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Lean Training Leads to More Streamlined MOC Process

Wednesday, February 15, 2017 - 11:00

“The staff has always been enthusiastic about quality improvement...Our staff has taken pride in making the MOC process easier and more accessible for our physicians. It’s been rewarding to see the level of excitement when they get behind a project.”

- Dr. Virginia Moyer, ABP Vice President of MOC and Quality

To ease the process of earning Maintenance of Certification credit for Improving Professional Practice activities (MOC Part 4), the ABP developed a system for pediatricians to apply for credit for quality improvement projects they already have completed.

But after reviewing applications for several months and answering multiple questions from pediatricians, the MOC staff realized its application process could use some quality improvement of its own.

In June, MOC staff plus other ABP colleagues and several diplomates participated in a Lean Kaizen workshop (which is a type of structured quality improvement process).

“We discovered there were questions on the application that weren’t really necessary or were redundant,” says Patience Lieno, Senior Administrator for MOC External Activities.

“We realized some of the instructions were confusing. Even the fonts and colors we used contributed to difficulty filling out the applications.”

By following the Lean Kaizen quality improvement model, the team made more improvements than they had dared hope for.

The amount of time it takes diplomates to fill out the forms was reduced by 67 percent—from 30 minutes to 10.

The amount of time it takes ABP staff to review the application was reduced by 58 percent— from four minutes to 1.5 minutes.

The average number of errors per application dropped from 1.8 to zero.

“It was so rewarding to be part of a quality improvement process that made such a huge difference in our processes and saved diplomates so much time,” Patience says. “Since the Kaizen event, the number of Small Group QI Applications submitted and approved more than doubled in the following quarter (Q3) with 180 submissions and 155 approved.”

Last year’s third quarter produced 123 submissions and 90 approvals.

During 2016, more than 20 ABP staff members from MOC and other departments participated in four different Lean quality improvement sessions, which emphasized understanding processes and improving the efficiency of processes by implementing small changes systematically.

“The staff has always been enthusiastic about quality improvement, and I saw a chance to make improvements internally,” says Virginia Moyer, MD, MPH, ABP Vice President of MOC and Quality. “Our staff has taken pride in making the MOC process easier and more accessible for our physicians. It’s been rewarding to see the level of excitement when they get behind a project.”

Dr. Elizabeth Meade, a pediatrician in Seattle, Wash., participated in the June Kaizen session, helping staff identify ways to improve applications for Practice Improvement credit.

“People want to do projects that are really important and affect their clinical work,” Dr. Meade says. “I think many still think it’s a huge deal to go through the [application] process.”

But after the team applied Kaizen principles and made improvements to the application, “I was really surprised at how simple and fast it was to complete,” she says.

Dr. Meade and other diplomates who provided feedback during the Kaizen sessions say they appreciated the opportunity to work with the ABP to improve the process. 

Diplomates who haven’t been involved in the ABP’s efforts to improve MOC may not realize how many positive changes have been made to make MOC and its components more valuable to diplomates, Dr. Meade notes.

“Being on the other side of it,” she says, “I see that there’s not only an interest, but there’s a drive to make this [MOC] more meaningful for people. The perception I’m getting is that the ABP has a new focus on trying to make board certification and Maintenance of Certification more relevant and meaningful for pediatricians.”