Pediatrician Maintenance of Certification Using American Board of Pediatrics' Performance Improvement Modules

Marina Arvanitis; Neal A deJong; Laurel K Leslie; Darren A DeWalt; Gregory D Randolph; Kori B Flower

doi:10.1016/j.acap.2017.03.014

Pediatrician Maintenance of Certification Using American Board of Pediatrics' Performance Improvement Modules

Acad Pediatr. 2017 Jul;17(5):550-561. doi: 10.1016/j.acap.2017.03.014. Epub 2017 Apr 2.

Authors

Marina Arvanitis¹, Neal A deJong², Laurel K Leslie³, Darren A DeWalt², Gregory D Randolph⁴, Kori B Flower⁴

Affiliations

¹ University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: marina.arvanitis@northwestern.edu.
² University of North Carolina at Chapel Hill, Chapel Hill, NC.
³ University of North Carolina at Chapel Hill, Chapel Hill, NC; The American Board of Pediatrics, Chapel Hill, NC; Tufts University School of Medicine, Boston, MA.
⁴ University of North Carolina at Chapel Hill, Chapel Hill, NC; Population Health Improvement Partners, Morrisville, NC.

PMID: 28377198
DOI: 10.1016/j.acap.2017.03.014

Abstract

Background: From 2010 to 2014, pediatricians completed Part 4 Maintenance of Certification (MOC) through practice- or organization-developed quality improvement (QI) activities approved by the American Board of Pediatrics (ABP). Organization-developed activities were online modules, such as the ABP's Performance Improvement Modules (PIMs), through which pediatricians implemented QI strategies in practice and reported quality measures.

Objectives: Aim 1 was to assess the proportion of pediatricians who completed practice- vs organization-developed QI activities for Part 4 MOC and to test the relationship between activities and pediatrician demographics. Aim 2 was to assess the relationship between PIM completion and improvement in care processes and outcomes as determined by PIM quality measures.

Methods: For aim 1, using deidentified demographic data from the ABP, we summarized QI activity completion and performed bivariate testing by pediatrician demographics. For aim 2, using deidentified parent and pediatrician-reported quality measures from the Attention-Deficit/Hyperactivity Disorder (ADHD), Asthma, Hand Hygiene, and Influenza PIMs, we used 2-sample tests of proportions to calculate pre-post changes in quality measures.

Results: For aim 1, of 50,433 pediatricians who completed Part 4 MOC from 2010 to 2014, 22% completed practice-developed and 78% organization-developed activities. More pediatricians completed organization-developed activities, regardless of age, gender, or subspecialty status. The majority (73%) of pediatricians who completed organization-developed activities completed ABP PIMs. For aim 2, PIM completion was associated with improvement on nearly all pediatrician- and parent-reported quality measures.

Conclusions: At the outset of the Part 4 MOC system, pediatricians most commonly completed online, organization-developed activities. Pediatricians and parents reported improvements in care processes and outcomes associated with PIMs, suggesting PIMs can be an effective means of facilitating practice improvement.

Keywords: Part 4 Maintenance of Certification (MOC); Performance Improvement Module (PIM); quality improvement (QI).

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Certification*
Clinical Competence
Humans
Pediatrics / education*
Quality Improvement*
United States