Initiating a CE Program: Strategies for Achieving Stakeholder Buy-In

By Sarah Meadows, MS, FACEHP, CHCP; Lynne Briggs; Maria Moreira, MD, FACEP

Developing a continuing education (CE) activity is an exciting but time consuming process: conducting a needs assessment, identifying educational gaps, engaging activity stakeholders, securing funding, developing an outcomes assessment plan and more. So, when tasked with developing a CE program for our hospital, we had to take a step back from activity development and take a 30,000-foot view. We found challenges, opportunities and successes along the way, ultimately resulting in an accredited continuing medical education (CME) provider designation and meaningful collaborations with other areas of the hospital who are delivering education to clinician learners.

Understand the Baseline

One of the crucial lessons from our years of developing performance and quality improvement initiatives is the importance of understanding the landscape. Denver Health is a large academic safety-net system spanning a general hospital and dozens of community-based clinics, which serve a third of Denver’s population annually. To serve Denver Health’s more than 7,000 employees, our Office of Education has grown quickly over the past four years to support education along a continuum of pre-health (high school and college students interested in healthcare careers) to interprofessional students, residents and fellows, to practicing clinicians with continuing professional development needs. Looking over these diverse training experiences, we sought to understand: What CE currently takes place? Who are our partners for delivering CE? What CE is not taking place but is of interest? How important is certified CE to our healthcare providers?

In 2018, we administered a survey to educators and learners from multiple health professions, which yielded 568 responses from clinical areas across our hospital, community-based health centers and school-based clinics. The results were informative about clinicians engagement in CE, the importance of receiving credit for continuing education and the likelihood of respondents seeking certification for new or existing educational activities (see Table 1). The robust response rate was also a positive indicator of respondents’ interest in what and how education is delivered at our hospital. Although Colorado does not have state-required CE for physicians or nurses, healthcare providers have various institution-specific and Board requirements that can be met through accredited CE activity completion, which was important to our survey respondents. This baseline data was crucial for determining an interest and a need that we could message to hospital leadership.

Table 1

Denver Health (DH) CE Survey Results

Primary way of participating in CE (n=567)*

Importance of CE certified for credit (n=567)

Likelihood of seeking activity certification (n=566)

Online: 63%

Extremely: 51%

Extremely: 28%

In-person at DH: 55%

Very: 28%

Very: 36%

In-person outside DH: 51%

Somewhat: 13%

Somewhat: 29%

Journal: 27%

Not so important: 6%

Not very likely: 6%

Other: 9%

Not at all: 3%

Not at all: 2%

*Survey participants could indicate more than one response

Define and Align Priorities

Education is at the center of Denver’s Health’s institutional strategic plan. By charter, our institution’s priorities include undertaking education, clinical care and research to drive operational excellence, community and academic engagement, growth initiatives, and quality, safety and service. These priorities provided a foundational education framework for us to align CE as an approach to meeting workforce needs. Once the alignment to institutional priorities was established, we were able to show clinicians and department leaders that many of the educational activities they were already participating in could be certified for CE credit. By creating a central CE program for the hospital, we could support departments to develop best practice CE activities that met the needs of accrediting bodies.

Identify the Right Collaborators

A small team can initiate a change, but to achieve that change within a large organization, a small team needs to be joined by a large crowd. Building a committed crowd requires knowing the stakeholders at multiple levels: Who can advocate for the change, where the information should be messaged and how we can demonstrate early success. We met with healthcare providers and staff in departments who were already developing CE activities with outside partners and identified champions to drive our change message. We created a report detailing our baseline findings and offered several options for providing certified CE activities at Denver Health, including benefits and challenges of each approach. These were diagramed to show how each could deliver CE both in the short term as well as into the future for sustainability. To demonstrate success, our Office of Education partnered with a local accredited CE provider to jointly provide educational activities in the short term. We selected a joint provider with extensive CE activity development knowledge and experience, and one who would actively work with us to achieve our long-term CE goals.

With hospital leadership buy-in, we determined our best approach was applying for CME accreditation through our state medical society, maintaining the continuing nursing education accreditation managed by our nursing department, and building meaningful partnerships with nursing and other areas of the hospital who were delivering CE. We began forming those partnerships by bringing the different groups to the table in a new CE Committee. The Committee contributes innovative ideas for developing interprofessional CE activities that meet the needs of our learners and ensures alignment with our educational and overall institutional mission and vision. With stakeholder buy-in at multiple levels and areas across the institution, we were able to initiate a centralized CE program to serve the needs of our hospital workforce.


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