Performance Improvement Activity (PI CME)

CME Credit Information for Performance Improvement CME credit (PI CME) for participating in a PI project

The American Medical Association recognizes continuing medical education occurring through participation in “performance improvement” activities (PI CME). Physicians may receive 20 AMA PRA Category 1 Credits if they participate in a quality improvement (QI) activity that involves at least one improvement cycle. The 20 credits are the total of 5 credits each for

  1. Reviewing baseline data, identifying root causes, and planning interventions
  2. Implementing interventions
  3. Reviewing post-intervention, identifying current root causes, and planning adjustments/additional interventions
  4. Summarizing changes

QI activities that involve a second linked cycle of improvement are eligible for a total of 30 credits in PI CME. The second cycle adds both implementation of adjustments/additional interventions [5 credits], and reviewing post-adjustment data, identifying current root causes, and planning further adjustments/interventions [5 credits].

Applications for PI CME must be submitted and approved before physicians begin their review of current/baseline data. The disclosures of conflict of interest must occur before physicians participate substantively in a CME activity. If a project has reached the stage of participants reviewing the current/baseline data before CME credit has been applied for and approved, the project is not eligible for credit.

Carrying out a combined PI CME for which CME credit is designated involves five stages:

  1. Planning
  2. Application for credit designation
  3. Additional actions to address potential commercial influence (i.e., disclosure)
  4. Reports on activity and on participants
  5. OCME&LL awards PI CME credit to participants

Information relevant to each of these steps is presented below with links to download applicable materials.

Fees

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.

1. Planning

Develop Preliminary Worksheet for PI CME Project. Initial planning for a PI CME activity should begin with identifying and designing the performance improvement (PI) activity. Reviewing Sections 1 and 2 under Part IV Credit Designation on the MOC website may be helpful. This planning should produce a preliminary worksheet outlining the PI project with at least one PDCA cycle. The document should be submitted as an attachment to the Application for Category 1 CME Credit for a Performance Improvement (PI CME) Activity (see step 2 below).

An example of an approved Preliminary Worksheet for a PI CME project can be found here.

Develop Draft of Enrollment Memo. The faculty planner/project lead must develop a document summarizing the PI project, and including the required disclosure and accreditation/credit designation text, to provide to prospective participants. The document should be submitted as an attachment to the Application for Category 1 CME Credit for a Performance Improvement CME (PI CME) Activity (see step 2 below).

An example of the Enrollment Email Memo can be found here.
An example of the Enrollment Form can be found here.

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 Category 1 CME Credit for Performance Improvement CME 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 a PI CME Project (DOC). The purpose of the Worksheet is to show that the project is structured with appropriate activities over at least once cycle of improvement. Refer to Sections 1 and 2 under Part IV Credit Designation on the MOC website for help in completing this form.

An example of an approved Preliminary Worksheet for a PI CME project can be found here.

Draft of Enrollment Email Message. Document summarizing the PI project, and including the required disclosure and accreditation/credit designation text, to be provided to prospective participants.

An example of the Enrollment Email Memo can be found here.
An example of the Enrollment Form can be found here.

If the activity is jointly provided with a group outside UMHS, please also provide the following:

3. Additional actions to address potential commercial influence

Enrollment Memo. After approval of credit designation for the PI CME project, an Enrollment Memo, approved by OCME&LL, summarizing the PI 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 Memo to document for the CME file that participants received the required CME information.

Commercial Support.  The revised UMMS policy (effective 4/26/2018) allows commercial support* for continuing medical education (CME) under certain conditions. To designate credit for activities wishing to receive commercial support the Office of CME and Lifelong Learning requires that two important conditions are met:

1. The Receipt of a Written Gift Agreement signed by a representative of the source of funding (the commercial interest) describing the terms, conditions, and use of all the commercial support for continuing medical education. The standard approved agreement, compliant with our Medical School’s requirements for commercial support of education, must be used. A signed written agreement must be received at least five working days before the start of the activity to allow time for review and the award of CME credit.

2. The Disclosure of Source of Support to Participants The source and nature (financial or in-kind) of all commercial support must be shared with participants before the activity begins. It is essential that participants know the source of funding to remain vigilant to biased content throughout the activity. Any perceived bias in content is reported through the activity evaluation and may lead to loss of credit.

Guidelines for Commercial Support The Office of CME and Lifelong Learning has developed guidelines (distributed with the Written Gift Agreement) to help faculty planners and others navigate the process.

Written Gift Agreement (PDF) This or a similar form is to be completed for each instance of in-kind commercial support. The Faculty Planner submits a copy of the agreement for the CME file.

Printed Acknowledgement of Commercial Support – Example (PDF) In-kind commercial support may be acknowledged in various formats, included in this example. For the CME file the Faculty Planner submits a copy of the acknowledgement and documentation that it was provided.

*Commercial support is financial or in-kind gifts/contributions from an ACCME-defined commercial interest (referred to as “Industry” in the policy) used to pay all or part of the costs of an accredited CME activity.

4. Reports on Activity and on Participants

Faculty Planner/Project Lead completes the report on the PI CME activity. The faculty planner/project lead submits the completed Report on a PI CME Activity (PDF) on following the requirements for credit designation within thirty days of the end of the project.

Participants document participation in and assessment of PI CME activity. After the Report on a PI CME activity has been submitted by the faculty planner/project lead and reviewed, OCME&LL will provide a customized attestation form to the faculty planner/project lead, who will distribute copies to individual participants. The completed forms will provide the final participant list and the participants' comments will provide part of the information to evaluatate the activity. Participants will return the completed forms to the faculty planner/project lead, who will review the forms and verify participants' participation. The faculty planner/project lead will then forward the forms to OCME&LL.

5. OCME&LL awards PI CME credit to Participants

OCME&LL Awards 20 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.

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
Phone: 734-647-8784
Email: juliwils@umich.edu