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CLER Site Visit

The CLER Program is designed to provide US teaching hospitals, medical centers, health systems, and other clinical settings affiliated with ACGME-accredited Sponsoring Institutions with periodic feedback that addresses the following six areas: patient safety; health care quality; care transitions; supervision; well-being; and professionalism.

To accomplish this, the ACGME conducts CLER site visits to the hospitals, medical centers, and other clinical settings of accredited institutions that sponsor residency and fellowship programs. During these visits, CLER Field Representatives meet with the executive leadership of the organizations; the organization’s leaders in patient safety, health care quality, and well-being; leaders of graduate medical education (GME); and groups of residents and fellows, faculty members, and program directors. Additionally, the CLER team visits various patient floors, units, and service areas to gather input from the broader range of clinical staff members as to how the organization functions as a learning environment.

At the conclusion of each visit, the CLER team meets with the organization’s executive leadership to share its observations of resident and fellow engagement in the six CLER Focus Areas. It is through this feedback that the ACGME seeks to improve both physician education and the quality of patient care within these organizations.

CLER Site Visit Scheduling

The CLER site visits are short-notice visits (no fewer than 10 days’ notice) and the Sponsoring Institution’s designated institutional official (DIO) is the primary contact. The CLER Field Representatives will visit one participating site per Sponsoring Institution. However, the site visitors may elect to go to more than one location at that site, especially if there are ambulatory clinical or specialty facilities within walking distance.

As part of the scheduling process, the Sponsoring Institution will be asked to confirm that both the DIO and the Chief Executive Officer of the participating site will be available to attend required opening and closing meetings. If a visit cannot be confirmed within 24 hours of contact, the Sponsoring Institution will receive a “pass.” The CLER team will make up to four attempts to schedule the visit (total of three passes allowed). Failure to accomplish a CLER site visit within the allotted number of attempts will result in a recommendation to the ACGME Board of Directors to confer upon the Sponsoring Institution the status of Administrative Probation ACGME policy 16.61.

To optimize the success of the scheduling process, three times a year, DIOs have the opportunity to “black out” up to five weeks on the CLER Program calendar via the Accreditation Data System. See below for more information.

Blackout Weeks

Blackout Weeks
Sponsoring Institutions can submit up to five CLER “blackout weeks” annually, requested three times per year via ADS.

Blackout weeks are intended to block scheduling of CLER visits for dates when institutional leadership and staff members are unavailable due to retreats, holidays observed by the institution, local holidays, board meetings, etc.

NOTE: Sponsoring Institutions with a status of Pre-Accreditation or Initial Accreditation will not be contacted to schedule a CLER visit until their status is changed to Continued Accreditation, and do not need to enter blackout requests until this status change occurs.

Process for Submitting Blackout Weeks
Three times a year, designated institutional officials (DIOs) and institutional coordinators can request blackout weeks by logging into ADS and clicking on “Blackout Dates” under “CLER” in the right-hand navigation menu. These windows recur every year on this schedule:

  • November 1-26 to enter requests for January-April
  • March 1-26 to enter requests for May-August
  • July 1-26 to enter requests for September-December

Only the DIO and institutional coordinator have access to this feature in ADS, and users can only to enter up to five weeks per time period.

Additional Information
In 2019, the CLER Program will already avoid scheduling site visits during the following weeks:

  • January 1-4, 2019
  • March 4-8, 2019
  • March 11-15, 2019
  • June 24-28, 2019
  • July 1-5, 2019
  • December 23-27, 2019
  • December 30-January 3, 2020

as well as on the following days (note: visits may still be scheduled during these weeks):

  • Martin Luther King Jr. Day (January 21, 2019)
  • Memorial Day (May 27, 2019)
  • Labor Day (September 2, 2019)
  • Thanksgiving (November 28-29, 2019)

The DIO and CEO of the site being visited must be available to participate in an initial and exit meeting for the CLER visit. When selecting blackout dates, check with the CEO of the clinical site to be visited to identify known dates of unavailability. Also consider any other times when institutional staff members may not be available.

The CLER Program will make every effort to comply with requests, but cannot guarantee that visits will not be scheduled during requested blackout dates.

E-mail questions to

Contact CLER Staff
Director, CLER Site Visit Program
Kristen Ward Hirsch
Senior Vice President, Clinical Learning Environment Review (CLER)
Robin Wagner, RN, MHSA
Other CLER Resources
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