Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

Promoting Excellence Across the Acute Care Continuum: The Kaweah Delta Medical Center CME Program

7/31/2014 11:15:04 PM | 0 comments

By Fred Wu, MHS, PA-C, and Lauren Sheeley, BS

Note: Outside large urban areas, it's not easy for healthcare professionals to find top-notch continuing education close to home. But the experience of the innovative CME program at Kaweah Delta Medical Center (KDMC) in Visalia, Calif., shows that with a little innovation, it can be done.

Two things we especially liked about this program:

  1. It follows a unique, interprofessional approach that brings together disciplines and specialties from across the Acute Care Continuum.
  2. It's jointly administered by KDMC and CEP America, which makes it a great example of collaboration between a hospital and physician group.

The following post was adapted from the poster presented at CEP America's 2013 annual conference.


In 2010, the Kaweah Delta Medical Center (KDMC) Continuing Medical Education (CME) Program was started as a collaborative effort between KDMC and CEP America. Housed within the Department of Emergency Medicine, it started as a single lecture session and now incorporates multiple sessions throughout the year, which include Emergency Medicine Grand Rounds, a Morbidity and Mortality Conference, emergency ultrasound education and other relevant emergency medicine educational programs.

The purpose of the CME program is to provide high-quality education that will improve performance in the emergency department (ED) by incorporating up-to-date literature, discussing controversies in emergency medicine and improving patient safety by utilizing an evidence-based approach to patient care. Measured performance indicators may include patient outcome, decreasing medical-legal risk, ED operations and overall clinical knowledge base.

Our target audiences are providers in the ED; however, because our specialty is broad, other specialties (e.g., pediatrics, surgery, critical care, anesthesia, orthopedics, etc.) may find our sessions relevant to their practice. Because CEP America has a strong presence in the California Central Valley, eight other CEP America client hospitals are invited to our programs as well as physicians from the EM residency programs at Kern Medical Center and UCSF-Fresno. (In addition, KDMC recently started it's own EM residency program, which incorporates some of the CME program material.) Local EMS units are also invited and have been enthusiastic participants.

The foundation of the CME program is Emergency Medicine Grand Rounds. These conferences are held throughout the year based on speaker availability. Some of our speakers are nationally known but also include local CEP America Partners. They are selected for their dynamic teaching styles and as experts in their respective fields. It should also be noted that many of our speakers are nationally/internationally recognized in their specialties and hold faculty positions at prestigious academic institutions.

Topics are identified by suggestions from the ED providers, review of past evaluations or at the discretion of the ED director of CME. The 2011 Model of the Clinical Practice of Emergency Medicine is also utilized to determine the education needs of emergency physicians.


The following list represents just a few of the speakers who have participated in the program. Several have enjoyed the experience so much that they've made multiple visits to KDMC.

** CEP America Partner

Here are just a few of the topics that have been covered in the CME program:

  • A Skeptic's Guide to the Medical Literature
  • When Dying is Your Emergency: Palliative Care in the Emergency Department
  • ED Sedation: Pearls and Pitfalls
  • Creating a Great Place to Work and to Care for Our Patients
  • Penetrating Neck Injuries
  • Mass Transfusion Protocol and Coagulopathy in Trauma
  • Case Studies in Pediatric Toxicology
  • Pediatric Trauma Management
  • Pediatric Respiratory Emergencies
  • The Extended FAST Exam and Ultrasound Guided Vascular Access
  • Alpine Search and Rescue
  • Bedside Tips and Tricks for the Critically Ill Patient
  • Managing Pericardial Tamponade in the Slowly Crashing Patient
  • Subarachnoid Hemorrhage: Pitfalls in the Diagnosis
  • Massive GI Bleeding
  • What's New in Airway Management
  • Abdominal Pain in the Elderly

In its first four years, the program served over 700 participants from a variety of professions and disciplines and awarded nearly 1300 CME hours:

The "other" category includes a significant number of health professions students. "The program has the added benefit of being a great recruiting tool," says program director Fred Wu. "It's a great way for students and other healthcare providers to get to know the hospital and CEP America in a relaxed but professional setting. It's also a great recruiting tool for future resident physicians when they come to our site and see some of the amazing speakers that will be lecturing to them."

Also included in that category are many local EMS personnel. "We reach out to all the agencies in the area when we promote our speakers," Wu says. "We definitely try to make it a benefit for the entire local medical community."

In addition to receiving near-perfect scores from participants, the program gets excellent feedback. "Emergency Medicine Grand Rounds has really gained a reputation across the hospital as a great thing to attend, which is really gratifying to see," says Wu.


The KDMC CME Program, jointly sponsored with CEP America, has provided world-class education to our region. It is a resource shared with the local medical community and highlights our group and hospital as regional leaders in clinical and educational excellence. It is primarily managed by the local CEP America site and promotes our presence within the hospital.

Editor's Note: Since this poster was presented in in 2013, the program has been going strong. At present, KDMC provides CME credit, while Wu and Lauren Sheeley of CEP America promote the program, recruit and host the presenters, manage the physical space and assist participants with the required continuing education paperwork.

About the Authors

Fred Wu, MHS, PA-C, has been with CEP America since 2004. He completed his undergraduate education at The Colorado College and his graduate education at Quinnipiac University, where he graduated with honors. Fred is currently the lead PA and director of CME at Kaweah Delta Medical Center in Visalia, Calif. He also previously served on the CEP America CME Committee. He currently serves on the Board of Directors (vice-president) for the Society of Emergency Medicine Physician Assistants (SEMPA) and also chairs the education committee for SEMPA. Active in EMS for over 20 years, Fred is still involved with EMS education on several levels, including the National Park Service Parkmedic Program through the UCSF-Fresno Emergency Medicine Residency Program.

Lauren Sheely, BS, joined CEP America as an on-site Assistant at Kaweah Delta Medical Center in 2009. In December 2013, Lauren began serving as an On-Site Assistant Lead for the Central Valley region. Lauren holds a bachelor's degree in business administration from the University of Arizona. In her spare time, she enjoys volunteering for Sigma Kappa Sorority, where she works to educate, mentor and train collegiate women. Lauren also loves spending time with her family: eighteen-month-old son Jackson and new baby girl Charlotte.

Kaweah Delta Medical Center, a not-for-profit district hospital, is the largest of three hospitals in Tulare County in California's Central Valley. The emergency department is a Level III trauma receiving facility and also sponsors an off-site Urgent Care Clinic. The hospital is a regional referral center for an array of services, including cardiac services, cancer care, sleep disorders and vascular labs, specialized orthopedics, comprehensive rehabilitation and mental health services. The Cardiac Services Program was named as one of the Top 100 Hospitals for Cardiovascular Services by HCIA-Sachs. To learn more, visit



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