Practice Assessment Resources (Part 4)
- MOC Part 4 requires ongoing participation in a local, regional or national outcomes registry or quality assessment program. The goal of Part 4 is for diplomates to regularly assess their performance in practice, by reviewing their outcomes, addressing identified areas for improvement, and evaluating the results.
- The Part 4 activity should be related to your current practice. Diplomates who hold multiple ABS certificates do not have to repeat Part 4 for each certificate.
- Diplomates are encouraged to find out what programs are available through your hospital. Many hospitals already participate in national registry programs. In addition, some surgical societies have programs available to individual surgeons. See the list below for examples of acceptable programs.
If there are no hospital-based or individual programs available to you, the ABS expects that you will select a focused area of practice for practice assessment/quality improvement. You should identify a practice area or types of procedures to study; define measures and goals; track patients' outcomes; analyze the outcomes and compare with your goals; and identify areas for improvement. You should then reassess your performance after implementing changes to gauge improvement.
- While the ABS requires that you participate in a practice assessment activity, it does not require or collect patient information or your individual results. The online form that must be submitted at the end of each three-year MOC cycle contains a section for you to indicate or describe the type of practice assessment activity you are are doing for Part 4.
- The ABS audits a percentage of the submitted forms each year; if audited, you will be asked to provide verification of enrollment or participation in a Part 4 program.
Examples of acceptable programs for Part 4:
The list below is not meant to be all inclusive, but rather to provide examples of good programs for meeting Part 4.
Vascular surgery-related programs:
Pediatric surgery-related programs:
The ABS approved in June 2012 the following parameters to guide the development of Part 4 resources. Going forward, Part 4 programs will be expected to adhere to these criteria.
- The activity tracks meaningful and measureable patient outcomes. Processes of care or composite indicators associated with improved outcomes, reduced complications, or a better quality of life may be included.
- The parameters assessed are important, scientifically acceptable, useable, relevant, and easy to collect.
- Individual results are provided to the surgeon at least yearly, preferably a minimum of every six months.
- A comparative analysis of individual and group results is provided.
- The method for tracking procedures and outcomes minimizes selection bias.
- The activity includes the ability for re-measurement after implementation of a quality improvement activity based on analysis of the results.
- The information is risk-adjusted when possible.
- The time period between recording of data and reporting of results is minimized as much as possible.
- Resources are provided to enable completion of quality improvement activities based on the results.
- The activity provides comparisons over different time periods to track the effect of quality improvement activities.
- Data entry is done by trained third-party personnel when possible.
- The information is subject to audit to assure its validity and reliability.