Blog

CLER: Our Blueprint for Transformation

Posted by [email protected] on Mar. 25, 2021  /  Subscribe 0

By SEGER S. MORRIS, DO, MBA
Program Director
Internal Medicine Residency | Baptist North Mississippi

There is often a distinct cultural difference between large academic research hospitals and smaller community-based hospitals. Sometimes this pertains to patient populations, sometimes it’s the career interests of the clinicians and administrators, and sometimes it’s the operational processes that come with being affiliated with a university versus a privately owned corporation. Whatever the reasons, starting a residency program at a community hospitals involves a cultural transformation to one that prioritizes clinical and academic excellence.

Fortunately, the culture at Baptist Memorial Hospital-North Mississippi is proudly centered upon clinical excellence. Now, we will use the Clinical Learning Environment Review (CLER) process by the Accreditation Council on Graduate Medical Education (ACGME) as a blueprint for integrating academic excellence into that existing culture.

The CLER initiative was designed to ensure that postdoctoral training programs (residencies and fellowships) do not function in a silo within the hospital or health system. Physicians need to be trained to lead care teams, and using CLER as our blueprint will ensure integration of our training program into all aspects of our hospital system. This not only ensures that our trainees develop a broad understanding of all stakeholders in the health system; but it also ensures that all of those stakeholders fully understand the perspectives that are important to the next generation of physicians. This ultimately will help us to develop a first-class training program, while also continuously improving patient care.

The months leading up to the arrival of our first class of residents will largely involve developing the infrastructure and relationships necessary for integration and cultural transformation via CLER. So what exactly does CLER involve?

There are six ‘Focus Areas’ of CLER, and each have a number of ‘Pathways’ within the focus area. These are essentially the standards that help ensure appropriate integration of training programs into health systems. We have formed a committee for each of these Focus Areas that will be led by one of our faculty members, but supported by representatives from clinical, administrative, and academic members of our health system. The six Focus Areas, a brief description (adapted from CLER Pathways to Excellence Version 2.0), and the committee chair are as follows:

1. Patient Safety (Chair: Seger Morris, DO) – The optimal clinical learning environment continually provides experiences that trainees need to engage with the clinical site’s efforts to address patient safety.
2. Health Care Quality (Chair: Seger Morris, DO) – The optimal clinical learning environment provides experiential and interprofessional training in all phases of quality improvement aligned with the quality goals of the clinical site.
3. Teaming (Chair: Sam Harris, MD) – The optimal clinical learning environment supports high-performance teaming. The concept of teaming recognizes the dynamic and fluid nature of the many individuals of the clinical care team that come together in the course of providing patient care to achieve a common vision and goals.
4. Supervision (Chair: David Duddleston, MD) – The optimal clinical learning environment provides all members of the clinical care team and patients with mechanisms to raise supervision concerns and continuously monitors trainee supervision to implement actions that enhance patient safety.
5. Well-being (Chair: Sumner Abraham, MD) – The optimal clinical learning environment is engaged in systematic and institutional strategies and processes to cultivate and sustain the well-being of both its patients and its clinical care team.
6. Professionalism (Chair: Shayan Butt, MD) – The optimal clinical learning environment recognizes that attitudes, beliefs, and skills related to professionalism directly impact the quality and safety of patient care.

Our CLER committee is Chaired by Seger Morris, DO, and Jacob Whelan, MD, is Vice Chair supporting the Teaming, Supervision, Well-being, and Professionalism Focus Areas).

Return to list