This toolkit is a roadmap to help hospitals achieve a successful visit from the Residency Review Committee and full accreditation from the Accreditation Council for Graduate Medical Education. This Solution focuses on Graduate Medical Education, ACGME Accreditation Residency and Fellowship Programs. Duke Medicine offers documented experience; provides an objective outside-party to review program/institution performance and a concrete roadmap to achieve compliance.

The RRC Site Visit Preparation Toolkit contains the following components:
- Top 11 Tips to a Successful Site Visit
- ACGME Required Evaluation
- Recommended Trainee File Contents, Graduate Survey Sample, and Duty Hour Quiz
- Annual Program Review and Improvement Plan Template
- Common PIF Question Responses
- In-depth Countdown to Site Visit
- GME Resources, Glossary and References
- One hour Consultation with Solution Champion*
*Additional support/consultation is available for a fee.

Below you will find a series of questions and answers that will guide you through the objectives, implementation, and outcomes.

Duke University Hospital's RRC Site Visit Preparation Toolkit is a roadmap to help hospitals achieve a successful visit from the Residency Review Committee and full accreditation from the Accreditation Council for Graduate Medical Education. This Solution focuses on Graduate Medical Education, ACGME Accreditation, Residency and Fellowship Programs. The Solution provider offers documented experience; provides an objective outside-party to review program/institution performance and a concrete roadmap to achieve compliance.

What are the goals of the Solution?
Goal: to become familiar with factors and processes used in GME accreditation.

Key objectives:
- Review key accreditation criteria
- Identify key ACGME required documents
- Plan the site visit countdown
- Prepare a perfect PIF
- Outline 11 tips to the successful site visit
- Assist all stakeholders in understanding their role
- Engage in continuous program assessment and educational quality improvement

Why is this Solution desirable?
This toolkit will enhance users' ability to achieve a successful site visit from a team with documented experience; provide an objective outside party to review program/institution performance and a concrete roadmap to achieve compliance.

What impact does this Solution have?
This toolkit results in the involvement of key GME people and positive experience for stakeholders. Successful accreditation with 4-5 year cycle and minimal citations. Action plan to address citations given by ACGME IRC and RRCs.

How was the Solution developed?
The toolkit was developed by Duke University Hospital's centralized GME office responsible for 75 ACGME and 60 internally sponsored programs. Knowledgeable and committed GME leadership organize institution wide requirements for preparing for site visit and provide support in a variety of ways to meet individualized programs in an effective and efficient manner.

Support for site visit preparation includes individual program consultation, templates, checklists, review of PIF, trainee files, policies, formal presentation to stakeholders, review of site visit experience and ACGME findings.

Are there any organizational considerations?
The central GME office requires being involved in some of the site visit preparation for each program. Additional support/resources are available to individual programs (stakeholders) in the form of consultation, templates, sample policies, explanation of requirements, workshops.

How do you measure success?
ACGME accredits institutions and most programs for a maximum of 5 years. The Duke University Hospital GME Programs' averages compare favorably to this goal.

Duke GME Programs feel supported in the process and ultimately use it as a way to improve their programs.

What are the resources, staffing and skills needed to successfully implement this Solution?
Committed program director and administrative support. Organizational climate which fosters graduate medical education.

Any advice for getting started with this Solution?
Sufficient funded protected time (for those providing support and individual program personnel preparing for site) to fulfill ACGME required functions.

Engaged interested dedicated participants (stakeholders) – program directors, faculty, coordinators/staff, residents/fellows. 

Knowledgeable key faculty and administrative leaders to facilitate.

Buy-in from leadership to encourage and support participation.

What successes has Duke University Hospital had with this toolkit?
DUH has had close to five year cycles with minimum deficiencies and utilizes the process to identify opportunities for improvement.

Programs report feeling supported and recognized the process as a meaningful one.

Best practices are shared and providing support at the institutional level across programs proves to be effective and efficient.

Any advice for sustaining  the success of this Solution?
Institutional understanding and appreciation for ACGME requirements.

Willingness to gather and utilize feedback from stakeholder. Programs must be included in identifying needs, challenges and the best way to offer support.

Familiarity with numerous models which can address frequent If not constant change in the accreditation environment. 

Ability to collect and share best practices and a willingness to share between and across programs.

Collaboration and sharing of best practices makes it easier to sustain momentum and morale.