ACGME Case Log

1. ACGME Case Log ACGME requires RRC assessment of adequacy of patient availability for resident education. Institutional data bases have been inadequate to meet this requirement. Individual resident case logs to replace the data bases were first implemented for surgery They are now being implemented for medical specialties � Neurology as of July 2004 At www.ACGME.org � instructions, examples, help

2. 2004 Neurology Case Log Usage 135 residents from 72 programs Average 57 patients per month (0 � 135) Average 3.5 minutes per patient (2 � 7) After tenth patient Help desk � 47 calls total During first few entries Problems � coding, continuity clinic, cross cover

3. Resident Case Log All data are entered on ACGME web site Resident logs in the patient data with their own password. The program director can review single or total resident data, but cannot change it. Resident should keep record of his/her patients until the information is entered. ACGME software program is available to save patient data for later uploading to the ACGME web site (booth)

4. Case Log Implementation Begin data collection 7/2004 RRC review of case log data 1/2006 Programs reviewed in 2006 7/2004 � 6/2005 data for PGY2-4 Incomplete for continuity clinic Case log fully implemented 1/2008 All data, all years Fully replaces institutional data

5. Case Log: Resident enters Demographics Date of the evaluation Institution Attending physician Clinical setting Year of birth Primary and secondary neurological diagnoses a. e.g., complex partial seizures and migraine headaches b. no more than three per patient. May be entered using a. categories of disease or b. typed in directly. For any patient for whom he/she: a. assumed a significant management responsibility b.important enough to warrant a written note in the chart.

6. Case Log - Inpatient Clinical Setting Consult service Primary service Intensive care listed separately Both junior and senior residents can count same patient Cross covering residents enter patient if patient management was required No other interaction can be counted Any single patient - only once per resident

7. Case Log - Outpatient Clinical Setting Clinic New Patient � entered only once Follow up if new to resident - entered only once Continuity clinic visit � each patient visit Consult Emergency Non-neurology outpatient clinics

8. Case Log - Admitted Patients Admitted from an outpatient setting a. Counted as an outpatient by resident seeing patient in clinic b. Counted as inpatient by admitting resident (if different) c. Counted only as inpatient, if same resident does both