New generation of CME taking 1st steps

Two continuing medical education pilots focus on changing physician behavior.

By Myrle Croasdale, AMNews staff. Dec. 13, 2004.

A physician was going about his work when a nurse came up to tell him she'd just done her hand hygiene and had left the water running.

"What she was saying was, 'It's your turn,' " said Michael White, MD, senior vice president of the McKeesport hospital in the University of Pittsburgh Medical Center, who cited this anecdote as an example of how a continuing medical education initiative involving performance improvement has changed the culture at his hospital.

UPMC's hand hygiene project is part of a broader effort at the medical center to combine quality improvement and CME.

CME researchers also are looking at ways to give physicians CME credit for learning done during their clinical practice.

At the University of Florida College of Medicine, a CME pilot program uses handhelds to get scientific-based information into physicians' hands at the moment they are making clinical decisions.

"In the past, we looked at CME and quality improvement as two different activities," said Barbara Barnes, MD, associate dean of CME at the University of Pittsburgh School of Medicine.

Now improving quality is being recognized for CME credit, Dr. Barnes said, and at UPMC, hand hygiene is one of three projects doing this. The others are on combating central line bloodstream infections and antibiotic resistance.

For the 18-month intervention on hand hygiene, a baseline measurement showed that physicians and housekeepers were the worst in compliance. After an initial awareness campaign, the housekeepers improved, but not the doctors, Dr. Barnes said.