Part IV—Performance in Practice
This component of ABFM Maintenance of Certification for Family Physicians (also referred to as ABFM MC-FP or simply, MC-FP) assesses a Diplomates competence in systematic measurement and improvement in patient care.
Performance in Practice Modules (PPMs)
Performance in Practice Modules (PPMs), the ABFM's Part IV modules, are web-based, quality improvement modules in health areas that generally correspond to the Self-Assessment Modules (SAMs).
Each physician will assess his or her care of patients using evidence-based quality indicators. After a physician enters data from 10 patients into the ABFM Website, feedback is provided for each of the quality indicators. The performance data is used by the physician to choose an indicator for which a quality improvement plan will be designed. Using a menu of interventions available from various online sources, the physician designs a plan of improvement, submits the plan, and implements the plan in practice. After a minimum of 1 week, the physician again assesses the care provided to 10 patients in the chosen health area and enters the data into the ABFM Website. The physician then is able to compare pre- and post-intervention performance, and compare their results to those of their peers. Evidence of improvement is not required to satisfy this MC-FP requirement.
Once a Part IV module is started, it must be completed within 1 year. If the module is not completed in that time, the module must be restarted or a new module selected. Successfully completed PPMs, as part of MC-FP, may be submitted as a Best Practice Initiative in the Highmark Blue Cross Blue Shield (Highmark Blue Shield) Quality BLUE program. Currently, 20 CME credits are awarded for successfully completing each PPM.
Approved Alternative Part IV Activities
The ABFM has approved numerous alternative Part IV activities developed by external providers. Click here for a current list of alternative activities approved for MC-FP Part IV credit. ABFM Diplomates who complete alternate MC-FP Part IV activities must submit the required MC-FP fees (beyond any cost paid to the external provider's fee) in order to receive MC-FP credit for the alternate activity. In addition, for the alternate Part IV activity to apply toward the MC-FP Part IV requirement, it must be completed in the stage the Diplomate wishes to receive the credit.
Alternative Part IV Activities Approval Program
The ABFM recognizes that many physicians already participate in quality improvement activities. Click here for more information about the standards and requirements for external providers of Part IV activities.
Self-Directed Part IV Efforts
The self-directed option for Part IV credit allows physicians
to implement relevant, customized quality improvement (QI) efforts, regardless
of whether providing continuing care. Physicians identify measures for pre- and
post-intervention data collection, develop custom QI plans, and describe the
implementation of evidence-based interventions. Information about the
Self-Directed Pathway and access to the application can be found here.
PART IV Activities That Do Not Require Continuous Patient Care
Methods in Medicine Modules (MIMMs)
The Methods in Medicine Modules (MIMMs) are Part IV modules that can be accessed through the Physician Portfolio. Physicians who do not provide continuing care for patients can complete a MIMM to satisfy one Part IV requirement. Since physicians who do have continuing care of patients are required to complete a Part IV module with patient continuity, the completion of a MIMM counts for MC-FP points only. These modules do not require direct access to continuity practice populations, but do include quality improvement concepts and activities that satisfy the MC-FP Part IV requirement. Currently, there is one MIMM available: Cultural Competency. Those physicians who complete the Cultural Competency MIMM are required to submit a copy of the certificate verifying completion of the module in order to have the ABFM grant MC-FP Part IV credit.
The Hand Hygiene Module has been developed in collaboration with the American Board of Pediatrics with the belief that participation in this activity will lead to decreased health care associated infections in your patient care activities. This Performance in Practice Module (PPM) provides for effective strategies and proven intervention tools to enhance hand hygiene. As an MC-FP Part IV activity, this module includes published guidelines from the CDC and WHO that introduce practice-proven improvement strategies and tips for creating a culture of safety. The Hand Hygiene Module is available to physicians who do not provide continuing care for patients, as well as those who do. The completion of the Hand Hygiene PPM will satisfy one Part IV requirement.
Diplomates can access modules through the Track Your Progress page in their Physician Portfolio.
Self-Directed Part IV Efforts
The self-directed option
for Part IV credit allows physicians to implement customized quality
improvement (QI) efforts that are relevant to the physician’s work context,
regardless of whether providing continuing care. Using the appropriate
application (clinical or non-clinical), physicians identify measures for pre-
and post-intervention data collection, develop custom QI plans, and describe
the implementation of evidence-based interventions. Information about the
Self-Directed Pathway and access to the applications can be found here.
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