Accreditation. Regulation. Continuing education. Privileging. These are loaded words in the healthcare-provider lexicon and can mean the difference between a caregiver who’s able to step into a situation and provide care, or one who cannot and must seek assistance from other personnel.
“Resuscitation training, in particular, is a space where many of these terms collide,” says Dr. David Markenson, Chief Medical Officer for the American Red Cross Training Services and Medical Director at the New York Medical College Center for Disease Medicine, which he co-founded in 2005.
“When people look at continuing education or initial education programs, they often are relating to issues around accreditation and regulation,” Dr. Markenson explains. “One of the perceptions that's out there is that CMS, the Centers for Medicaid and Medicare Services, requires specific resuscitation courses. There's also a belief that one needs specific resuscitation courses to meet Joint Commission requirements. The answer to that is most healthcare institutions requires evidence-based education and resuscitation, but they do not require a specific program.”
Credentialing needed, but program choice allows for educational options
While providers have the responsibility to offer an evidence-based resuscitation training program, they also are given the freedom to choose a program whose educational scope and delivery method suits their needs. This latitude of choice involves the ability to choose from a wide variety of offerings, some of which may wind up not meeting organizational end goals. It’s here that credentialing and privileging should be seen for what they are, notes Dr. Markenson, who also is a pediatric emergency medicine and pediatric critical care physician, as well as being internationally recognized as a pioneer and leader in disaster medicine, health system preparedness and education, public health preparedness, and operational medicine.
“I often get asked about credentialing and privileging for physicians and advanced-practice professionals,” he says. “People often use [those terms] interchangeably, and they're actually not. Credentialing, for those who don't know, is the process of validating credentials. The credentialing process is usually a binary—you have them or you don't. Credentialing for a physician would usually involve [elements such as] graduating medical school, having a board certification, and being licensed in [a particular] state.”
Then, he adds, “Once you get past the credentialing phase as a physician, you enter privileging, which says, ‘OK. We buy that you're a doctor. We buy that you're boarded in emergency medicine. Now, what procedures and care are we going to allow you to do within the laws of our healthcare institutions?’ That's privileging.”
A huge difference between the two? Credentialing seldom requires a resuscitation course, and sometimes privileging does. In many cases, a facility will accept a certification from a resuscitation course as proof the provider is competent and will extend resuscitation privileges accordingly. That facility may or may not specify a particular resuscitation course—the accrediting bodies don’t require them to. Most choose courses that they feel are broad, meet the evidence, and show competency. And that list may or may not include resuscitation training.
“Credentialing privilege is often designed to meet the needs of the CMS, Joint Commission, and state laws,” Dr. Markenson says. “None of those things actually specify resuscitation or specific resuscitation courses.”
A better approach would be for hospitals to get out ahead of the curve and require criteria that a course with cognitive learning, psychomotor learning, and cognitive psychomotor evaluation in person, and that integrates a team building in person, all elements that are found in the American Red Cross Resuscitation Suite, he points out.
“What we're finding is hospitals that narrowed their wording in guidelines and policies to shut out online courses that weren't meeting their quality needs, the Red Cross resuscitation program and all the elements involved meet their requirements completely.”
Learn more about the American Red Cross Resuscitation Suite ™ for BLS, ALS and PALS.
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