Development, Testing, and Implementation of the ACGME Clinical Learning Environment Review (CLER) Program.

Area of Science:

• Graduate Medical Education
• Patient Safety
• Healthcare Quality Improvement

Background:

• Following the Institute of Medicine's report on resident hours and patient safety, there's a need for enhanced institutional oversight.
• Teaching hospitals face increasing scrutiny regarding the quality and safety of patient care.

Purpose of the Study:

• To introduce the Clinical Learning Environment Review (CLER) program by the ACGME.
• To promote patient safety and quality of care within teaching hospitals.
• To assess six critical areas within the clinical learning environment.

Main Methods:

• The ACGME will implement the CLER program over 18 months.
• Site visits will be conducted at approximately 400 clinical sites.
• The program focuses on six key areas: resident engagement in patient safety, quality improvement, care transitions, supervision, duty hours, fatigue management, and professionalism.

Main Results:

• The CLER program aims to understand how the learning environment addresses safety and quality.
• It will generate baseline data on current practices in accredited institutions.
• This initiative impacts 116,000 current residents and fellows.

Conclusions:

• The CLER program is expected to provide formative feedback to teaching institutions.
• It will generate national data to guide performance improvement in graduate medical education.
• This program represents a significant step in enhancing the quality and safety of care provided by future physicians.