Thanks for the “CLER” success

cler5313A recap of OHSU’s participation as a volunteer for the ACGME’s new Clinical Learning Environment Review program

After the enthusiastic participation and input of more than 150 OHSU faculty, trainees and staff, OHSU is calling the Clinical Learning Environment Review, or CLER, site visit in late April a great success. A full written report of findings from the Accreditation Council for Graduate Medical Education will be available in several weeks, but meanwhile, the Graduate Medical Education office in the School of Medicine has one message for everyone involved: Thank you!

“We wanted to get an accurate picture of the clinical environment in which our trainees learn and care for patients, and I believe that goal was achieved. The ACGME representatives told us they saw a very professional, collegial and engaged group during the two-day site visit,” said Patrick Brunett, M.D., FACEP, associate dean for GME. “I’d like to thank everyone involved, and to especially call out the involvement and support of OHSU Healthcare leaders, faculty leaders, program directors, residents who led the ‘walk-arounds’ and Sue Simmons, for her superb work as director of the GME office.”As previously announced, the CLER program is a new tool being “beta-tested” by the ACGME to assess the graduate medical education learning environment of U.S. teaching hospitals and participating sites.

The GME office, with the support of OHSU Healthcare leadership, volunteered our institution to be an early participant in the CLER program. OHSU is only the 20th of approximately 400 institutions that will receive a CLER site visit. The four representatives of the ACGME who visited OHSU are national and regional leaders of this new process (see names below).  

“By volunteering, I felt OHSU could embrace a unique opportunity to learn about our own GME environment, and also help shape this new process at the national level,” said Dr. Brunett.

The focus areas include trainee participation in patient safety and quality improvement initiatives; transitions of care; supervision of trainees; duty hours oversight, fatigue management and mitigation; and professionalism.

“I’d like to thank Dr. Brunett for volunteering OHSU for the CLER visit and providing excellent leadership for the OHSU community regarding this process. It was an opportunity to hold a mirror up to the institution and study the clinical learning environment as a whole from an objective perspective,” said Chuck Kilo, M.D., MPH, chief medical officer, OHSU Healthcare. “I believe we performed well in the six focus areas, and through the process of this visit, we were also given a glimpse into areas in which we can improve.”

The following questions were central to the site visitors’ meetings, conversations and tours of OHSU clinical areas:

  • Who and what form the infrastructure of OHSU’s clinical learning environment?
  • How integrated is the GME leadership and faculty within OHSU’s current clinical learning environment infrastructure?
  • How engaged are the residents and fellows in using OHSU’s current clinical learning environment infrastructure?

A written report will be issued to GME leadership in approximately four weeks, and the feedback may be used at the discretion of the institution. In its initial phase, CLER data will not be used in accreditation decisions by the ACGME Institutional Review Committee. OHSU will host another CLER visit in about 18 months.

In particular, the GME office would like to thank the following people who were key contributors to this successful visit:

OHSU Healthcare leaders

  • Peter Rapp, Executive Vice President/OHSU, Executive Director, OHSU Healthcare
  • Deborah Eldredge, R.N., Ph.D., Director, Nursing Quality, Research/Magnet Program
  • Cynthia Grueber, MHSA, Senior Vice President/Chief Operating Officer, OHSU Healthcare
  • Charles Kilo, M.D., MPH, Chief Medical Officer & Vice President for Quality, OHSU Healthcare
  • Laurie McKeown, M.D., Program Manager, Safety Program
  • Troy Schmit, Director, Quality and Safety Management

OHSU residents

  • Filza Akhtar, D.O., Department of Family Medicine
  • Adam Obley, M.D., Department of Medicine
  • Emily Olsen, M.D., Department of Anesthesiology & Perioperative Medicine; GMEC resident member
  • Gordon Riha, M.D., Department of Surgery
  • Keiran Tuck, M.D., Department of Neurology

School of Medicine faculty

  • Dan Handel, M.D., Associate Professor, Department of Emergency Medicine; Co-Chair, Safety Executive Council
  • Scott Sallay, M.D., Clinical Associate Professor, Department of Medicine; Medical Director, Inpatient Informatics
  • Matt Slater, M.D., Associate Professor, Department of Surgery; Chair, Quality Executive Council

Site visitors to OHSU included:

  • Robin Newton, M.D., ACGME Regional Vice President, CLER Site Visit Program and leader for the OHSU site visit
  • Carl Patow, M.D., ACGME Regional Vice President, CLER Site Visit Program
  • Robin Wagner, R.N., MHSA, Vice President, CLER Program
  • Kevin Weiss, M.D., ACGME Senior Vice President, Institutional Accreditation; Co-Chair, CLER Evaluation Committee