CME Credit Information for Performance Improvement CME credit (PI CME) for participating in a QI project being documented for Part IV Maintenance of Certification (MOC)
Before developing a quality improvement (QI) project being documented for Part IV Maintenance of Certification (MOC) and PI CME credit, please contact the UMHS Part IV MOC Program for guidance. The Part IV MOC Program can provide information that may appreciably alter the planning of a QI project.
The American Medical Association recognizes continuing medical education occurring through participation in “performance improvement” activities (PI CME). Physicians may receive 30 AMA PRA Category 1 Credits™ if they participate in a quality improvement (QI) activity that involves two linked cycles of data-guided improvement. The 30 credits are the total of 5 credits each for:
- Reviewing baseline data, identifying root causes, and planning interventions
- Implementing interventions
- Reviewing post-intervention, identifying current root causes, and planning adjustments/additional interventions
- Implementing adjustments
- Reviewing post-adjustment data, identifying current root causes, and planning further adjustments/interventions
- Summarizing changes
PI CME has the additional requirement that the application for PI CME be submitted and approved before physicians participate in their initial review and analysis of data. This allows disclosures of conflicts of interest and other CME requirements to occur before physicians substantively participate in the activity. If a QI project has reached the stage of reviewing the current/baseline data before CME credit has been applied for and approved, the project is not eligible for CME credit.
Carrying out a combined PI CME and Part IV MOC activity for which CME credit is designated involves five stages:
- Application for credit designation
- Additional actions to address potential commercial influence (i.e., disclosure)
- Reports on activity and on participants
- PI CME and Part IV credit is awarded to participants
Information relevant to each of these steps is presented below with links to download applicable materials.
For the sequence and guidelines for activities involved in having Part IV MOC also designated for QI projects being documented for PI CME, see Guidelines and Expectations for Combined Part IV MOC and PI CME QI Projects (PDF).
Please contact OCME&LL for information regarding fees.
Note: Effective July 1, 2014, applications needing a full review in ten business days or less will be charged an additional $200 rush fee.
Develop Preliminary Worksheet for Part IV Eligibility. Initial planning for a combined PI CME and Part IV MOC activity should begin with identifying and designing the quality improvement (QI) activity as described in the MOC section of the Quality Department website under Part IV Credit Designation, Sections 1 and 2. Section 2.d explains how to access and complete a Preliminary Worksheet outlining the QI project. Have UMHS Part IV MOC Program personnel review and pre-approve the worksheet's description of a QI project eligible for Part IV MOC. The worksheet pre-approved for Part IV is submitted with the application for joint approval for PI CME.
Develop Draft of Enrollment Email Memo. Part IV MOC Program staff and the faculty planner/project lead will follow these steps to develop the draft of the Enrollment Email Memo:
- Faculty planner/project lead indicates on the Preliminary Worksheet submitted to the Part IV Program that joint PI CME credit will be sought.
- Part IV MOC Program staff will ask the faculty planner/project lead for information regarding disclosures of conflicts of interest that will be needed for PI CME approval.
- Faculty planner/project lead will provide disclosure information to Part IV MOC Program.
- Part IV MOC Program staff will prepare the draft Enrollment Email Memo that includes the required CME information, and will send a copy to the faculty planner/project lead for review.
- Faculty planner/project lead will review the Enrollment Email Memo and submit it as an attachment to the Application for Category 1 CME Credit for a Combined PI CME & Part IV MOC Activity (see step 2, below).
Additional materials for educational planning may also be helpful:
Educational Planning for a CME Activity: Linking Problems and Results (PDF). This one-page document illustrates planning terminology from ACCME that is used when completing the application for CME credit.
Planning CME Presentations that Facilitate the Translation of New Knowledge into Practice (PDF). This one-page document illustrates how to plan not only for learning, but also for that knowledge to be implemented.
2. Application for credit designation
Application for Performance Improvement CME Credit for a QI Project Being Documented for Part IV MOC This online form must be completed and submitted. It contains detailed instructions. The last page of the application has a checklist of additional items that are or may be required.
Information that is required to accompany the application includes:
CME Disclosure Form (PDF). A completed form for each faculty planner/project lead, as well as anyone else in a position to control educational content, must accompany the application. For individuals with relevant financial relationships, the “Resolution” section at the bottom of the form must be completed.
Identifying, Resolving and Disclosing Conflicts of Interest Flowchart (PDF) This tool defines conflicts of interest and outlines the steps needed to resolve and disclose properly.
Note: Individuals prohibited from planning or presenting educational content include:
- Those who refuse to disclose the existence of relevant relationships with commercial companies.
- Those who are employees or owners of a commercial interest, except in very rare instances.
Preliminary Worksheet for Part IV Eligibility. The purpose of the worksheet is to show that the project is structured with appropriate activities over linked cycles of improvement. Before submitting it with the application for Joint PI CME and Part IV MOC credit, have UMHS Part IV MOC Program pre-approve it for Part IV eligibility. For the Preliminary Worksheet and a completed example, see Part IV Credit Designation, Section 2.d.
Draft of Enrollment Email Memo Typically, the enrollment process occurs as explained for Part IV MOC activities on the MOC section of the Quality Department website under Part IV Credit Designation, Section 2.e. For PI CME activities, added to the email memo are the following required elements:
- Disclosure information for all persons in a position to control educational content
- CME accreditation and credit designation statements
The additional text is highlighted in an example here. For combined PI CME and Part IV MOC activities, Part IV Program staff will add the disclosure information and accreditation and credit designation statement to the Enrollment Email Memo developed for the specific QI activity. The Enrollment Email Memo is sent to participants, with OCME&LL included (carbon copied) as an email recipient.
If the activity is jointly provided with a group outside UMHS, please also provide the following:
- Supplemental Documentation Form for Joint Providership with Non-Medical School Groups (PDF). This form must accompany the application for jointly provided activities.
- Budget for Jointly Provided Activities – Example (PDF). This illustrates the type of financial information to be attached.
3. Additional actions to address potential commercial influence
Copy of Enrollment Email Memo. An Enrollment Email Memo summarizing the QI project and including the additional required disclosure information and CME accreditation/credit designation text, should be sent to via email to participants. The faculty planner/project lead will include OCME&LL staff as recipients of the Enrollment Email Memo to document for the CME file that participants received the required CME information.
Commercial Support. The ABMS Portfolio Program will not approve any QI activity that receives commercial support, either formal or in-kind.
4. Reports on activity and on participation
Project lead completes reports on the activity/project:
- For Part IV MOC, submit the completed Report on a QI Project Eligible for Part IV MOC (DOC).
- For PI CME, submit the completed Report on a PI CME / Part IV MOC Activity (PDF).
Participants document participation in and assessment of the activity. After the reports for Part IV and PI CME have been approved, the Part IV Program prepares a customized attestation of participation form that includes the information required for Part IV and supplemental information required for PI CME. The Part IV Program coordinator will provide the form to the project lead to distribute to those who participated in all of the key steps of the project.
Project lead receives attestation of participation forms. The project lead co-signs the participants' forms and submits them to the Part IV Program, who will prepare copies. One set will be kept for Part IV Program activity files and the other set will be forwarded to OCME&LL for the CME files.
5. PI CME and Part IV MOC credit is awarded to participants
OCME&LL awards 30 AMA PRA Category 1 credits™ to participants:
- For UM participants, this is added to their transcript of participation in UM CME activities maintained by OCME&LL.
- For non-UM participants, OCME&LL sends a CME certificate to retain in their personal records of CME participation.
Part IV MOC Program forwards a list of participants to ABMS, which forwards the information to the relevant board. The boards post Part IV participation on the websites for individual diplomates.
Address questions and submit applications and other materials to:
Julie ReBeau, Program Manager
Office of Continuing Medical Education and Lifelong Learning
2800 Plymouth Rd, Building 400
Ann Arbor, Michigan 48109-2800