Decide What to Work On


a. Some Things to Consider

You may be starting out with something in mind that you and your team would like to improve. This may or may not match existing ABFM “Improvement in Practice” modules. That’s fine. But whether you are trying to generate a list of possible projects or you already know what you want to do, the following criteria are helpful in making a final decision about what to tackle first.

High Priority
Likely Support at the Top
Likelihood of Good Collaboration from Those Involved
Low Cost
Easily Available Pre-Structured Options
Possibility and Desirability of Partnering with Other Practices

Also consider the diverse options available for meeting Part 4 MOC and ACGME requirements, including modules developed by medical specialty boards and others, any specially approved “alternate” modules that might be available, and the self-directed module option available from some boards (which can be pursued independently or in collaboration with other practices).


b. Begin To Collect Data

To help you decide what to work on, early on you should ask yourselves what you can measure (count) that will help you better understand the problem, challenge, or opportunity you are considering. What will give you useful information about what is going on right now? Collecting this initial information is called “gathering baseline data.”

Try to identify data that is already easily available. But you may need to gather new data. This can range from collecting waiting room patient experience surveys to a simple count of how often something is occurring, such as the number of walk-ins you see in a week.

When deciding what data to collect, begin with your team members. Gather their input before settling on a measure, how it will be collected and by whom. Share the task of collecting the data. Also:

  • Use clear operational definitions of measures so all know how the measure is obtained and can record it correctly.
  • Ensure that the timing of data collection is appropriate.
  • Use sampling techniques to minimize the burden, but be sure samples are representative and adequate.
  • Collect narrative and qualitative data in addition to quantitative data.
  • Plot data over time.


c. Tools to Help You Get Started

Improvement Planning Worksheet

The experience of many practices suggests that it can help you get a handle on key aspects of this process if you make a pass at filling out an Improvement Planning Worksheet, like this one (click here) very early on.

Aim Statement Worksheet
The first and fourth tasks in the improvement process and question 4b on the Improvement Planning Worksheet ask you to precisely identify your target for improvement. While early drafts may be pretty rough, this should become your “aim statement.” Carefully crafted, it should help you clarify the focus and boundaries of your activities. Click here for an Aim Statement Worksheet.


Note: When it comes to setting objectives in the context of organizational or medical specialty board expectations, there may be a tendency to have higher than necessary expectations. You should try to resist this tendency.