NBCRNA Our Mission To promote patient health and safety through - PDF document

9/30/2011 NBCRNA Our Mission To promote patient health and safety through credentialing programs that support lifelong learning Our Vision To be recognized as the leader in advanced practice nurse credentialing to protect and enhance the value of the CRNA credential CPC | Continued Professional Certification 2 September 2011 1

9/30/2011 Clarification of Roles of NBCRNA vs. AANA • NBCRNA • AANA – Mission is public – Mission is CRNA protection advocacy • Distinction important • Accreditors and regulators require a separation between membership organization and the credentialing body • NBCRNA incorporated to provide the best governance model for nurse anesthesia credentialing. CPC | Continued Professional Certification 4 September 2011 Today’s Agenda • Why change the recertification process now? • What is the proposed CPC Program? • What are the benefits of this new program? • Answers to common questions. • What are the next steps? CPC | Continued Professional Certification 5 September 2011 2

9/30/2011 CPC Why change the recertification process now? Changes in Healthcare Credentialing • Initial certification is only a start • Knowledge at one point in time is no longer enough (robust continuing education is essential) • Mastering competency through evidence-based learning • Professional growth and development must be lifelong and integrated into practice CPC | Continued Professional Certification 7 September 2011 3

9/30/2011 Shift to Continuing Competency Model • An ongoing, dynamic process • Focused on evolving knowledge, skills and technologies • Continuous education, mastery and assessment throughout your career • Allows for quick response to changing trends in the healthcare landscape CPC | Continued Professional Certification 8 September 2011 Shift to Continuing Competence Typical methods used by other credentialing organizations to ensure Continuing Professional Competence: • self-assessments • continuing practice • peer/supervisory review • performance reviews • examination • portfolios • high quality continuing • evidence-based practice education with end-of- competency modules course assessments CPC | Continued Professional Certification 9 September 2011 4

9/30/2011 Shift to Continuing Competency • Credentialing organizations and other advanced practice nursing professions have made the change • 73% of ABNS organizations accept testing for recertification • Anesthesiologists have made the shift to Maintenance of Certification CPC | Continued Professional Certification 10 September 2011 Evidence Supporting Change • Physician certification processes that include testing are significantly correlated with superior patient outcomes – Sharp LK, Bashook PG, Lipsky MS, Horowitz SD, Miller SH. “Specialty Board certification and clinical outcomes: the missing link.” Academic medicine 2002: 77(6) 534-542. • Self-assessment of performance correlates poorly with a provider’s actual competence – Kruger J, Dunning D. “Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessment.” Journal of Personality and Social Psychology . 1999; 77(6) 1121-1134. 5

9/30/2011 Evidence Supporting Change • Health care agencies should not rely solely on continuing education to maintain competency – Swankin D, LeBuhn RA, Morrison R. “Implementing continuing competency requirements for health care practitioners.” 2006. AARP Public Policy Institute, Washington DC . • Periodic demonstration of knowledge, skills and judgment are critical to public safety – Institute of Medicine “Crossing the Quality Chasm: A New Health Care System for the 21 st Century.” Washington DC: National Academy Press. 2001. CPC | Continued Professional Certification 13 September 2011 Evidence Supporting Change • Increased formal education and training leads to improved test scores – Brennan TA, et al. The role of physician specialty board certification status in the quality movement. JAMA , 2004; 292(9):1038-1043. • All health care provider organizations should have periodic provider recertification with measurable demonstration of continuing competency. Testing is one method of a measurable assessment of knowledge. – Kan N, Burkhalter B, Cooper M. Measuring the competence of health care providers. Operations research issue paper, Vol 2 Bethesda MD. US Agency for International Development (USAID) by the Quality Assurance Project (QA) 2001. CPC | Continued Professional Certification 14 September 2011 6

9/30/2011 Comparison with Anesthesia Providers Component Anesthesiology Nurse Anesthetist Anesthesiologist Assistant Frequency 2 years 2 years 10 years Licensure No RN and or APRN Medical doctor CE 40 hours 40 hours 350 hours Examinations Continuing No Maintenance of Demonstration of Certification Competence every 6 Assessment years (year 7 – 10) Practice No 850 hours Yes with case evaluation and simulation CPC | Continued Professional Certification 15 September 2011 Comparison with APN Component Nurse Certified Nurse Nurse Nurse Anesthetist Midwife Practitioner Practitioner (AANP) (NCC) Frequency 2 years 5 years 5 years 5 years Licensure YES YES YES YES CE 40 hours 20 hours and 3 self 75 hours 15-50 hours learning modules (18 - 20 CE per module) Examination No Proposed in 5 years: Optional: Specialty Performance in Computer based Assessment Practice and Standard exam or CE + Evaluation 125 Cognitive Assessment practice questions in core competencies Practice 850 hours No 1000 hours No CPC | Continued Professional Certification 16 September 2011 7

9/30/2011 Consumer Expectations • Consumers expect that healthcare providers are competent throughout their professional careers • Consumers believe that professional regulatory bodies ensure licensees’ competency • 52% believe being licensed means periodic evaluation and assessment • 95% believe healthcare professionals should be required to show up-to-date knowledge as a condition of re-licensure Source: Citizen Advocacy Center, 2007. CPC | Continued Professional Certification 17 September 2011 Consumer Expectations • 90% believe it is important for healthcare professionals to be periodically re-evaluated • 84% believe healthcare professionals should be evaluated on their qualifications • 78% believe healthcare professionals should be required to pass a written test of medical knowledge at least every five years Source: Citizen Advocacy Center, 2007 CPC | Continued Professional Certification 18 September 2011 8

9/30/2011 CPC What is the Proposed Continued Professional Certification (CPC) Program? A new standard for ongoing certification of registered nurse anesthetists The Proposed CPC Program • Replaces NBCRNA’s current recertification program • Addresses ever-evolving changes in the practice of anesthesia • Responds to public, governmental and other stakeholders desire for assurance of ongoing assessment of minimum competence • Focuses on ongoing growth and development of competency throughout your career • Incorporates the latest thinking related to learning and credentialing CPC | Continued Professional Certification 20 September 2011 9

9/30/2011 Background of the Proposed CPC Program • 3 year study of continuing competency models – Included benchmarking study of 331 continuing competency programs • Focus groups at national meetings – Students, practitioners, educators, national and state leaders • Recertification Practice Analysis • Recertification Task Force – Included nurse anesthesia practitioners and educators – Evidenced based review of credentialing literature CPC | Continued Professional Certification 21 September 2011 Information Sharing • Over the past 2 years, the NBCRNA BOD members have provided information at a variety of meetings about upcoming changes to the recertification program – National meetings – State meetings • 30 state meetings • Over 2,000 CRNAs in attendance CPC | Continued Professional Certification 22 September 2011 10

9/30/2011 Proposed Program Components • Recertification cycle every 4 years – 35 continuing education credits per year; some with an assessment component • 15 credits require some type of assessment of learning • 20 credits do not require CPC assessment – Evidence-based self-study on the four core competencies – Work/practice requirement CPC | Continued Professional Certification 23 September 2011 Proposed Program Components • A practice-focused recertification examination every 8 years – Content outline related to the knowledge and CPC skill for everyday practice CPC | Continued Professional Certification 24 September 2011 11

9/30/2011 Four Core Competencies • Airway management techniques • Applied clinical pharmacology • Human physiology and pathophysiology • Anesthesia technology CPC | Continued Professional Certification 25 September 2011 CPC What are the program benefits? 12

9/30/2011 CPC Answers to Some Common Questions Why change if research indicates we are practicing safely? • We agree that as a profession nurse anesthetists provide safe care. However, • The current system does not validate competency or continuing learning – Our goal is to create a more robust program – Demonstration of lifelong learning CPC | Continued Professional Certification 34 September 2011 13