In 2000, the Institute of Medicine published a high-profile critique of the quality of patient care in this country, Crossing the Quality Chasm. In response, the Accreditation Council for Graduate Medical Education (ACGME) mandated that post-medical school physician training programs prove that their residents are competent in six areas of practice.
An existing Robert Wood Johnson Foundation (RWJF) national program, Partnerships for Quality Education, developed a four-week curriculum called Achieving Competence Today (ACT) aimed at teaching medical residents and nursing students two of the six competencies—practice-based learning, and systems-based and quality improvement-based practice. By 2006, some 25 teaching institutions had adopted the ACT curriculum.
Under a subcontract from the Partnerships for Quality Education (PQE) program office, Harvard Pilgrim Health Care, and additional grants from RWJF, from 2006 to 2009, ACT was expanded into a program of its own: Achieving Competency Today. It consisted of two parts:
- A team at the University of Virginia developed a Web-based open-source version of ACT (subcontract).
- Six teaching hospitals already using ACT took steps to further tailor the curriculum to their needs and expand its use within their institutions (grants from RWJF).
The University of Virginia developed a new, interactive website that provides information and sample curricula on how to teach six competencies that have been developed by the Accreditation Council for Graduate Medical Education (ACGME). The Web site also provides resources for the American Association of Colleges of Nursing (AACN) Essentials of Graduate Nursing competencies.
The six participating teaching hospitals were:
- Beth Israel Deaconess Medical Center, Boston
- Christiana Care Health System, Newark, Del.
- University of Pennsylvania Health System, Philadelphia
- University of Cincinnati College of Medicine
- University of Missouri School of Medicine, Columbia
- The Johns Hopkins Hospital, Baltimore
The hospitals adapted, institutionalized and expanded the ACT curriculum at their schools by:
- Making the ACT curriculum a required rotation for their residents.
- Spreading the use of the ACT curriculum beyond the initial audience of residents and nursing students to include pharmacists and nursing staff.
- Adapting the ACT curriculum to the needs of their students and institutions.