CME as a Strategic Resource in Quality Improvement with Katie West MSN

TitlesEP 133: The Impact of CME in a Hospital SettingCME as a Strategic Resource in Quality Improvement
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[00:00:00] Are you a CME professional working in a hospital or healthcare system feeling like you're constantly swimming, upstream. You know, your work is crucial. But sometimes it feels like you're on the fringes struggling to prove your value beyond checking accreditation boxes. You dream of a world where CME is at the heart of your organization's quality improvement efforts, where you're invited to strategic planning meetings and where clinicians eagerly engage with your programs instead. You're trapped in a cycle of reactive planning, limited resources, and the constant challenge of demonstrating meaningful impact. What have I told you? 

[00:00:39] There's a way to transform CME from an afterthought to a strategic powerhouse within your healthcare system. Today, we're diving deep with an expert who's done just that. Katie west, a CME strategist and writer with over a decade of experience in healthcare, we'll show you how to position CME at the center of your organization's mission. Integrated seamlessly with quality improvement initiatives. And measure its impact in ways that will make even the most skeptical administrator. 

[00:01:10] Sit up and take notice. Get ready to rocket launch your approach to CME in hospital and healthcare systems. I'm your host, Alex Howson and we're abut to unlock the secrets to making your CME program indispensable here on Write Medicine. 

[00:01:31] Katie West: My background is in clinical nursing care, in a variety of settings. I've worked in long term care, home care, but primarily in inpatient, cardiac telemetry care. I was kind of in that position when I realized I was pretty good at, , training students, new nurses, new hires, really anybody I had kind of a knack for seeing where they were getting stuck in their understanding of a topic or a concept and realized that I could kind of adjust the way I explained something based on where they were getting stuck and just realized, Oh, this is a, an area that I feel good in.

[00:02:06] Katie West: And I feel like I could do this. Then, our unit educator went on maternity leave and I had the opportunity to fill in for her while she was out and realized. Just how fascinated I was with the science and philosophy of teaching and learning and decided to kind of start steering my ship in, towards an MSN in education, if you will.

[00:02:27] Katie West: But was still kind of in that track of management and leadership, in that hospital setting. And I, about a year later, had a pretty turbulent https: otter. ai role for a really large inpatient unit and kind of came away from that really jaded and really just started looking for anything else.

[00:02:46] Katie West: And I found this RN CME specialist role in our organization and I had no idea what CME was really other than my own experience with You know, being a nurse and, and getting my own CEEs. I applied not really knowing what I was [00:03:00] getting into and I got the position and , it's just been, wonderful.

[00:03:04] Katie West: It's been like a whole new world here. So, it's really changed the, the vision that I had for my life and, and where I wanted to go and what was possible. And it's been really exciting. So I've been in this role for about. Six years now, and I've started to do kind of dabble in a little bit of freelancing on my own with some CME strategy consulting and, writing content.

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[00:03:25] Alex Howson: I wanted to dig into what CME looks like in a hospital and healthcare system with Katie. But first I asked her to tell me what excites her about the science and philosophy of learning. 

[00:03:37] Katie West: I just love, uh, you know, finding out why, we do things the way that we do and, uh, what makes things more effective and not effective and, you know, having been through nursing school and obviously many trainings as a nurse, you know, and, and seeing what is helpful and what's not helpful and, you know, what engages me and what doesn't engage me.

[00:03:57] Katie West: And just realizing that there was, research and science behind this about, you know, strategies that actually, it's not just a guess. Oh, maybe this will work. It was just really fascinating to me. So knowing that I already had kind of a, a strength in that area for, for being able to explain and teach, I wanted to know more about how to do that correctly, so to say.

[00:04:18] Absolutely. So let's talk a little bit about how CME planning and delivery works in a hospital and healthcare system. What does it look like in that kind of setting?

[00:04:32] Katie West: I think it's pretty special, honestly. See, I mean, a hospital or health system setting, um, I have a much more direct line to my learners than, say, like a medical education company.

[00:04:42] Katie West: You know, these are clinicians I've worked with personally, either in the clinical setting before I was in this role or just now in the role and how huge they are for, you know, as content experts and planning the education that we provide. When it comes down to it, these are, there are clinicians that are treating me, they're treating my family and my friends and the people in my community.

[00:05:01] Katie West: So it matters that the education we're providing is worthy of their time, it's relevant to their needs, and it's making a difference in their practice. So I think it's just a lot more personal for one. Two is, the delivery of it, we kind of our bread and butter are these, you know, morbidity and mortality meetings, these case reviews, grand rounds, things like that.

[00:05:23] Katie West: And we don't have a lot of, little to no commercial support. So, we're an internally funded. Department and, a lot of our education is by and for the clinicians that we're working with, there's not, you know, these outside speakers coming in, it's really these clinicians that are doing the work, as content experts and then preparing the content and things like that .

[00:05:44] Katie West: A lot of our practice gaps are identified by partnering with quality improvement committees in the hospital and health system. So we'll partner with them or we have, partnering with.

[00:05:55] Katie West: different service lines, for instance, if we have an oncology service line that's working on new [00:06:00] guidelines for breast cancer screening or lung cancer screening, we're connecting them and their expertise with our primary care providers in these outpatient clinics, and really just making sure that, they know they have what they need to know to coordinate the right care.

[00:06:16] Katie West: And I should also mention, this hospital system, is a, rural health system in northern Michigan. This is eight community hospitals and numerous outpatient clinics. Um, so it's a pretty broad, audience, but because of that local kind of thread, it works well.

[00:06:31] So identifying practice gaps and developing education, that's going to really support care coordination in a hospital and healthcare system is pretty challenging. And a lot of education providers struggle with this. So I asked Katie if she had any perils that she could share with listeners around hi, to make this happen more seamlessly. Here's what she said. 

[00:06:55] Katie West: Building good relationships with, not just the clinicians, but, the leadership in those service lines, they're kind of working on these strategies and are able to see, What's coming up as far as what's what's needed in those service lines specifically, so there's, you're able to do a little bit more forecasting and, um, proactive work instead of just reacting all of the time to, you know, something that comes up in a quality improvement setting or something like that.

[00:07:22] Katie West: So building relationships with, people in those service lines that are able to have a bigger picture. The clinicians obviously are hugely important, but they're obviously in the work. And so being able to kind of have access to people who have a little bit more capacity to, um, look at strategy is really helpful.

[00:07:38] /

[00:07:38] As Katie described her experience of

[00:07:42] building relationships and partnering with different service lines in her hospital and healthcare network. It became clear to me that. She's very proactive in building these relationships and reaching out to service lines and other departments to help develop education. And assigned it to me. Like she was describing CME at the heart of quality or performance improvement. 

[00:08:06] Katie West: Yeah, it's, it's been something that I learned, um, from, from my director, who's been a really great mentor in CME for me, uh, who's, who's really understood how important CME is as a strategic resource, as something that needs to be at the heart of it, I would say it hasn't always been so integrated into a lot of the processes that we do. Um, but we've worked really hard to make it.

[00:08:29] Katie West: So, in the last several years, especially, um, through the pandemic and everything, just working with, our clinicians and, Trying to provide as much value as possible so that they understand how valuable it is to have CME as part of the conversation.

[00:08:48] Katie West: So it's again building those relationships over time and inserting ourselves consistently, trying to get a seat at the table so that we're able to, bring CME up as an important strategic resource. So [00:09:00] I think we're in a better place than we've ever been before with that, but it hasn't always been.

[00:09:04] Katie West: So as far as how much of the work is Reaching out proactively versus kind of having them come to us. It's a little bit of both at this point, I think. Because we've been able to do that consistently over time, we do have more than ever service lines or, different people reaching out, talking about we want to do education, related to, whatever's coming down the pipe for them.

[00:09:26] Katie West: And then also just still being consistent at, those quality improvement committees or, or wherever we have those relationships and being able to say, Oh, have we thought about, using CME for this? We're such a small department for, how big our scope is, if there were more of me or more of my time, I think there would be a lot more, proactive reach out on on our end.

[00:09:47] Katie West: At this point, it's doing as much as we can with the time that we have 

[00:09:50] it's always a challenge in hospital and healthcare systems CME to

[00:09:55] create education with limited time and resources because. See me professionals in these contexts where a lot of different hats. 

[00:10:03] Given the emphasis that Katie placed on quality improvement and the relationship with CME. 

[00:10:08] I was curious about whether having that relationship made it easier for clinicians to participate. In quality improvement initiatives.

[00:10:18] Katie West: Yeah, I think, I think it's huge. Um, especially initially if people have not been, working with CME as much, but they see that CME is attached to something, they peaks their interest and they think, okay, I'll give this a little bit more of my time and a little bit more about what's happening here.

[00:10:34] Katie West: It's definitely something that will catch the attention of, of clinicians. more than if it was not there, as we know, clinicians have so much that they're doing and they only have so much time, so if, if CME is attached, I do think that they give it a little bit more of their attention, and are more engaged, than they otherwise might be. 

[00:10:50] Here's the obvious question. When we're talking about hospital and health care CME, what type of activities are we actually talking about? Katie. I actually just wrote an article about this topic for the Alliance Almanac, and I'll make sure to include a link in the show notes to the article.

[00:11:10] Katie West: I'm trying to do more, process improvement CME, because these are things that are happening all the time in the, in the health system and in the hospital setting these processes and these performance improvement, projects and being able to kind of insert ourselves and go, Hey, we know you're already doing this work.

[00:11:25] Katie West: Here's this. Template that we can put that work on to that helps you get credit for the work that you're doing. So we've tried to get the word out about that a little bit more and increase the, the amount of, process improvement CME that we're doing in our system. Cause as I said, the, work is already.

[00:11:42] Katie West: Being done or that there's desire for that work to be done. So to be able to put it in such an attractive package as a possible 20 credits for CME, especially in that performance improvement space, is really powerful. We try and do some of those we do, , [00:12:00] journal, CME, CE has been something that we've done more of in our health system in the last few years, and that's been really helpful for, if we have a, service line or medical director who, sees a journal article with, new treatment guidelines or if it's something that they feel is important for their, group and something that they need to adopt into practice, they might work with me to put that into a format that is journal CME and then they can distribute that, with their providers and they can get credit that way as well.

[00:12:29] Katie West: So we do have, those. Plug and play activities, which are the grand rounds or the, case reviews. But trying to increase some of those activities that, really, the work is really being done and being able to kind of just package it in a way.

[00:12:44] Katie West: that allows them to get credit for that. 

[00:12:46] We hear a lot in CME about gamification and interactive online modules and that kind of thing. So I wondered how feasible these types of activities are within a hospital and healthcare system.

[00:12:58] Katie West: Right, right, exactly. Um, I do think that we get a lot of preconceived notions, with some, physicians if they see something is a game or gamified, or we're trying to do something different or new, they, have, a little bit of resistance to that.

[00:13:13] Katie West: So we usually path of least resistance. If this is something that's working for them and they like this modality, we'll, try and, work with that, but we do have, an annual symposium that we do every year. And it's like a, a two day, conference that we do with concurrent CME sessions and some plenary sessions.

[00:13:31] Katie West: And when we have something like that, that's an area where we can go, okay, how can we get creative with some of the. Learning formats and do more hands on and some of these gamified, ways of teaching. So, so it's not that we're not able to use it at all, but it definitely is less in the moment.

[00:13:47] Katie West: I think the biggest barrier is just human resources. I have experience with course authoring softwares like Articulate, and I would love to be able to do, more interactive, online modules that they could do, with a simulated case study if you've got an avatar patient or something and you're walking somebody through that.

[00:14:06] Katie West: But just with the, scope of the work that we're doing, there just really isn't time to be able to put time into doing that.

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[00:14:11] One of the topics that Katie talks about in her Alliance.

[00:14:15] Almanac is the idea of shared learning. And so I wanted her to share a little bit more about what she means by this, in the hospital and healthcare CME context. And to talk a little bit about how she measures. the effectiveness of CME programs, particularly for things like case reviews and morbidity and mortality sessions. 

[00:14:40] Katie West: So I think, those morbidity and mortality or case review meetings are a really good example of that. We have, several different, tumor boards where we have, oncologists and surgeons, whatever the specialty might be coming together and they're reviewing a current case.

[00:14:56] Katie West: So we have this, patient and instead of relying on, [00:15:00] one or a few clinicians point of view or their experience, they're bringing it to this forum of, multiple experts and specialists in the area and being able to discuss it, they're looking at literature together, they're reflecting on their own experience and sharing and gaining new insights just in this collaborative discussion space.

[00:15:21] Katie West: So there's a lot of that I'd say that that happens with hospital CME is the bulk of the content is that just collaborative discussion and shared learning. 

[00:15:32] Katie West: We do a lot of, surveying and evaluation. So there's a lot of, self reported change. I'd say a lot of our outcomes are self reported through the evaluations that we do at the end of the activity. We do have access with our partnership with our quality improvement groups and, different data analysts in our system to be able to pull quality data or patient data.

[00:15:55] Katie West: But sometimes it's not always clear cut as to. This specific intervention was associated with this change in the data here. So, unless we have something really specific, like we're, educating primary care providers about, mammograms, and we can measure an increase in mammogram scheduling after the education, a lot of times it really is more of the self reported change that we're measuring.

[00:16:18] Katie West: In the setting that we're in with, the hospital or the outpatient clinics, the work being so embedded into their, their practices, the, focus on outcomes is incredibly important in being able to show the bigger picture and tell the story of some of the education that we're doing.

[00:16:35] Katie West: We do have access to the data when, we need to use it to inform where we're going. We are absolutely using the data for different purposes. And so again, with the human resources, we're not always collecting the same type of data every time when we're planning these types of activities.

[00:16:55] Katie West: A lot of the, the Data that we're getting to plan the activities is coming from either literature or, quality indicators in the practices where they're saying, okay, this is clearly an area where we are not doing as well as we'd like, and so, we have that, but it is a lot of just working with the clinicians and asking them what's not working for you, where do you need more resources, what do you need more support with.

[00:17:20] The education that Katie. Designs and delivers.

[00:17:24] In this hospital and healthcare system. Focuses a lot on care coordination. And so I was curious about how she structures education, that's reaching across different specialties and different parts of the health system to create coordinated education. to support coordinated care.

[00:17:42] Katie West: I would say that because we do the annual symposium, Every year with the target audience of primary care providers.

[00:17:50] Katie West: Sometimes the target audience includes hospitalist or ED, but it really is a dedicated activity, large scale activity that is, our experts being the ones [00:18:00] to deliver the content to our primary care audience, from the, viewpoint of, in our care coordination. What to primary care providers need to know that maybe they don't know as much of or What's something that we need to work on and I think because we have a dedicated Large scale activity for that it helps inform conversations throughout the rest of the year 

[00:18:21] And to wrap up here's the crystal ball question. I asked Katie what changes or innovations she hoped to see in CME within hospital and healthcare systems in the coming years. 

[00:18:32] Katie West: I'd love to see more joint accreditation.

[00:18:35] Katie West: It's something that our program is working on right now, just taking stock of the different departments that we have that have historically delivered clinical education, they've kind of all been in these different silos, especially as a, rural health system that has come together over the last several years and used to be much more siloed in these individual community hospitals or, clinics.

[00:18:57] Katie West: So taking stock of where are we delivering clinical education and who are we delivering it to? And can we be more efficient in our approach? Can we maximize the value for these clinicians by giving credits to more than just our, physicians and our APPs with the CME, can we include our pharmacists and our nurses, and our therapists, because because the work that we do is so integral for, for so many different disciplines, you know, we're not, just educating physicians or just educating nurses. The care is provided by all of these different groups.

[00:19:28] Katie West: So, to be able to provide a benefit to all of them with accredited education would be really great.

[00:19:35] Katie West: We have the most impact when we can, have a seat at the table in, in those quality improvements or in the strategic.

[00:19:42] Katie West: Priority conversations, and be able to, included it kind of at a base level. 

[00:19:47] My conversation with Katie underscores the transformative impact of embedding CME into hospital and healthcare systems and the necessity of fostering strong internal. And cross service line relationships to champion these educational initiatives. Here are three takeaways. Integrate CME into your hospitals, core strategic planning and quality improvement initiatives by aligning your educational programs with organizational goals and partnering with various service lines, you can elevate CME from a compliance requirements to a driver of institutional excellence. Second capitalize on collaborative learning formats, like morbidity and mortality meetings, case reviews and multi-specialty tumor boards. These shared learning experiences, enhance education and improve care coordination across different specialties within healthcare systems. And third while self-report to changes, remain valuable, explore partnerships with quality improvement teams, to access broader data sets and look for creative ways to demonstrate the impact of your CME programs on patient [00:21:00] care outcomes. Even when direct correlations might be challenging to establish.

[00:21:05] I hope Katie's experiences have inspired you to view your role through a new lens. 

[00:21:10] One that places CME at the heart of your organization's strategic initiatives. As you move forward. Think about it taking one action this week, based on what you've learned, maybe it's reaching out to a quality improvement committee member brainstorming a new process improvement. CME activity are exploring ways to measure your program's effectiveness. 

[00:21:30] More comprehensively. If you find today's episode valuable, please take a moment to rate and review the show. Your feedback helps other CME professionals discover these crucial insights from peers, clients, and colleagues. And if you've got questions or topics you'd like us to explore in future episodes, reach out to me on LinkedIn or subscribe to write medicine insider@alexhouse.com. 

[00:21:56] Write Medicine is here to support you in your mission to create high impact CME. Until next time. Keep innovating, keep collaborating and keep pushing the boundaries of what CME can achieve in your health system.