Guidelines for Case Conferences

Case conferences include regularly scheduled series or conferences (RSS/RSC) that meet daily, weekly, or monthly for discussion about specific patient management problems to improve the care of patients within an institution. They may be eligible for AMA PRA Category 1 Credit^TM when planned to meet the Updated Accreditation Criteria and MMS accreditation requirements and policies. The series as well as each session of a case conference must be pre-planned and must meet all necessary criteria.

Case conferences such as Cancer Conferences or Tumor Boards are often multidisciplinary, and are planned/presented by the institution's professional staff. The intent is to bring together selected specialists and managing physicians to review data, determine accurate staging of a disease, discuss clinical options including standards of care, map ways to sequence necessary procedures and treatments, recommend a care plan, evaluate outcomes and determine additional options. Cancer Conferences or Tumor Boards provide an opportunity for physicians and their team members to share an understanding of standards in cancer prevention and treatment, new technologies, and available research trials.

Case conferences such as Morbidity and Mortality Conferences are designed to review and evaluate complications and deaths to improve physician performance and patient safety. Their intent is to provide a forum for physicians to learn from complications and errors, to modify behavior and judgment based on previous experiences, and to prevent repetition of errors. M&M conferences are also important to identify systems issues that impact patient care. Cases are selected as the result of unanticipated outcomes, teaching value, potential medical error, and patient safety issues.

Other case conferences may be designed by an institution to coordinate care for complex cases requiring interdisciplinary expertise. To meet MMS accreditation requirements, conferences must analyze patient management issues compared to standards of care, integrated multidisciplinary ideas, and patient safety. Case conferences focused on administrative issues such as number of beds occupied or a review of length of stay are not eligible for AMA PRA Category 1 Credit. Case conferences that assess and evaluate management decisions, review literature, critique outcomes may be appropriate for credit.

An understanding of the Updated Accreditation Criteria and MMS policies for accreditation is required for CME activity planners. It is recommended that the activity planner for case conferences be appointed to serve on the CME committee.

Planning For Case Conferences

1. A case conference series may be reviewed for AMA PRA Category 1 Credit by a CME Committee on a yearly basis when appropriate. Identification of a practice performance gap, description of a learning need, global objectives, and an evaluation plan are required criteria for AMA PRA Category 1 Credit. When a case conference focuses on a specific clinical area, annual global objectives may be appropriate. However, when topics within a case conference vary widely, objectives for each session may be necessary. The CME Committee will determine the appropriateness of specific activity or global objectives.
2. In addition to an overall plan, each session of a case conference must be pre-planned. Cases may be selected for presentation based on complexity, unusual manifestations of the disease, complications, focused review/update or special interest. Case presentations usually include the patient's medical history, clinical findings, diagnostic studies, therapy modalities, research data and other relevant information.
3. A planner or moderator must be designated for each session. That person is responsible for ensuring that selected cases include all relevant information, that appropriate specialists and other healthcare team members are invited to attend, and to lead the discussion. Where possible, including a health science librarian to provide an applicable bibliography will enhance the session.
4. No more than 3 cases or themes illustrated by specific cases may be provided in an hour. The selection of cases must be based on educational needs of the institution's staff. Quality improvement data, review of standards of care, identified problems, and special projects to review care are sources for case selection.
5. Each case conference series or Regularly Scheduled Series (RSS) must implement an evaluation plan to assess outcomes such as the extent to which learning objectives were met and how to improve future sessions. Evaluations may occur periodically or for each session. They must include an assessment of the ways that participants will use new learning in practice.
6. Each session of an RSS must comply with the ACCME Standards for Commercial SupportSM and MMS policies related to activity planning and faculty disclosure of relationships with commercial interests and commercial support. Smaller groups with consistent attendance may choose to provide activity planner and faculty disclosure annually. When attendance varies, faculty disclosure at each session is required.
7. Case conferences that are awarded AMA PRA Category 1 Credit must use the appropriate designation and accreditation statements on all activity materials.