JCAHO credential edges toward realization

Graduate Diplomate’ to complement CPHQ

You’ll soon have to decide if you want to go for the new credential, "Diplomate of the Academy," that will be offered by the Academy for Healthcare Quality in a year or so. The Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, plans to pilot-test the academy’s curriculum late next year, then enroll its inaugural class in early 2000. (See the Academy’s timetable, p. 219.)

Bruce Ente, MA, director of educational services development at the Joint Commission, says the Diplomate credential will complement the CPHQ credential offered by the Healthcare Quality Certification Board (HQCB) in San Gabriel, CA. "We don’t envision this exclusively or even primarily as a credential for quality managers or other quality professionals," says Ente. He points out two major differences between the diplomate credential and the CPHQ:

"Unlike CPHQ, the academy will have a formal curriculum," Ente says. An academic curriculum is being assembled by the university partners and will be the "consensus national standardized curriculum on quality leadership, measurement, and improvement."

The academy is not targeted at the quality manager position in terms of target audience or curriculum content. "Ours is a much broader curriculum," Ente says. The Academy curriculum will, like the CPHQ, address the theory and methods of quality improvement and management, but also will look at the full array of hospital organizational and clinical processes to which quality improvement efforts are applied. "Many of the topics will be familiar to people from Joint Commission standards — things that really matter in a hospital." The Academy curriculum also will include issues in the wider health care environment outside a hospital — strategic planning, financial management, legal matters, managed care financing, and delivery.

"Those issues go beyond CPHQ’s reach," says Ente. The health care professionals targeted by the Academy need something more, he says. The Diplomate doesn’t take anything away from the CPHQ designation; it adds to it and enables its graduates to function in today’s changing environment, Ente maintains.

From CEOs to clinicians to department heads

The academy’s curriculum is designed to be applicable to a broad range of health professionals who are involved in planning, managing, measuring, or improving health services and patient outcomes. Candidates could be health care executives — CEOs, CFOs, COOs — hospital department heads, service chiefs, vice presidents for medical affairs, medical records professionals, or clinicians who are interested in moving into management positions. Some candidates could be interested in quality from the purchaser or payer perspective.

"Students could also come from the ranks of HCFA [the Health Care Financing Administra tion] who are responsible for training state agency personnel for Medicare and Medicaid certification surveys," continues Ente. "In addition, the Diplomate credential could raise the bar for consultants."

The Joint Commission has added the University of California at Los Angeles (UCLA) to the roster of its new Academy for Healthcare Quality. UCLA joins Emory University in Atlanta, Northwestern University in Chicago, Ohio State University in Columbus, and the University of Pennsylvania in Philadelphia, all of which will, in collaboration with the Joint Commission, govern, manage, and operate the academy. Catherine Robinson-Walker, MBA, former executive director of the Network for Healthcare Management in Berkeley, CA, is the academy’s first executive director.

Certification utilizes distance learning

The mission of the "university without walls" is to provide contemporary graduate-level education on quality evaluation, measurement, management, and improvement. Methods used will include a combination of face-to-face seminars and state-of-the-art distance learning approaches.

University faculty are actively developing a curriculum that will address issues such as health care environment, organization management and leadership, patient care delivery processes, organization evaluation, and change management. Much of the topical content will relate to Joint Commission standards.

Janet L. Maronde, RN, BS, CPHQ, executive director of HQCB, says "what eventually rolls out remains to be seen," but equates the aca demy with the Institute for Quality, sponsored a number of years ago by the Glenview, IL-based National Associa tion for Healthcare Quality (NAHQ). "What NAHQ found is that not enough people were taking advantage of the Institute to sustain it. The Joint Commission might be more successful in finding people interested in a graduate program."

She says HQCB looked at an advanced credential for higher-level people and found the same thing. "There weren’t sufficient numbers to make it viable over the long term. We want to be there for our certificants 10 and 20 years from now, so the numbers of estimated certificants each year need to be large enough to sustain the program without outside financial assistance.

"From what I have seen, the academy’s curriculum content will be structured around the Joint Commission model. So, from our perspective, it’s not as comprehensive as the CPHQ credential, which focuses on generic QM/CM/UM/RM concepts and applications," says Maronde. The CPHQ program is aimed at the two-year-level QM professional, and the exam allocates 90% to generic QM, which includes many models. Only 10% of the CPHQ exam covers specific standards and regulations.

The program model calls for 160 hours of course work, about three-quarters of which would be done through self-paced distance-learning technologies. Depending on how much time each enrollee wants to spend on the distance-learning component, it would move more quickly or slowly. "Progress also depends on the prior experience of the student," explains Ente. "Someone with a CPHQ, for example, would move more quickly through the program on quality theory and methods than, for example, a nursing unit director."

40 hours of on-site seminars required

If a candidate spent four or five hours a week on the 120-hour distance-learning segment, it would take about six months. That segment would be followed by 40 hours of graduate-level on-site seminars, either at Joint Commission headquarters or at one of the university partners. The on-site course work could be taken in one continuous week or over two to three weekends. The courses might even be offered on a night-school basis over the course of 15 weeks per semester. Choices would depend on the student’s geographic location. The cost of the program is not yet decided, but Ente says it will be priced similarly to comparable-length professional continuing education programs.

The academy will pilot-test its curriculum and distance-learning media next year. The program will first be tested with Joint Commission surveyors, and applications will be accepted for enrollment in 2000. For more information, contact Bruce Ente, director of Educational Services Development at the Joint Commission, (630) 792-5960; e-mail: bente@jcaho.org.