period: Vanderbilt SOM CME: September 01, 2010 – December 31, 2013
Forthcoming Accreditation Period: CWRU SOM: January 1, 2014 – December 31, 2016
To contact the CME provider: email Case Western Reserve University School of Medicine at medcme@case.edu

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To receive credit for your work at this website, please do the following:

1. Complete the entire activity or learning module. (Credit is granted individually for a) the rapid QI skills self-assessment activity, b) the QI skill development plan, c) for each of the six QI skills learning modules, and d) for completion of the QI Project planning and assessment activities.)
   
   Again, please note that you must complete all activities on this site to receive the 15 CME credits for completion of the “My QI Project” planning and assessment activities.
   
   Also note that for many multiple choice questions found in the six learning modules, you will find that if you answer the question correctly (in the opinion of the module authors), you will be informed that this is the case and told why (provided with their rationale). If you answer a question incorrectly in the opinion of the module authors you will be informed that this is the case and told why and then asked to try again till you respond correctly. In this way, you should emerge from these experiences knowing the ‘correct’ answers to all such question. Doing so is the minimum required to successfully work your way through the learning modules.
2. Complete the post activity evaluation for each of these activities and for each learning module.
3. As each activity or module is completed, proceed to the certificate page. You will be awarded CME credit (AMA PRA Category 1 credit(s)^tm), if you indicated you are an MD or a DO when you registered. Otherwise, you will be awarded a certificate of completion. You will automatically receive your CME certificate or certificate of participation online. You can access a record of your completed activity(ies) and your certificate(s) by going to your "My Account" area (when you are logged in to the site).

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The CME planning committee for this CME activity consisted of:

• Kurt Stange, MD, PhD, Chair, Professor of Family Medicine at Case Western Reserve University School of Medicine / UH
• Mary Dolansky, RN, PhD, Assistant Professor, Frances Payne Bolton School of Nursing at Case Western Reserve University
• Christina Delos-Reyes, MD, Assistant Professor, Department of Psychiatry at Case Western Reserve University
• Srinivas Merugu, MD, Associate Training Director, Internal Medicine at St. Vincent Charity Medical Center
• Mark Cheren, EdD,, Editor in Chief, President, Improvement Learning, 3093 Warrington Rd., Shaker Hts., OH 44120

Dr. Mark Cheren, Editor in Chief of the Healthcare Improvement Skills Center and a member of the HISC CME planning committee wishes to disclose that he is sole proprietor of Improvement Learning LLC, the private, for profit consulting firm where the Healthcare Improvement Skills Center (HISC) website is housed. And Dr. Kurt Stange, Chair of the HISC CME planning committee, wishes to disclose that he has served as principal investigator on two educational projects that used the HISC website and modules and that these projects were funded by the American Board of Family Medicine Foundation.

All other planners and contributors indicated no financial relationships to disclose.

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This educational activity has received no commercial support.

The policy of Case Western Reserve University School of Medicine CME Program (CWRU CME) requires that the Activity Director, planning committee members and all activity faculty (that is, anyone in a position to control the content of the education activity) disclose to the activity participants all relevant financial relationships with commercial interests. Where disclosures have been made, conflicts of interest, real or apparent, must be resolved. Disclosure will be made to activity participants prior to the commencement of the activity. CWRU CME also requires that faculty make clinical recommendations based on the best available scientific evidence and that faculty identify any discussion of "off-label" or investigational use of pharmaceutical products or medical devices.

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This is a fully interactive website that incorporates visual media, charts and links to a variety of other external sites and multi media resources.

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This continuing medical education (CME) program is intended for a national and international audience that includes all practicing healthcare providers. It has also been used effectively by healthcare professional preparation programs (serving undergraduate medical students, residents and fellows).

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Current best practice suggests healthcare providers analyze practice performance to identify opportunities for improvement on an ongoing basis, develop an improvement plan, implement the plan, monitor the plan, and incorporate changes that result in improvement of practice. A large percentage of healthcare professionals presently lack the conceptual knowledge and methods to systematically perform these functions. At this website, physicians, nurses, healthcare administrators and other healthcare professionals are introduced to the concepts and methods of systematic quality improvement in an accessible and engaging way. They emerge prepared to design and implement modest initial QI projects with a high likelihood of success.

More specifically, the site facilitates rapid self-assessment of one's quality improvement skills, where users are invited to identify what they already know about QI, what they might like some help with and what they would be interested in learning more about. The site also offers activities that support development and enhancement of core QI skills. These include a QI skill development plan activity and six highly interactive, case driven learning modules. The third section of the site offers activities and resources that support the planning, execution and assessment of a small quality improvement project in one's own (or a colleague's) practice setting.

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Please click here for a full list of the learning objectives for the six interactive learning modules on this site.

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It is the policy of the Case Western Reserve University School of Medicine CME Program to maintain the privacy of patients’ Protected Health Information (PHI) and to abide by all state and federal privacy laws (including the Health Insurance Portability and Accountability Act of 1996 (HIPAA)). Of specific concern to CME providers are situations where PHI might appear in a presenter’s written educational materials or audio/visual materials. For example, information attributable to a specific patient might be included in a written case study or verbal discussion of a case or might appear in a visual presentation such an x-ray or similar diagnostic image or test where patient identifiers have not been removed. Accordingly, PHI may not be present in any aspect of an educational presentation without a patient’s written authorization (and such authorization must be HIPAA compliant after April 14, 2003). Prior to presenting a presenter must represent and warrant that he/she has HIPAA-compliant authorization for any PHI in the presentation or presentation materials or that he/she acquired such protected health information from a source that (a) obtained a HIPAA-compliant authorization which authorizes Presenter's use of PHI during the presentation; or (b) was not under a legal obligation to maintain the patient's confidentiality.

It is the intent of the Case Western Reserve University CME Program in conformance with University policies to prevent identity theft to maintain the confidentiality of any physician or healthcare provider information obtained or utilized by the CME Program in the course of registration for CME activities, participation as faculty, preparation and release of transcripts of activities for which credit has been earned, or any other CME Program function that involves confidential information. Such confidential information includes physician mailing address, in some instances the last four digits only of the Social Security number (used as a unique identifier) and record of credit hours earned. All such confidential information will be (1) retained in a secure, password-protected electronic data base and filing system, (2) never displayed where it may be observed or recorded and (3) released individually only upon receipt of written authorization from the party requesting their own information. The sole exception to the above is the use of the last four digits of the Social Security number in printed class lists to assure that participants with identical names are able to appropriately register or sign in.

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Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication.

Although every effort is made to ensure that this material is accurate and up-to-date, it is provided for the convenience of the user and should not be considered definitive. Neither the authors nor the Case School of Medicine nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from the use of such information.

Learners are encouraged to confirm the information contained herein with other sources. This information should not be construed as personal medical advice and is not intended to replace medical advice offered by physicians. The Case School of Medicine will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising here from.

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Completion of each module and its respective evaluation will ordinarily take between 55 and 65 minutes, including its respective evaluation. Completion of other activities varies greatly depending on the individual, his or her background and/or the nature of the project(s) undertaken.

• Use a PC or Macintosh computer.
• This site is not yet fully functional (and not able to be used) with iPads or other tablet devices.
• HISC 3.0 supports these browsers:
• Firefox 2.0+
• Internet Explorer 7+
• Safari 3+
• Opera 9+
• Chrome 1+
• Any problem with them should be considered and reported as a bug to HISC 3.0 Technical Support.
• JavaScript must be enabled.
• If you have installed any "pop-up stopper" software, you will need to disable this software before entering any of the modules.
• Use a monitor with the resolution set to 1024 x 768 pixels or greater.

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We wish to acknowledge and express our sincere appreciation for support for original work contributing to the development of this project from a grant awarded by the Contemporary Education Initiative of "The Network" at the Center for the Health Professions, University of California, San Francisco. We would also like to acknowledge and express our gratitude for the unusual encouragement and support provided to this project by the Case Western Reserve University Division of Information Technology Services in the form of technical assistance and an unsecured loan, making it possible to initiate a major redesign and upgrade of the HISC Website and accompanying healthcare improvement skills web modules, in 2004-5.

The Case Western Reserve University School of Medicine Program in Continuing Medical Education, the University of Missouri-Columbia School of Medicine, the Academy for Post Graduate Health Care Education, and the Institute for Healthcare Improvement all contributed a great deal of encouragement and in-kind staff time to the initial stages of this undertaking. In addition, IHI's New Health Partnerships project awarded a small grant making it possible to incorporate an example of patient participation in an improvement project in Module 2, Building a Team.

Finally, we would like to acknowledge, here, the participation and significant contributions of Medical Directions Inc., Tucson, Arizona, to the initial development of this site; and the participation and significant contributions of imageNation LLC, Lakewood, Ohio, in recent years.

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Re: Use of This Site

For more information about this site, about assessing the impact of its use in your setting, or about the possibility of adapting its content to the special needs of a given population of healthcare professionals or a particular healthcare setting, society, organization or system, please contact:
Mark Cheren, EdD
Editor in Chief, HISC Website
Healthcare Improvement Skills Center
3093 Warrington Rd. Shaker Heights, OH 44120-2460
mcheren@improvementlearning.us
TEL: 216-295-9942
MOB: 216-225-8616

Re: Technical Problems with This Site
Please go to https://www.improvementskills.org/contact-us.cfm to reach the “User Support and Feedback” page.

Re: CME Credit
For more information about CME credit related to the activities at this site, please contact the Case Western Reserve University School of Medicine’s Program in Continuing Medical Education
Telephone: 216. 983.1239 and 800.274.8263
Email: mmedcme@case.edu
http://casemed.case.edu/cme/

Re: ABIM MOC
For more information about using this site to meet the American Board of Internal Medicine Maintenance of Certification Part 2 requirement, please call: 800-441-ABIM.

Re: ABP MOC
FFor more information about using this site to meet the American Board of Pediatrics Maintenance of Certification Part 2 requirement, please write or call:

The American Board of Pediatricsbr 111 Silver Cedar Court Chapel Hill, NC 27514

Telephone: (919) 929-0461 Business Hours: (8:30 am - 5:00 pm ET Monday - Friday) E-mail: abpeds@abpeds.org

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