Accreditation
Duty Hours
CLER
Evaluation / Milestones
Potpourri
100
when a Review Committee determines that a program or sponsoring institution has demonstrated substantial compliance with the requirements.
What is Continued Accreditation
100
The period that a resident or fellow is in the hospital (or other clinical care setting) continuously, counting the resident’s (or fellow’s) regular scheduled day, time on call, and the hours a resident (or fellow) remains on duty after the end of the on-call period to transfer the care of patients and for didactic activities.
What is Continuous time on duty:
100
provides the profession and the public a broad view of sponsoring institution’s initiatives to enhance the safety of the learning environment and to determine how residents are engaged in the patient safety and quality improvement activities.
What is Clinical Learning Environment Review (CLER)
100
A required body comprising three or more members of the active teaching faculty who is advisory to the program director and reviews the progress of all residents in the program.
What is Clinical Competency Committee:
100
when the program director a) appoints the members of the faculty and is involved in the appointment of the chief of service at the integrated site, b) determines all rotations and assignments of residents, and c) is responsible for the overall conduct of the educational program in the integrated site. There must be a written agreement between the sponsoring institution and the integrated site stating that these provisions are in effect. This definition does not apply to all specialties. (See specific Program Requirements)
What is an Integrated Site
200
assesses selected aspects of a program or sponsoring institution identified by a Review Committee
What is Focused Site Visit
200
Duty hours beyond the normal work day when residents are required to be immediately available in the assigned institution
What is In-House Call
200
A required faculty activity involving the oversight and direction of patient care activities that are provided by residents/fellows.
What is Clinical Supervision:
200
Assessment of a resident/fellow with the primary purpose of providing feedback for improvement as well as to reinforce skills and behaviors that meet established criteria and standards without passing a judgment in the form of a permanently recorded grade or score.
What is Formative Evaluation:
200
A term used to identify a requirement which is mandatory or done without fail. This term indicates an absolute requirement.
What is Must
300
when a Review Committee determines that an application for a new program or sponsoring institution substantially complies with the requirements. Initial accreditation is considered a developmental stage.
What is Initial Accreditation
300
Rotation or educational experience designed to either eliminate in-house call or to assist other residents during the night. Residents assigned to night float are assigned on-site duty during evening/night shifts and are responsible for admitting or cross-covering patients until morning and do not have daytime assignments. Rotation must have an educational focus.
What is Night Float
300
Recognition by either a resident or supervisor of a level of resident fatigue that may adversely affect patient safety and enactment of appropriate countermeasures to mitigate the fatigue.
What is Fatigue management
300
Formative examinations developed to evaluate resident/fellow progress in meeting the educational objectives of a residency/fellowship program. These examinations may be offered by certification boards or specialty societies.
What is In-Training Examination
300
report that specifies information to be provided, including a due date for the report. The progress report must be reviewed by the sponsoring institution’s Graduate Medical Education Committee, and must be signed by the designated institutional official prior to submission to the Review Committee.
What is a Progress Report
400
when the Review Committee determines that a program or sponsoring institution that has failed to demonstrate substantial compliance with the requirements
What is Probationary Accreditation
400
One (1) continuous 24-hour period free from all administrative, clinical and educational activities.
What is One Day Off
400
A four part method for discovering and correcting assignable causes to improve the quality of processes; the method may be applied to individual learning, courses, programs, institutions, and systems, in repeated cycles.
What is a PDSA Cycle (Plan, Do, Study, Act)
400
Systematic collection and analysis of information related to the design, implementation, and outcomes of a resident education program, for the purpose of monitoring and improving the quality and effectiveness of the program.
What is Program Evaluation
400
A term used to designate requirements so important that their absence must be justified. A program or institution may be cited for failing to comply with a requirement
What is Should
500
A Review Committee determines that a program or sponsoring institution has failed to demonstrate substantial compliance with the requirements
What is Withdrawal of Accreditation
500
Assigned duty within the institution encompassing hours which may be within the normal work day, beyond the normal work day, or a combination of both.
What is Scheduled Duty Periods
500
The relaying of complete and accurate patient information between individuals or teams in transferring responsibility for patient care in the healthcare setting.
What is Transitions of Care (TOC)
500
Assessment with the primary purpose of establishing whether or not performance measured at a single defined point in time meets established performance standards, permanently recorded in the form of a grade or score.
What is Summative Evaluation:
500
used to indicate that something is distinctly urged rather than required. An institution or program will not be cited for this
What is Suggested
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