Updated 5/2010 Acknowledgements for RSS/Grand Rounds Series 1. Application: All RSS/Grand Rounds Series are required to apply for initial approval by the Intermountain CME Committee. Similarly, all RSS/Grand Rounds Series are required to reapply for approval by the Intermountain CME Committee annually. 2. Activity Content: The course director must ensure that the content for all CME activities is balanced, objective, scientifically rigorous, promotes improvements or quality of healthcare independent of commercialism, and consistent with the Intermountain Healthcare CME Program Mission Statement. Content must include establishment of course goals/learning objectives that are appropriate for the needs of the accredited series and the development of educational methods. 3. Activity Evaluation(s): One activity evaluation per accredited year is required for the accredited RSS/Grand Rounds Series. Intermountain CME will produce and distribute evaluations to participants of a specific activity for completion. Based on the needs of the Intermountain CME office, the coordinator of the series may be asked to collect evaluations and submit to Intermountain CME. Evaluations must assess four elements as follows: a. The extent to which each educational objective is being met. b. The quality of the instructional process. c. The participants’ perception of enhanced professional effectiveness. d. Any commercial bias conveyed by the presentations. 4. CME Statements: CME Statements must be included on all publications (flyers, brochures, and announcements) reflecting the activity is CME accredited. Publications should not display the CME Statements suggesting an activity is CME accredited until the RSS CME Application has been approved by Intermountain CME Committee. CME Statements are as follows: a. Accreditation: Intermountain Healthcare Continuing Medical Education is accredited by Accreditation Council of Continuing Medical Education (ACCME) to provide continuing medical education for physicians. b. Designation: Intermountain Healthcare Continuing Medical Education designates this educational activity for a maximum of (number of credits) AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. c. ADA: Intermountain Healthcare CME fully complies with the legal requirements of the ADA and the rules and regulations thereof. If any participant of this program is in need of accommodation, please do not hesitate to call and/or write to the CME office in order to receive service. A request for accommodation can be made by calling (801) 442-3930. Reasonable prior notice is required. d. Standards for Commercial Support (SCS): Intermountain Healthcare CME adheres to ACCME Standards regarding industry support of continuing medical education, and, disclosure of faculty and commercial sponsor relationships (if any) will be made known at the activity. 5. Disclosures: All speakers/presenters must disclose any relevant financial relationship with regards to the content of their presentation. The ACCME defines a relevant financial relationship as a financial relationship(s) with a commercial interest in any amount occurring within the past 12 months that create(s) a Conflict of Interest (COI). The disclosure form(s) must be completed by all individuals that plan, present, or have influence over the activity prior to the start of the activity to identify if a COI exists. If a COI exists, the method the Course Director or Coordinator will use to resolve should follow the Intermountain Healthcare CME Conflict of Interest policy. Page 1 of 2 Updated 5/2010 6. Honorarium payments: If an honorarium payment is discussed with a speaker/presenter/moderator, the Course Coordinator will notify the Intermountain CME office as soon as possible. The Intermountain CME office will collaborate with the course coordinator and speaker/presenter/moderator to ensure a Letter of Agreement (LOA) is signed prior to the start of the activity. The Intermountain CME office will observe the Intermountain Healthcare CME Honorarium policy. 7. Commercial Support: All commercial support must be requested and disseminated through the Intermountain CME office and will directly follow the Standards for Commercial Support as designated by the ACCME. Series interested in obtaining funding from external sources should contact Intermountain CME office for additional details regarding Educational Grant Account. Industry representatives are not permitted to exhibit at any regularly scheduled series activities. 8. Compliance: The requesting department is responsible to monitor and ensure compliance for each RSS/Grand Rounds activity. The following items are required to be included at every CME accredited activity: topic of activity (title), name of speaker/presenter, speaker/presenter disclosure(s), learning objectives, and CME Statements. 9. Financial Responsibility: Assignment of Financial Responsibility form must be completed and turned in with this signed Acknowledgements for RSS/Grand Rounds Series form. Expenses incurred by this series will be the responsibility of the Department/Course Director according to the signed Assignment of Financial Responsibility form. Intermountain Healthcare Continuing Medical Education office reserves the right to withdraw credit at any time if the requesting department is unable to demonstrate the above stated regulations are being met. I have read, understood, and agreed to comply with the above stated regulations. I recognize that credit provided by the Intermountain Continuing Medical Education office is subject to these regulations and may withdraw credit if these regulations are not appropriately met. ____________________________________ Title of RSS/Grand Rounds Series ____________________________________ Signature of Course Director ____________________________________ Course Director (please print name) ____________________________________ Date Page 2 of 2