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Credentials help practitioners make sense of the whole
Over 34% of our survey respondents have been in health care twice as long as in QI. In fact, the skills and trade words you use today were probably unheard of when you took your first job. So you've already spent many weekends feverishly writing papers and cramming for exams to learn the tools you use today. Yet, you know the learning can never stop if you want to stay in the game.
To help you maintain perspective on the matter, two QI/TQM readers share their views on learning new skills while re-cycling those that will never be obsolete.
(Please note, as you peruse the graphs presenting pertinent findings from the 1999 Salary Survey, that due to the 6% return rate on the 700 surveys mailed, these data are not projectable to our entire readership nor to the industry as a whole.)
Admittedly, quality specialists are in a bit of a bind, given your disparate backgrounds and the speed of change. Nearly 90% of our survey respondents work between 41 to 60 hours a week, which leaves precious little time to keep up with the latest.
One of the paradoxes of the job is the need to be conversant with so many knowledge areas while possessing the ability to pull them together into systemwide initiatives.
On an optimistic note, however, Mike Rudolf, director of Improvement Services at VHA East Coast in Berwyn, PA, sees no problem in making a staunch commitment to being a generalist. His recent training includes quality improvement and management. For the past seven years, Rudolf has served as adjunct faculty at Pennsylvania State University. "First and foremost," he advises, "align your personal goals with the organization. And it goes without saying that we have to be lifelong learners. But, that said, we always need generalists who have the ability to see how all the pieces of the organization function as a whole."
Oddly enough, it might even pay not to be the best and the brightest, except in diplomacy and team building. Rudolf says, "It's hard to admit that you can't do everything. But how to do it in a way that makes the system function better — that's the key. As long as you use a collegial approach to seeking help, people won't feel like they get hammered every time you come around."
Last year, Eileen Craig, RN, MSN, CPHQ, capped her nursing credentials with an official quality improvement credential, the Certified Professional in Healthcare Quality or CPHQ. Craig, director of Clinical Risk Management and Nursing Performance Improvement at Our Lady of Lourdes Medical Center in Camden, NJ, says, "It increased my understanding of the global dimension of my job from the risk management elements to the quality improvement end."
She started the transition from clinical nursing into QI in 1992. Much of what she learned along the way, as well as positions she held, are now incorporated into other jobs. Her responsibilities involve integrating all of the functions related to QI. The quality credential "gives me a clearer perspective on how the pieces of the whole picture fit together." The real measure of success in QI, she adds, is whether staff throughout the system view performance improvement as their personal responsibility.
The CPHQ credential is not earned by wimps. Spon-sored by the Glenview, IL-based National Association for Healthcare Quality (NAHQ) (www.nahq. org, (800) 966-9392), the exam was first administered in 1984. Formerly, it tested for recall of material — in other words, if you could memorize, you could probably pass. But today, candidates must show their ability to apply the knowledge by solving case studies. "It was a valuable opportunity for me," Craig recalls, "because it helped me pull together a lot of the knowledge I had acquired through the years. But when I walked out of the exam, I did not think I passed. The questions were so complicated — pretty much like real life!"
Last year, out of the 1,014 candidates who took the exam, 695, or 69%, passed, according to an NAHQ report. Knowledge areas include strategic management, data analysis, leadership, and the basics of managed care. The NAHQ ensures the authenticity of the exam by inviting QI professionals to "sponsor" or submit questions for possible inclusion. Exam content changes annually. "The examiners suggest that candidates meet with people in the field who are working with pieces of the exam material you need to concentrate on," Craig notes.
All told, preparation required a heavy investment of time. Her countdown: Three months prior to the exam, Craig took the two-day review course. At two months, she launched an intensive routine of studying her notes. At three weeks, she identified her knowledge gaps and bore down on them.
How does Craig's investment stack up against the payoffs? Besides the time, the cash outlay amounted to approximately $500 for the NAHQ membership, review course, and exam fee. Her employer covered it as a continuing education (CE) benefit. Maintenance requirements include CE credits every two years. Those can be satisfied by attending NAHQ's annual review courses as well as other approved offerings.
The payoff has been rich in terms of Craig's job mastery and confidence. Her salary has not increased. She notes that the CPHQ credential does give QI job candidates an upper edge. In fact, many employment ads list it as a requirement. There are currently over 7,000 active CPHQs in the United States and overseas.