Maintenance of Certification Program (MOC)
List of MOC Portfolio–Approved Projects
Approved Projects for Physicians 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.
Unless otherwise stated, these projects are only available to physicians with a relationship with Seattle Children’s or its affiliates.
Abdominal CT Utilization in Pediatric Appendicitis at Community Hospitals
This project focuses on decreasing CT use and increasing ultrasound use in pediatric patients presenting to community hospital emergency departments with appendicitis. Participants will work to implement and disseminate a clinical protocol as well as standard work to reduce equivocal ultrasound reads. Participation in this project is limited to physicians who work at Seattle Children’s, Providence Regional Medical Center – Everett, and Providence St. Peter Hospital - Olympia.
Attending Observations of Resident Handoffs
This project addresses handoff quality for the inpatient rehabilitation service in order to improve overnight and weekend care by on call residents/fellows. Attending physicians will participate in educational sessions on handoffs and the importance of the IPASS style. Participants will then observe handoffs, complete IPASS competency assessment forms, and identify barriers to handoff improvements.
BRUE Implementation Collaborative
Recently, the American Academy of Pediatrics (AAP) published a Clinical Practice Guideline for Brief Resolved Unexplained Events (BRUEs). The BRUE Implementation Collaborative is a partnership with researchers from the Children’s Hospital Association and 15 other children’s hospitals that aims to improve adherence to the recommendations. Participation in this project is limited to physicians who work at participating sites.
Equity, Diversity and Inclusion (EDI)
2018 Best Project
The aim of this MOC project is to improve equity, diversity, and inclusion, and integrate a culture of equitable, diverse, and inclusive practices at Children's. This project builds on the initial Equity, Diversity and Inclusion (EDI) training – a prerequisite for this MOC project. This project offers a unique opportunity for physicians to deepen their understanding of core concepts, reflect on their experience, and implement changes in their own practice.
Improve NICU Admission Temperatures Collaboration
This regional, multidisciplinary collaboration addresses neonatal hypothermia, particularly in very low birth weight (VLBW) babies, which is associated with increased mortality and morbidity. This effort seeks to decrease adverse outcomes from hypothermia in NICU patients by implementing interventions at each NICU site that will improve thermoregulatory management in the first hour after a baby is born. Participation in this project is limited to providers at each of four regional network NICUs: University of Washington, Providence Regional Medical Center – Everett, St. Joseph Medical Center, and Valley Medical Center.
Increasing Influenza Vaccination Rates for Ambulatory Clinic Patients
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.
Introducing Myocardial Strain to Echo Lab
The aim of this project is to improve the quality of assessment of cardiac function by adding an assessment of myocardial strain to echocardiogram reports in long-term survivors of cancer. A strain protocol will be created and implemented, and all echo lab physicians will receive training in myocardial strain and its interpretation. Participants in this project will interpret a set number of studies and submit a subset of these for evaluation in order to create consistency across interpreting physicians. In addition, participants will meet regularly to review data and work as a team to identify strategies for improvement.
King County Health Improvement Partnership (K-CHIP)
The Healthy People 2020 goal for adolescent vaccination coverage is 80%. In Washington State in 2018, the proportion of adolescents who had at least one Tdap (tetanus, diphtheria, and acellular pertussis), at least one MCV (meningococcal conjugate), and were up-to-date on HPV (human papillomavirus vaccine) by their 13th birthday was only 28.1%. In King County, the proportion vaccinated was 32.4%. The aim of this project is to improve vaccination rates of adolescents in King County. Over a 6-month period, clinics will do this by identifying missed opportunities to vaccinate adolescents, implement improvements, receive regular data and coaching, and benefit from participating in a community of clinics working toward the same goals.
Mitigating Burnout Mindfully
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.
PCP Handoff Improvements
The aim of this project is to improve communication with Primary Care Physicians (PCPs) at the time of inpatient discharge from Seattle Children’s Hospital by seeking to increase the quality and number of PCP calls, i.e. “warm” handoffs. Participants gather feedback from PCPs to share with residents and look for areas of improvement in delivering handoffs.
Physician Leadership – Leader Standard Work
Seattle Children's launched a robust program in 2013 to improve the alignment of hospital (administrative) leaders and physician leaders around quality, reliability, and effectiveness of physician leaders through leader standard work (LSW). The effort currently focuses on leadership methods that include safety as a core value, leaders rounding to influence, feedback, performance accountability, and learning/implementing the system for daily improvement. Physician leaders are expected to demonstrate and model safety as a core value, round to influence using feedback, and use error prevention tools to identify and escalate issues. They submit data on these activities every week and attend a series of meetings to evaluate and improve upon their data. Participation in this project is limited to physician leaders at Seattle Children's.
Reach Out and Read – Inpatient Reading Program
Seattle Children's Hospital's participates in the national Reach Out and Read program that provides eligible patients ages 6 months to 5 years with new books at each medical clinic visit. Reach Out and Read builds on the relationship between parents and medical providers to develop critical early reading skills in children while encouraging families to read aloud together. When functioning optimally, the program provides books to all eligible children at every clinical visit. Despite intentions to model this aim and practice, practitioners often fail to distribute books consistently due to concerns about time, forgetting or overlooking established protocols. This project aims to improve adherence to established protocols through coaching and evaluation of the process of getting the books to families. All participants will complete the Reach Out and Read online training program, engage medical teams to improve the rate of book delivery, and identify barriers and ideas for further improvements.
Seattle Children’s Care Network (SCCN) Asthma
Asthma is the most common chronic disease in pediatrics, and one of the leading causes of emergency department and inpatient encounters in pediatrics. The aim of this project is to decrease asthma exacerbations for patients 5-18 years of age in the SCCN by implementing standardized processes and guidelines, developing an asthma education toolkit/library to use across SCCN, and designing data dashboards, benchmarks, and alerts utilizing systems currently in place. All participants will complete an asthma visit workflow current state assessment; implement the use of standard asthma visit workflows, templates, and dashboards; serve as leaders/facilitators in their practice; and review data to evaluate the effect of interventions detailed in the asthma protocol.
SHEEP (Sleep Health: Expectations and Evaluations for Physicians)
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.
2019 UW Medicine Inventor of the Year - Dr. Jim Stout
This award recognizes Spirometry 360 and the impact it has had on improving health care.
The mission of Spirometry 360 is to help clinicians succeed in providing the best respiratory care for their patients, including the use of routine diagnostic spirometry as a vital sign. Spirometry 360 achieves this by employing a variety of online communication technologies to deliver spirometry as a distance-training program.
The Spirometry 360 faculty includes a respiratory therapist and generalist as well as specialist physicians with an interest in respiratory medicine, teaching and improving care. The staff includes technical experts in online training, multimedia and other software production, health education and quality improvement.
Although this project is based at the University of Washington in the Department of Pediatrics, participants from across the United States are welcome. Prior participants include physicians from Vashon, Washington; Wenatchee, Washington; McMinnville, Oregon; Burbank, California; Phoenix, Arizona; and Valhalla, New York.
Time is Brain
Neonates diagnosed with hypoxic-ischemic encephalopathy (HIE) severe enough to require therapeutic hypothermia treatment are at high risk for seizures. For those that develop seizures, a significant percentage display symptoms only detectable through EEG monitoring and do not show physical changes visible to caregivers. The aim of this project is to decrease the time from admission to the NICU to the start of continuous video EEG monitoring in neonates with HIE. Following physician and EEG education, participants in this project will take part in huddles to discuss order and priority of procedures, ensure checklist completion, regularly review data, and reflect on areas for improvement.
Use of Individualized Provider Feedback to Improve Antibiotic Prescribing
As part of the Antimicrobial Stewardship Program, this MOC project aims to optimize inpatient antibiotic prescribing at Seattle Children's. The team plans to achieve this by giving providers direct, personalized information about their antibiotic prescribing and how it can be improved. Participants will work with their division chief to determine which clinical behaviors to track and report, provide in-person education to providers in their division on the clinical behaviors selected, and distribute baseline and post-intervention results.