The University of
New Mexico
Graduate Medical
Education
GME Forum &
Operations
Committee
30 January 2007
Chair: Ben Hoffman, MD, Gerald Charlton, MD
Present: Hoffman, Busby, McLaughlin, Timm, Bachofer, Chang, Cleve, Morley, Ma, Peifer, Borgman, Pohl, Matthew, Crookston, Charlton, Murray, Howarth, Lay, Quintana, Saavedra, Cosgrove, Olson, Servilla, Chapin, Bereiter, Kingsley, Eldredge, Carmichael, Ogburn, Jensen, Harris, Sparkman, Krinsky
Minutes
The GME Forum and the GME Operations Committee meetings were combined for the month the January 2007 meeting. The minutes of the GME Forum meeting on 26 August 2006 and the minutes of the GME Operations Committee from 24 October 2006 were distributed and reviewed by the committee members.
Action: The committee accepted the minutes of the GME Forum 8/26/06 and the minutes of the GME Operations 10/24/06 as presented at the meeting.
Committee Reports
-GMEC meeting minutes from 10 October 2006, 14 November 2006, and 12 December 2006 were distributed to the committee. The GMEC approved the recommendations made by the Rightsizing Committee as outlined in these minutes. The ACGME Letters of accreditation and program reviews that were performed by the PRC were reviewed and discussed. Discussion over revising the duty hour protocol occurred. Resident salaries and benefits for 2007-08 were reviewed by the committee. Salaries and benefits were as approved by the institutional six-year plan to bring salaries to the mid point of the western region based on the AAMC resident salary survey. The committee acknowledged the possibility of union negotiations could change the plan. New program directors were appointed in Child and Adolescent Psychiatry and Surgery. The GMEC strongly recommended the Office of GME employ a computer technician to assist program with New Innovations, web site development, and assist GME with maintaining their internal databases. Strategies of obtaining an administrative fee from major participating institutions which would provide the Office of GME with a break even budget instead of a deficit budget were discussed. The results of the alleged duty hour violation in Pulmonary/Critical Care were discussed. The violation occurred as the result of an ACGME resident survey in which the fellow misunderstood the question. A follow-up report from Medicine and subspecialties was reviewed and discussed by the committee.
-Policy and Procedure Committee minutes form 12 October 2006 and 18 January 2007 were distributed to the committee for review. The following policies received minor revision: callroom for the disabled, catastrophic leave, sick leave, Hepatitis B Vaccine, Workers Compensation, TST, Positive Drug Test, background checks, and guidelines for special trainees. A new policy statement on Deficit Reduction Act, and Lactation Station was adopted. The duty hour protocol received major revisions and is discussed in more detail in these minutes.
-Program Review Committee met on 5 October 2006, and 7 December 2006. Program reviews were conducted in Gastroenterology, and Family Medicine Las Cruces. Program review follow-ups were reviewed for Neurological Surgery, Orthopaedics, Hand Surgery, Cytopathology, Sleep Medicine, and Surgery. ACGME letters of accreditation were reviewed and discussed for Otolaryngology, Clinical Neurophysiology, Family Medicine, Orthopaedic Sports Medicine, and Orthopaedic Trauma. A follow-up was conducted on the accreditations in Medicine subspecialties. Several programs have been cited for inadequate office space for trainees, and several program have had recommendations made on the issue at the time of program reviews. Office space must be resolved by the institution, but it the primary responsibility of the Chair of the Department to resolve such issues.
Rightsizing Committee met on 2 November 2006. Funding requests were for UH funded positions for 2008-09. The following program were recommended for funding from the following sources: Anesthesiology, 1 FTE, 2008-09, UH; Dental, 2 FTE, 2007-08, Departmental; Medicine, 1 FTE, 2007-08, VAMC; Pulmonary Critical Care, 1 FTE, 2007-08, VAMC, Rheumatology, 1 FTE, 2007-08, VAMC, 1 FTE, 2008-09, UH, and Pathology Molecular Genetic 1 FTE, 2007-08, Departmental; Psychiatry, 1 FTE, 2007-08, VAMC; Addiction Psychiatry, 1 FTE, 2007-08, VAMC; Geriatric Psychiatry, .50 FTE, 2007-08, VAMC; Radiology, 1 FTE, 2007-08, VAMC; and Urology, 1 FTE, 2007-08, VAMC.
Resident Council meetings occurred on 3 October 2006, 7 November 2006, 5 December 2006, and 4 January 2007. Unionization was a primary topic of discussion. Representative of the 1199 and CIR addressed the group. The Resident Council voted to separate the unionization committee from the Resident Council in order to avoid conflicts of interest. Representatives were appointed to the MEC, Medication Safety Committee, and Smoke Free UNM.
Program Coordinators Council met on 28 September 2006, 26 October 2006, 30 November 2006, and 25 January 2007. A presentation was made by Judith Brillman, MD on the ACGME competencies. New Innovations was discussed. Sarah Morley made a demonstration of a tool the HSC Library had developed to assist coordinators with tracking resident compliance with the web-based modules. Applicant’s personal states plagiarism was discussed. Preparation for rank order with the NRMP was discussed. Changes in training license renewal were discussed. The GME Office is attempting to obtain National Provider Numbers for all trainees and the information will be shared with programs once they are successful.
Old Business
-Unionization update (CIR) was presented to the committee. The Committee of Interns and Residents election will be held on Wednesday 31 January 2007. Polling sites will be at UH in the Tully Room on the 3rd floor and at the VAMC on 5-C 101 from 6 AM to 8 PM. The voting proceeding will be subject to the rules and regulations of the UNM Labor Board. The election will be orderly and fair. Forty percent of the resident population must participate. The vote for unionization must be at least fifty percent plus one vote. If the vote is for unionization, the collective bargaining will be between the institution (UNM) and the CIR.
-Revised policies were distributed to the committee for review and discussion. The guidelines for Special Trainees were revised to reflect trainees can serve a period of only 90 consecutives days and special trainees must be included in the graduated levels of supervision database through clinical affairs. Duty Hours Compliance Policy was revised to strengthen the procedure. Effective 1 March 2007 all duty hours must be tracked through New Innovations for all ACGME programs. Duty hours will be reviewed by the GMEC and Operations monthly. Residents are required to enter or confirm duty hours for by previous week by Tuesday of each week. Program with duty hour violations must report and submit any duty hour violations to the Office of GME within 72 hours of the violation. Best practices will be demonstrated to the committee at future Operations Committee meetings.
Quarterly Duty Hour Report October – December 2006
Duty hours for each ACGME training program were distributed for the quarter covering the period of October 2006 through December 2006. One trainee in Neurological Surgery reported a violation of six tenths of an hour. The program counseled the trainee. Violations of thirty hours of continuous service were reported in Internal Medicine for Ward rotations at both UH and the VAMC. Additionally, several Internal Medicine residents reported receiving less than ten hours off between service when on ward rotations at UH and the VAMC. An action plan was submitted to the committee.
Action: The committee accepted the report as presented to the committee. The action taken by the Department of Neurological Surgery and the Department of Internal Medicine were accepted as appropriate.
ACLS/PALS/BLS at Orientation
Terri McCarty, MD, Associate Dean of Medical Technology was unable to attend the meeting. She will be rescheduled for another time. Dr. McCarty wanted to discuss the ACLS/PALS/BLS training at Intern Orientation. Of particular concern was the ability to training approximately 125 interns in such a short period of time. One option would be staggering intern training at intervals after orientation. The discussion will occur at a future meeting.
Learning Central Reporting
Sarah Morley of the HSC Library offer to provide departments with an electronic reporting mechanism that would track the residents in each department that have completed the web based learning modules. Departments should contact her and she will come to the department and load the tracking tool on their computers. Departments are responsible for tracking and ensuring resident completion of the research design modules prior to promotion to the HO II level and the completion of patient safety, and ethics by the end of their training program.
HSC Library Competencies
Jon Eldredge of the HSC Library has developed a list of informatics competencies which all professional should have core skills. Members of the committee were asked to go to the HSC Library web site and review, evaluate, and provide feedback on the information.
Web Based Curriculum Product Demo
Ben Hoffman, MD, Interim Associate Dean for Graduate Medical Education has selected commercial educational modules that would help address the ACGME Competencies. The modules would be for all residents and would replace the GME Web based curriculum that is housed in Learning Central. The institution has been able to develop modules for patient safety, ethics, and research design. The commercial products are more extensive and would provide better learning opportunities and be more assessable. The product will be demonstrated at another meeting in the near future.
University of Washington Transfer of Patient Care Demo
The University of New Mexico HSC has formed a patient safety task force to establish a procedure to improve the process of the transfer of patient care. The task force is considering systems in use at other institution rather than developing an internal system. Ben Hoffman, MD demonstrated a system for the transfer of patient care that is utilized at the University of Washington HSC. The University of Washington HSC would consider offering the system to UNM HSC at an affordable cost. The system incorporates the current UNM systems of Cerner and PowerChart. The UW system updates information approximately every two hours. Programs were asked to individually access the system and make recommendations to the institution. The committees were asked for faculty and resident volunteers to participate in the task force.
Round Table
Intern programs were reminded that the last day to change the National Residency Matching Program Quota is 31 January 2007. After that time programs will not be able to increase or decrease the number of positions participating in the NMRP match.
The next GME Operations Committee will be 27 February 2007.
The next GME Forum will be 27 March 2007.
Distribution Materials: Forum minutes 9/26/06, Operation Committee minutes 10/24/06, GMEC minutes 10/10/06, 11/14/06, 12/12/06, Policy & Procedure Committee minutes 12/12/06, 1/18/07, Program Review Committee minutes 10/05/06, 12/07/06, Rightsizing Committee minutes 11/02/06, Resident Council minutes 10/03/06, 11/07/06, 12/05/06, 01/04/07, Program Coordinator Council minutes 9/28/06, 10/26/06, 11/30/06, 1/25/07, UNM Labor Management Relations Board notice of election, Special trainee guidelines, Duty Hour Compliance Policy R 11/06, Quarterly Duty Hours Report October to December 2006, 30 hr continuous service action plan from DOIM
