How often do diplomates need to attest to a Quality Improvement (QI) Activity or complete a Practice Performance Assessment (PPA) module?

Diplomates will need to attest to participating in a QI activity once during the three-year OCC cycle.

I have an active non-time-limited certification. Am I still required to complete a QI Activity?

Although participation in the Osteopathic Continuous Certification (OCC) process is voluntary for diplomates with a non-time-limited certification, there are other requirements such as maintaining an active license and earning the required CME.

If you have a non-time-limited certification and also hold a subspecialty or conjoint certification, you will need to participate in each component of OCC, including Component 4.

What is a QI activity?

QI consists of systematic and continuous actions that lead to measurable improvement in health care services and the status of targeted patient groups. The National Academy of Medicine (formerly the Institute of Medicine) defines quality in health care as a direct correlation between the level of improved health services and the desired health outcomes of individuals and populations. QI activities can be completed within your institution or as part of a national initiative. Attesting to a QI activity will be counted as completion of one PPA module.

What are some examples of QI Activities?

QI activities often fall into two major categories: Process Improvement and Condition Management/Improvement. Although not a comprehensive list of all possible QI activities, the following tables are examples provided to help recognize activities you may already be participating in that may satisfy the OCC Component 4 PPA requirement.

Process Improvement (examples)
Access to care Discharge (planning, documentation, elimination of delays, etc.) Fire prevention (i.e., Fire Safety in the OR)
Hand washing Meaningful Use Attestation for EMR Patient Satisfaction/Patient Experience of Care (PEC)/ Physician Communication Skills (patient surveys, CAHPS, Press Ganey) minimum 20 surveys/patients
Radiation safety (i.e., Image Gently, Image Wisely, etc.) Standardization of patient handovers from the OR to the ICU Telehealth services (i.e., use to expand practice access)
Telemetry (i.e., use and impact) Wound care
Condition Improvement/Management (examples)
Acute myocardial infarction Alcohol use/withdrawal Asthma
Delirium Depression screening Diabetes/glycemic control
DVT/PE/VTE Falls Fetal monitoring
HIV screening Hypertension Infection prevention and control (i.e., compliance with the Joint Commission’s Surgical Care Improvement Activity (SCIP) Core Measure Set; infection control in the laboratory, etc.)
Osteoporosis Pneumonia Tobacco Use
Other activities that may count for PPA credit attestation (examples)
American College or Radiology (ACR) RADPEER CMS Core Measures CMS PQRS Quality Measures
Committee service (participation as a member of an institutional/ departmental QI/clinical quality/ safety review committee – minimum one year service required to receive credit Compliance Control Focused Professional Practice Evaluation (FPPE)
MACRA/Merit-based Incentive Payment System (MIPS) participation Mammography Quality Standards Act (MQSA) Medical Audit or ACT Mammography Accreditation Program (MAP) National Clinical Registry Participation (by submitting data – examples of clinical registries include IRIS (Intelligent Research in Sight); PCMH Sleep Medicine Registry; other national clinical registries as listed on www.nih.gov/health- information/nih-clinical-research-trials-you/list-registries or www.patientregistry.ahrq.gov)
NCQA Patient-Centered Medical Home (PCMH) Recognition Program participation Ongoing Professional Practice Evaluation (OPPE) Patient Safety Organization – participation in an AHRQ-listed PSO (https://pso.ahrq.gov/listed)
Performance Improvement in Pathology (PIP) Prescription Drug Monitoring Program (annual registration) Publications (i.e., publishing an article in a peer-reviewed journal)
Simulation courses *HANDS (Handling All Neonatal Deliveries Safely) Initiative – If you are an OB/GYN who completed Ascension Health’s HANDS Initiative, please follow the Ascension Health internal reporting process. They will report your completion to the AOA for PPA credit.
How do I obtain and submit a QI Activity attestation?

Log on to the AOA Physician Portal to complete and submit the QI Activity attestation form from the OCC Component 4 webpage.

Are there activities that do not count as a QI Activity?

While the following activities are worthwhile, they do not meet the Bureau of Osteopathic Specialists (BOS) standard for Practice Performance Assessment and will not count toward completion of the OCC Component 4 requirement:

  • Attending CME conferences/participating in CME activities
  • Journal Club
  • Participating and/or passing the OCC longitudinal assessment and/or OCC written exam
  • Preceptoring/teaching students and residents
  • Unpublished case studies
What if I am participating in an improvement initiative not in the table above?

The table above is not a comprehensive or all-inclusive list of all possible QI activities. Diplomates are encouraged to attest to and submit any activity that focuses on quality, practice, or process improvement for PPA credit towards the OCC Component 4 requirement.

Can I fill out one form to attest to multiple QI Activities?

An attestation form will need to be completed and submitted separately for each QI Activity. AOBNP diplomates need only to submit one attestation form for each 3-year OCC cycle; however, additional activities may be submitted if desired.

What if I am not currently participating in a QI Activity?

Diplomates must attest to participating in a QI Activity at least once within the current 3-year OCC cycle to meet the Component 4 requirement.

How will the AOBNP verify the QI Activity attestation?

When a QI Activity is submitted by way of the attestation, form a verifier’s information is requested as the diplomate may be subject to a random audit. When a diplomate is selected for audit, the AOBNP will use the contact information provided to verify the diplomate’s participation.

*Please note: If you have documentation of completion of a QI Activity (i.e., a certificate of completion/participation), you may remove yourself from the random audit process by emailing a copy of the documentation directly to the AOBNP and including an explanatory note stating the document should be included with your OCC Component 4 QI Activity attestation submission.

To access the QI Activity attestation form or to view frequently asked questions log on to the AOA Physician Portal.

The portal also allows you to check your status for each of the OCC components.