What's important -- and not -- in QM
What’s important and not in QM
QMs gauge their profession
Have you ever taken an exam that included irrelevant questions or left out others that should have been there? Every three years, before the next applicable Certified Professional in Healthcare Quality (CPHQ) examination is written, the Healthcare Quality Certification Board (HQCB) in San Gabriel, CA, asks health care quality professionals for their input on what’s important in their field. Each test question that appears on the exam is directly linked to one of the tasks deemed significant. Maybe you were one of the 3,000 participants in this year’s role-delineation study. The results of the job analysis surveys distributed last February to a random sampling of quality professionals are being tabulated now and will affect the 1998 examination.
"We try to reach a good sample of people working in the quality field," says Jan Maronde, RN, CPHQ, Executive Director of HQCB, "not just CPHQs or NAHQ members. We ask that they have a minimum of one year of experience in the field to respond to the survey."
What the QM professional needs to know
There are 100 tasks covered on this year’s November exam. Of the 140 tasks on the job analysis survey, responders’ ratings resulted in the elimination of 34, so 106 tasks will be covered on the 1998 exam. Of the six tasks that will be added, half are in the case management category. No tasks were eliminated in the categories of information management or education. "The message we get from the data is that the areas of case management, information management, and training are important to people in our field at the moment," says Maronde.
A detailed report on the survey’s findings will be available to the public by the end of September. Some findings will be posted as well at HQCB’s website, http://www.cphq-hqcb.org.
"A trend we noticed," continues Maronde, "has to do with demographics of the responders. Slightly more middle and senior management responded this time. Those working in the field are a little more experienced than in years past 25% had five years experience or less; 75% had more than five years. Our recertification statistics indicate that 10% leave the field each year. The stats may mean that a larger percent of people in the field are already certified and that our program is maturing."
The composition of the HQCB, CPHQs, and the membership of the NAHQ is reflective of the demographics of health care quality professionals. While the majority are RNs, individuals with other credentials are significantly represented. A notable proportion of CPHQs includes physicians, attorneys, pharmacists, executives, and others with diverse backgrounds. A demographic change noted by the HQCB over the past two years is a steady decline in numbers of RNs and a corresponding increase in individuals who hold no health care licensure or certification, such as MBAs and PhDs involved in data management and analysis.
Of the 1,063 candidates who took the November 1996 CPHQ examination, 784 passed an overall pass rate of 74%. Seventy-six percent of first-time examinees passed. Of the U.S. physicians who took the exam for the first time, 62.5% passed.
Following questions about demographics, the survey lists 140 tasks that survey takers are asked to rate on a scale of zero to five in terms of significance to their jobs. The tasks are separated into five categories:
• management and leadership strategic, operational, and financial;
• information management design and data collection, statistical analysis, interpretation;
• education, training, and communication;
• performance measurement and improvement planning, implementation, evaluation, integration;
• accreditation and licensure coordinate, apply standards.
The survey taker is asked in an end section how well the CPHQ exam covers important activities performed by the quality professional, and if any were left out.
Health care quality issues, whether they be QI, risk management, or case management concepts, seem to be consistent from country to country. To determine that for sure, a global version of the job analysis survey is in the works. "We recently finished an international pilot," says Maronde. "The only items QM professionals rated as insignificant were, understandably, those on U.S. regulations. There was very little difference otherwise." There are no equivalent certification boards in other countries.
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