Maintenance of Certification Program (MOC)

List of MOC Portfolio–Approved Projects

Approved Projects for Physicians/Physician Assistants With a Relationship With Seattle Children’s or Its Affiliates

We are excited to offer opportunities for physicians to learn how to continuously improve the delivery of care to their patients. The following is a list of projects currently approved for ABMS Part 4 MOC credit for physicians (and Category 1 PI-CME credit for physician assistants certified with the National Committee on Certification of Physician Assistants (NCCPA).

Unless otherwise stated, these projects are only available to physicians/physician assistants with a relationship with Seattle Children’s or its affiliates. Contact MOC if you would like to participate in a project, or if you have any questions.

Addressing Suicide Risk in Primary Care to Reduce Youth Suicide

Suicide is a leading cause of death among 10-to-24-year-olds in the United States, and non-fatal suicidal thoughts and behaviors (STB) are prevalent and increase risk of death by suicide. Nearly half of youth who die by suicide contact a primary care provider (PCP) within one month prior to suicide, and national guidelines recommend all medical settings screen for STB. However, lack of infrastructure and training to manage STB within primary care (PC) reduces likelihood of STB screening and leads many patients with any STB to be triaged to the Emergency Department (ED). EDs are an important resource for some youth experiencing STB; however, ED visits can be unnecessary for lower-risk patients. This project aims to address these challenges by developing and evaluating a PC-based screening, triage and intervention pathway for youth with low-moderate STB risk that will be delivered by PC staff and a behavioral health (BH) clinical support team.

Project participants will attend meetings and participate in focus groups to provide initial input to intervention design, review prototype workflow and provide feedback; as well as attending clinical training on adapted intervention to be used in the pilot phase, etc.

Caring for Gender Diverse Youth – A Project ECHO (Series I & II)

2022 Best Project (Project ECHO Series I) 

Gender diverse patients face significant barriers to receiving adequate healthcare, including having negative experiences in the healthcare setting. In a survey of gender diverse adults, 33% of those who saw a healthcare provider in the past year reported having at least one negative experience related to being transgender, with higher rates for people of color and people with disabilities. 23% of respondents did not see a doctor when they needed to because of fear of being mistreated as a transgender person. The aim of this project is to increase participant knowledge and self-efficacy regarding best-practice care for gender diverse youth in order to improve the healthcare experiences of gender diverse youth and improve access to gender-affirming care.

Participants will attend at least three workshops – each workshop will include a brief didactic with knowledge assessment, case-based learning with peer feedback, review of self-assessment survey data, and identify and mitigate barriers. They will learn to discuss and respect a patient's gender, to document names and pronouns correctly, and to recognize the attitudes and behaviors they could change.

Code Blue (2023 version)

2021 MOC Project with the Greatest Impact

Performance of high-quality CPR is challenging as a high-acuity, low-frequency event, with significant consequences in terms of patient outcomes. The 2023 version of Code Blue Project aims to improve resuscitation quality at Seattle Children’s by focusing on compliance with best practice measures for in-hospital CPR events in accordance with the American Heart Association and the PALS guideline recommendations.

Participants will perform reviews of CPR (“Code Blue”) events to determine whether best practices were achieved and CPR coach presence was increased, as well as looking at process measures, such as debriefing and effectiveness of crowd control. During these reviews, the project team will identify and mitigate barriers to improvement, engaging physicians in the QI process.

Equity Focused Quality Improvement (EFQI)

QI has the potential to overcome social barriers to health and eliminate disparities in outcomes. The aim of the Equity Focused QI (EFQI) projects is to identify and eliminate inequities operating at multiple levels such as institutional, workforce, patients, family, and community within the SCH system that led to health disparities. Through EFQI coaching and peer-learning, participants will learn the skills (e.g., data display, leading equity discussions, etc.) to focus QI work on overcoming social barriers by improving systems and processes, with the goal to eliminate any identified disparities.

This project is open to QI project owners/teams with a desire to improve EFQI skills. Please contact if you are interested in leading an EFQI project.

Generate And Teach Health Equity Routinely™ (GATHER)

2022 MOC Project with the Greatest Impact

GATHER is an expansion of our Equity, Diversity and Inclusion MOC project with the aim of improving faculty engagement in equity, diversity and inclusion using quality improvement, self-reflection, and peer discussion. Sessions run quarterly starting in October 2021, and are open to all physicians and physician assistants providing care for children at UW and Children’s locations. 

View GATHER MOC Project Curriculum Resources

Improving VLBW Nutrition in Level III-IV NICUS

Nutritional management and outcomes of very low birth weight (VLBW) babies vary across our regional network NICUs. For example, every one of our 4 level III-IV NICUs has a different feeding protocol and 2021 VON weight Z-score at initial discharge ranged -0.43 to -1.18 across these centers. Nutrition and growth are associated with respiratory and neurodevelopmental outcomes for this high-risk population.

This project aims to optimize the growth and nutrition of neonates. Specifically, to improve growth at discharge of VLBW babies in level III-IV NICUs by 10% in 6 months, and identify disparities in nutritional processes/outcomes in VLBW babies in level III-IV NICUs by maternal race/ethnicity, and/or language for care in order to direct additional interventions in the next phase of this project with the goal to reduce them (if any). Participants will develop and/or apply tools and interventions to their practice, attend both regional and site-specific QI meetings to review project data, and reflect on the impact of this initiative on their practice.

Increasing Influenza Vaccination Rates for Ambulatory Clinic Patients

2020 MOC Project with the Greatest Impact

2016 Best Project 

The overall goal of this project is to improve influenza screening rates in ambulatory settings at Seattle Children's through creating standard work. Specifically, this project aims to:

  • Achieve an influenza vaccination rate of 90% for all medically fragile populations (as defined by U.S. News & World Report) seen in our outpatient clinics between October 1 and December 31 each year.
  • Ensure their status is documented in CIS.

Participation in this project is limited to physicians who work at Seattle Children's.

Mitigating Burnout Mindfully

2021 Best Project

Rates of burnout are on the rise for medical professionals, which leads to decreased patient satisfaction, decreased patient safety, and decreased physician and staff well-being. This project aims to reduce burnout by increasing trait mindfulness in physicians and advanced care practitioners. Participants will attend workshops to learn about and recognize various stress responses, develop skills of mindful communication to enhance patient care, collegial relationships, and personal relationships, create a personal toolkit of useful mindfulness techniques, and actively use these methods in at home exercises.

Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN)

Juvenile Idiopathic Arthritis (JIA) requires complex care for inflammatory arthritis. Symptoms may come and go, and flares, which are characterized by inflammation and worsening of symptoms of pain, stiffness, and fatigue. JIA has no cure and the goal of care is to achieve a state of inactive disease or very low disease activity. Undertreated disease can result in permanent disability and chronic pain. Currently, there are variations in how JIA is treated and in outcomes achieved by different treating centers. This project aims to improve the processes of care and outcomes for JIA children and youth, reduce unwarranted variation, so that more patients are able to achieve low or inactive disease and reach their life goals with improved quality of life.

REST is Best in Bronchiolitis

REST is Best in Bronchiolitis aims to improve care for bronchiolitis at Seattle Children’s Hospital and the surrounding community by aligning patient care with the best available evidence, reducing unnecessary variation in care, and helping to ensure that patients get the right care at the right time in the right setting. Specifically, the project aims to decrease the proportion of children aged 1-23 months cared for with bronchiolitis at SCH (within the urgent care clinics, emergency department, and inpatient acute care units) who receive one or more non-recommended tests/treatments (beta-agonists, chest X-rays, and viral panels) by 20% at project completion. Participants will apply tools and interventions to their practice, such as reviewing and editing institutional pathways and order sets; participating in care team huddles to review project goals, care processes and data; engaging parents/families when discussing care decisions, etc.

Seattle Children’s Care Network (SCCN) Antibiotic Stewardship

This project aims to improve the health of children with acute otitis media (AOM) by providing educational interventions for primary care providers specifically related to prescribing first line antibiotics. By October 2023, we will reduce antibiotic prescription duration for pediatric patients in Seattle Children’s Care Network (SCCN) practices who have been diagnosed with otitis media by 10% for all ages and by 25% for children over age 2 years in order to meet recommended AAP guidelines. And by October 2023, we will increase the proportion of providers prescribing amoxicillin vs. other antibiotics by 10% overall as first line antibiotic for pediatric patients (excluding patients who have a documented penicillin allergy).

Project participants will lead or facilitate interventions such as implementing standard templates and order sets, implementing patient education and visual tools regarding antibiotic stewardship at practice site, educating care team at the practice site about the project, reviewing data relative to outcome measures, etc.

SHEEP (Sleep Health: Expectations and Evaluations for Physicians)

2019 Best Project

2017 Best Project

Due to shifts in burden of patient coverage and expectations for 24-hour access, faculty physicians have disrupted sleep habits. This can lead to fatigue, insomnia, and other significant adverse physician and mental health consequences (shift work disorder). Suboptimal physician wellness subsequently can negatively affect patient care and patient safety. It can also lead to poor physician career satisfaction and poor physician retention (loss of physicians to other careers with more traditional work schedules or early retirement). This project aims to educate physicians about sleep disturbances due to atypical shift work and ways to mitigate these deleterious effects ultimately leading to better sleep habits, improved physician health, improved patient care and better physician retention. Participants will attend workshops, implement strategies, complete surveys and diaries, and review data at team meetings.

Washington State Health Improvement Partnership (WACHIP) Cohort-5

Childhood and adolescent vaccination rates remain suboptimal, and vaccine administrations have decreased during the pandemic. Reasons for this are multifactorial, including factors at the level of the patient and family, provider, primary care practice, and community. The aim of this project is to improve child and adolescent vaccination coverage in King County and Washington State. Over a 9-month period, participating clinics will do this by identifying missed vaccination opportunities, implementing improvements, receiving regular data and coaching, and will benefit from participating in a community of clinics working toward the same goals.


Seattle Children’s MOC Program is collaborating with the Washington Chapter of the American Academy of Pediatrics (WCAAP) to spread the learning of GATHER to the statewide community. The learning collaborative will begin in April 2023 and sessions are open to all open to all Washington State pediatric health care providers, including pediatricians, family physicians, and Advanced Practice Providers. Please visit WCAAP webpage for details: