Pediatrician Maintenance of Certification Using American Board of Pediatrics' Performance Improvement Modules

From 2010 to 2014, pediatricians completed Part 4 Maintenance of Certification (MOC) through practice- or organization-developed quality improvement (QI) activities approved by the American Board of Pediatrics (ABP). Organization-developed activities were online modules, such as the ABP's Performance Improvement Modules (PIMs), through which pediatricians implemented QI strategies in practice and reported quality measures.

Aim 1 was to assess the proportion of pediatricians who completed practice- vs organization-developed QI activities for Part 4 MOC and to test the relationship between activities and pediatrician demographics. Aim 2 was to assess the relationship between PIM completion and improvement in care processes and outcomes as determined by PIM quality measures.

For aim 1, using deidentified demographic data from the ABP, we summarized QI activity completion and performed bivariate testing by pediatrician demographics. For aim 2, using deidentified parent and pediatrician-reported quality measures from the Attention-Deficit/Hyperactivity Disorder (ADHD), Asthma, Hand Hygiene, and Influenza PIMs, we used 2-sample tests of proportions to calculate pre-post changes in quality measures.

For aim 1, of 50,433 pediatricians who completed Part 4 MOC from 2010 to 2014, 22% completed practice-developed and 78% organization-developed activities. More pediatricians completed organization-developed activities, regardless of age, gender, or subspecialty status. The majority (73%) of pediatricians who completed organization-developed activities completed ABP PIMs. For aim 2, PIM completion was associated with improvement on nearly all pediatrician- and parent-reported quality measures.

At the outset of the Part 4 MOC system, pediatricians most commonly completed online, organization-developed activities. Pediatricians and parents reported improvements in care processes and outcomes associated with PIMs, suggesting PIMs can be an effective means of facilitating practice improvement.