CLER findings suggest that if residents and fellows are to learn to improve the health of the populations they serve, they need to be aware of quality goals, such as those set by regulators, payers, and others outside the CLE (e.g., use of universal protocol, reducing central line associated blood stream infections, catheter-associated urinary tract infections, or potentially avoidable 30-day readmissions). They should also learn to critically evaluate their CLE’s own processes of patient care and how those affect patient outcomes.The ACGME defines each CLER focus area in CLER Pathways to Excellence: Expectations for an Optimal Clinical Learning Environment (Executive Summary). Journal of Graduate Medical Education: September 2014, Vol. 6, No. 3, pp. 610-611.
HQ Pathway 1: Education on quality improvement
HQ Pathway 2: Resident/fellow engagement in quality improvement activities
HQ Pathway 3: Residents/fellows receive data on quality metrics
HQ Pathway 4: Resident/fellow engagement in planning for quality improvement
HQ Pathway 5: Resident/fellow and faculty member education on reducing health care disparities
HQ Pathway 6: Resident/fellow engagement in clinical site initiatives to address health care disparities