For the most part, local school boards have spent much of their time on crisis management and operational details and little time on systematic planning and policy development Cohen, Such a contradiction stems from the increasing pressure of special interest groups on the board and superintendent, although these district officials welcome community participation and parent interest, particularly in planning activities Glass, While some would say that "the local board of education is a cherished and unique institution in the American educational system" Conley,p.
Deliberations of the Task Force were guided by the need to develop standards that: The revised requirements are intended to promote patient safety, resident well-being, and inter-professional team-based care by providing greater flexibility within an established framework, allowing programs and residents more discretion to structure clinical education in a way that best supports the principles of professional development.
With this increased flexibility comes the responsibility for programs and residents to adhere to the hour maximum weekly limit, and to utilize flexibility in a manner that optimizes patient safety, and resident well-being and education. In addition, the requirements eliminate the documentation requirement for residents to justify clinical and educational work hour variations.
Clinical and educational work hours represent only one part of the larger issue of conditions of the learning and working environment, and Section VI has now been expanded to include greater attention to patient safety and resident and faculty member well-being.
The requirements are intended to support programs and residents as they strive for excellence, while also ensuring ethical, humanistic training. Ensuring that flexibility is used in an appropriate manner is a shared responsibility of the program and residents.
With this flexibility comes a responsibility for residents and faculty members to recognize the need to hand off care of a patient to another provider when a resident is too fatigued to safely provide care and for programs to ensure that residents remain within the hour maximum weekly limit.
Patient Safety, Supervision, and Accountability These new and expanded requirements have been added in recognition of the need to make explicit that resident education must occur in an environment designed to emphasize a culture of safety and quality improvement, with appropriate levels of supervision and accountability.
This increased emphasis on patient safety and quality improvement is expected to improve resident education and patient safety. It is necessary that residents and faculty members consistently work in a well-coordinated manner with other health care professionals to achieve institutional patient safety goals, such as consistent reporting and disclosure of patient safety and adverse events.
It is essential that residents learn both to identify the causes of patient safety events, and to institute sustainable systems-based changes to ameliorate patient safety vulnerabilities.
This includes receiving data on quality metrics and benchmarks related to their patient populations. Finally, although the attending physician is ultimately responsible for the care of the patient, every physician shares in the responsibility and accountability for his or her efforts in the provision of care.
Professionalism This section describes professionalism in the broad context of what it means to be a physician, including the ultimate responsibility of provision of comprehensive care to the patient.
Requirements in this section highlight the critical importance of awareness and accountability for fitness for duty, as well as the responsibility of all residents and faculty members to display responsiveness to patient needs that supersedes self-interest.
This includes the recognition that under certain circumstances, the best interests of the patient may be served by transitioning care to another qualified and rested provider. Well-Being The addition of expanded and more specific requirements regarding resident and faculty well-being emphasize the need for programs and institutions to prioritize well-being and recognize that physicians are at increased risk for burnout and depression.
Programs and Sponsoring Institutions have the same responsibility to address well-being as they do to ensure other aspects of resident competence.
Further, self-care is also an important aspect of professionalism, and a skill that must be learned and nurtured in the context of other aspects of graduate medical education.
Promotion of well-being, ensuring protected time with patients, and minimization of non-physician obligations are expected to improve both resident education and quality of patient care. Key components of the requirements of programs and institutions in this area include:After 60 years of use, the CES program retired the Standard Industrial Classification (SIC) system and replaced it with NAICS.
NAICS is the product of a collaborative effort between the United States (U.S.), Canada, and Mexico. A classification system shared across the three countries allows direct.
Selecting, testing, and implementing changes is a core element of the Model for Improvement, a simple yet powerful tool for accelerating improvement that has been widely used by the Institute for Healthcare Improvement and hundreds of health care organizations in many countries to improve numerous health care processes and outcomes.
The Teacher Keys Effectiveness System (TKES) is a common evaluation system designed for building teacher effectiveness and ensuring consistency and comparability throughout the state. The Teacher Keys Effectiveness System (TKES) consists of three components which provide multiple sources of data.
This form should be completed by program staff and/or home providers prior to the start of their assessment window. One form should be used for each classroom that includes more than one child.
The Public Inspection page on alphabetnyc.com offers a preview of documents scheduled to appear in the next day's Federal Register issue. The Public Inspection page may also include documents scheduled for later issues, at the request of the issuing agency. These new and expanded requirements have been added in recognition of the need to make explicit that resident education must occur in an environment designed to emphasize a culture of safety and quality improvement, with appropriate levels of supervision and accountability.