Connecting education to exceptional patient care.

National Initiative IV

Improving Patient Care through Medical Education: A National Initiative of Independent Academic Medical Centers


NI IV: Achieving Mastery of CLER, focused on navigating the ACGME’s new CLER program. The CLER program was designed to evaluate the level of institutional responsibility for the quality and safety of the learning and patient care environment, and NI IV provided teams the training and guidance necessary to a) identify strengths and weaknesses across the six focus areas, b) prioritize areas for improvement, c) outline, streamline and implement improvement strategies, and, d) significantly and measurably advance the institutional level of preparedness.

The overall structure of NI IV had three compliments: monthly teleconferences, monthly assignments, and four live meetings. Monthly team teleconference groups were structured by area (Patient Safety, Quality Improvement, Transitions of Care, Supervision, Fatigue Management, or Professionalism), with cross pollination and sharing of best practices across all six areas occurring at the on-site meetings. Institutions that had already experienced a CLER visit were spread throughout the teleconference groups so their experience reaches a wide audience. The AIAMC has developed a repository of critical information from institutions with CLER site visit experience (key learnings, surprises, ‘insider’ tips, etc.), which will be updated regularly and shared with all participants. On-site meeting sessions addressed, among other things: how to prepare for a visit and how to better engage the c-suite.


The focus of NI IV was the ACGME’s CLER Program. We recognized that institutions were not equipped to successfully develop and maintain a clinical learning environment that optimizes the principles outlined in the six focus areas. The AIAMC’s six years’ experience with three successful National Initiatives provided a rich and unique resource to the GME community.

Goals & Outcomes for NI IV included:

  • Identify strengths and weaknesses across the six focus areas
  • Prioritize areas for improvement
  • Engage the C-Suite in quality & patient safety
  • Outline, streamline and implement improvement strategies
  • Significantly and measurably advance the institution’s clinical learning environment
  • Participate in a collaborative national effort to identify and share best practices
  • Author one or more manuscripts at the conclusion of the Initiative


Meetings: Four meetings were planned as followed:

  • October 4 – 5, 2013 Hyatt Magnificent Mile     Chicago, IL
  • March 29 – 30, 2014   Rancho Bernardo Inn   San Diego, CA*
  • October 17 – 18, 2014   Omni Ft. Worth Ft. Worth, TX
  • March 28 – 29, 2015   Loews New Orleans   New Orleans, LA*