Maintenance of Certification (MOC) — Additional MOC Information
Practice Quality Improvement: How Do You Assess How You're Doing? As with all of the steps in the MOC process, the ABR's PQI requirement has the goal of ensuring that diplomates engage in lifelong learning and improvement. The logic of the requirement is simple, and keeping it in mind will help you to complete the project itself.
Before you can improve how you are doing, you need to know how you're doing. To that end, the ABR requires diplomates to conduct at least one continuous quality-improvement project over the 10-year cycle of the MOC program. Any project should fall into one of the following five major PQI categories. You can choose to work within one of these categories in a variety of ways.
- Adherence to clinical practice guidelines and technical standards. Under this category, you need to assess whether and how well your practice adheres to clinical practice guidelines and technical standards developed by medical societies using evidence-based methods, including expert consensus. The American College of Radiology (ACR) has developed most of the guidelines and standards for radiology practice, and many are geared to specific subspecialties.
- Accuracy of image interpretation. You can assess how accurately you interpret the images you read through a process of double reading, in which two radiologists read the same image and compare the results. You then must collect statistics on the degree to which other radiologists agree with your diagnosis. One way to do this is by participating in the RADPEERTM program developed by the ACR, but you can set up your own peer-review project by cooperating with your colleagues.
- Report timeliness. You will need to collect records of how long it takes from the time an image is captured to when you give a report of your interpretation to the referring physician.
- Patient safety and medical error reduction. This category is similar to the first one, but here you will assess how well you adhere to patient-safety guidelines promulgated by the RSNA, the ACR, the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations [JCAHO]), and other organizations that promote evidence-based medicine, clinical performance measures, and standards to prevent medical errors and improve patient safety.
- Referring physician surveys. These surveys are designed to determine how satisfied referring physicians are with the services you provide. A sample survey instrument can be found on the ABR Web site (www.theabr.org).
Whichever project category you choose, the MOC program requirements are the same. Over the 10-year MOC cycle, you must:
- Step 1: Seek out education on the PQI process. The RSNA will help you by providing education on the PQI at its annual meeting, through publications in RadioGraphics, and through resources on the RSNA Web site. By the end of year 1, you will need to select a project and let the ABR know what you have chosen by completing the online attestation form on the ABR Web site.
- Step 2: Begin to implement your project by collecting and analyzing baseline data. Analysis of these data should help you to identify the areas of your practice that you will work to improve and the root causes of the need for improvement. What you learn in this process will help you develop an improvement plan.
- Step 3: Collect and analyze your improvement-plan data, and then evaluate the data to see if your plan helped you to move toward your goal.
- Step 4: Repeat these steps for as many cycles as needed to meet your performance goal. If your goal is met, select and attest to an additional PQI project. In year 9, you will need to prepare a report that summarizes your projects, results, and conclusions.
Throughout the process, the RSNA will help you to understand the principles of quality and to develop or identify tools you can use to meet the PQI requirement. Go to RSNA.org/quality for information about the resources currently available and in development.
Other MOC Resources In addition to helping you meet the MOC requirement for PQI, the RSNA offers a number of resources to help you meet all of the requirements of the MOC program:
- RSNA Annual Meeting—The RSNA Scientific Assembly and Annual Meeting is a prime source of continuing medical education (CME) credit for radiologists and radiologic physicists. The meeting offers a variety of CME and self-assessment module (SAM) credits through refresher courses, scientific sessions, and other educational programs.
- Self-Assessment Modules—RSNA SAMs consist of peer-reviewed educational materials related to a wide variety of subspecialty areas. All RSNA SAMs meet the ABR's MOC requirements for self-assessment and are eligible for CME credit. You may access SAMs here, or take in-person SAMs at the RSNA Scientific Assembly and Annual Meeting or at the RSNA Highlights™ conference.
- My CME Action Plan—This Web-based template allows you to develop the personalized education plan recommended by the ABR as part of the MOC process. As you complete the plan, you list your CME requirements, prioritize your educational needs, plan future CME activities, and record MOC-related activities for lifelong learning. Go to My CME Action Plan.
- RSNA CME Credit Repository—RSNA automatically deposits CME and SAM credits earned through RSNA activities into the RSNA CME Credit Repository (RSNA.org/cme). As an RSNA member, you can also enter other earned CME credits to create a cumulative CME report or print a CME certificate for RSNA-awarded AMA PRA Category 1 CreditTM.
- CME Gateway—RSNA and several other medical specialty organizations maintain an online CME Gateway (www.CMEgateway.org). The CME Gateway allows you to view, print, and generate reports of CME credits earned from each of the sponsoring organizations to which you belong.
Useful Web Sites: For additional information on RSNA's MOC resources, call 1-800-272-2920.
