title: Institutional Oversight of the Graduate Medical Education Enterprise: Development of an Annual Institutional Review.
abstract: BACKGROUND
  The Accreditation Council for Graduate Medical Education (ACGME) fully implemented all aspects of the Next Accreditation System (NAS) on July 1, 2014. In lieu of periodic accreditation site visits of programs and institutions, the NAS requires active, ongoing oversight by the sponsoring institutions (SIs) to maintain accreditation readiness and program quality.
  
  
  METHODS
  The Ochsner Health System Graduate Medical Education Committee (GMEC) has instituted a process that provides a structured, process-driven improvement approach at the program level, using a Program Evaluation Committee to review key performance data and construct an annual program evaluation for each accredited residency. The Ochsner GMEC evaluates the aggregate program data and creates an Annual Institutional Review (AIR) document that provides direction and focus for ongoing program improvement. This descriptive article reviews the 2014 process and various metrics collected and analyzed to demonstrate the program review and institutional oversight provided by the Ochsner graduate medical education (GME) enterprise.
  
  
  RESULTS
  The 2014 AIR provided an overview of performance and quality of the Ochsner GME program for the 2013-2014 academic year with particular attention to program outcomes; resident supervision, responsibilities, evaluation, and compliance with duty-hour standards; results of the ACGME survey of residents and core faculty; and resident participation in patient safety and quality activities and curriculum. The GMEC identified other relevant institutional performance indicators that are incorporated into the AIR and reflect SI engagement in and contribution to program performance at the individual program and institutional levels.
  
  
  CONCLUSIONS
  The Ochsner GME office and its program directors are faced with the ever-increasing challenges of today's healthcare environment as well as escalating institutional and program accreditation requirements. The overall commitment of this SI to advancing our GME enterprise is clearly evident, and the opportunity for continued improvement resulting from institutional oversight is being realized.
authors.affiliation: Office of Graduate Medical Education, Division of Academics, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Amedee
authors.affiliation: Office of Graduate Medical Education, Division of Academics, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Janice C
authors.initials: JC
authors.lastname: Piazza
keywords: Accreditation; education–medical–graduate; internship and residency; program evaluation; quality improvement