Ask the expert: What is the best way to tackle Attachments 1 and 2 on the IRD?

Residency Program Insider, November 24, 2009

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The institutional review document (IRD) is the equivalent of the program information form during an institutional review.Attachments 1 and 2 ask about program-specific citations The IRD requests that the institution supply information of program-specific citations on Attachment I of the IRD. Documentation includes citation categories that every program sponsored by the institution has received.

The Attachment 1 form, included at the end of IRD—Part II, is designed to list program-specific citations organized into six categories. The IRD Attachment 1 citation category document represents specific program citations that require tighter oversight by the sponsoring institution and areas that the DIO and GMEC must focus on to meet ACGME compliance. During the institutional review, the ACGME field staff will assess actions taken by the sponsoring institution and programs to resolve listed citations.

Attachment 2 must contain the actions taken to address citations received on the most recent program site visit. The response must be placed in categories demonstrated on Attachment I. The sponsoring institution and program must demonstrate a collaborative effort to correct citations and show how the results of the corrective action will be measured. Program-specific citations and corrective action may be reported in several formats. The key point is to keep information concise and organized by citation category.

Take the following steps to prepare Attachments 1 and 2:

  • Review program RRC letters to assess citations from the most recent program revie.
  • Document the programs adjacent to the appropriate citation categories listed as represented on Attachment 1
  • Have the DIO and GMEC review and make recommendations to programs regarding corrective actions for the program citations if not already resolved since the last RRC review
  • Assess programs for resolution of citations.
  • Describe the sponsoring institution’s and program’s action in addressing corrective actions for program citations (Attachment 2)
  • List the outcome measures (Attachment 2)

This week’s question and answer are from Insider’s Guide to the ACGME Institutional Review by Josephine R. Fowler, MD, MS, FAAFP, which is now available at a reduced price.

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