Application Packet

The four documents below are the documents required for submission for MOC credit consideration. 

1. Physician Attestation form needs to be signed by every member of the QI project. It attests to their meaningful participation in the QI project. This will need to be submitted via email.
2. Physician Attestation Project Leader needs only to be filled out by the leader of the QI project. It will require a list of names of all the meaningful participants of the QI so the committee can ensure that all members have sent in their specific attestation form.
3. The QI Project Application - This is the application that details out all the metrics and measures that have been done for this QI project. This form does require supplemental documents such as graphs or additional charts.
4. Progress Report QI Application - Sponsors will use this form to submit detailed progress reports of their approved/ongoing QI project every 12 months to the sponsorship committee.

Examples of approved projects

Dear Project Leader,

Thank you so much for volunteering to be a Project Leader!

The American Board of Pediatrics has standards in regards to the quality of the QI project, but also for being a project leader and member of the team. In order for every member of your team to receive MOC points for the QI project, they have to display meaningful participation. Meaningful participation is detailed as:

1. The Pediatrician Must be:
   • Intellectually engaged in planning and executing the project.
   • Participate in implementing the project’s interventions (the changes designed to improve care).
   • Review data in keeping with the project’s measurement plan.
   • Collaborate actively by attending team meetings, whether in person or virtually.

Whether or not your members of the QI project have met the meaningful participation guidelines is up to you as the project leader. If you feel like one of your members has not fulfilled the requirements for meaningful participation, they will not be allotted the MOC points awarded for your QI project.

Please do not hesitate to contact our QI committee with any questions you may have during this process. Thank you again for being a Quality Improvement Leader in our community! We look forward to working closely throughout this process.

Sincerely,

LLUCH QI Committee