Transcript CBIC: Piths, Pearls, and Pitfalls of Measuring Competency

Piths, Pearls, and Pitfalls
of Measuring Competency
Fran Slater Feltovich,
MBA, RN, CIC, CPHQ
CBIC Director
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Pith
The essential or central part of
anything
Essence; gist
Force; strength; vigor
The American Heritage Dictionary
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How does Pith apply to
Measuring Competency?
We must clearly understand the
core components of what we are
trying to measure
We must be able to apply the force
of appropriate measurement
processes
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What is the “pith” of an
effective IPC Program?
A competent ICP
The core
components that
the ICP needs to
know to be
competent
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Competency
What is competency?
The state or quality of being capable to
perform
Why is it important to health care
professionals including ICPs?
Patients’ lives are at stake
Would you consider yourself
competent?
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IOM Report – To Err Is Human
Shined the spotlight on medical
errors including HAI
Opened the eyes of the public
Called for a comprehensive
approach to improving patient
safety
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IOM Report: Health Professionals
Education: A Bridge to Quality
“Health professionals are not
adequately prepared to provide the
highest quality and safest medical care
possible”
Insufficient assessment of ongoing
proficiency
Ensure students and working
professionals develop and maintain
proficiency in 5 core areas.
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IOM Core Competencies Include:
Delivering patient-centered care
Working as part of interdisciplinary
teams
Practicing evidence-based
medicine
Focusing on quality improvement
Using information technology
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Once Is Not Enough
2003 IOM Recommendations:
All health professional boards should
move toward periodic demonstration
of ability to deliver patient care
Certification bodies should require
certificants to maintain competence
by periodically demonstrating the
ability to deliver patient care
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Trickle Down Effect
Public outcry and demand for
changes
JCAHO Patient Safety Goals
Mandatory reporting of HAIs
Future: Mandatory prospective
demonstration of competency???
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CBIC Bylaws Mission
To improve the quality of
healthcare by increasing the
number of professionals
whose knowledge mastery in
infection prevention and
control and applied
epidemiology has been
demonstrated by certification.
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What is the Pith of CBIC
Certification?
The Practice Analysis (PA)
“This process involves a systematic
collection of information that describes
behaviors and activities performed by
occupants of the job in question.”
Goldrick, et al. Practice analysis for infection control and epidemiology in the new
millennium. AJIC 30:8, December 2002
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CBIC PA Purpose:
To determine and comprehensively
describe the functions of the ICP
role
To determine the core functions
that should be assessed in a
certification examination
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CBIC PA, cont.
Email survey to practicing ICPs
Developed by a panel of expert
ICPs
Conducted every 5 years to reflect
changes in practice
Based on North American practice
standards (US & Canada)
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PA Results
Statistically analyzed to determine
core elements that are essential for
an ICP practicing with 2 years
experience
Used to develop the content
outline for the certification exam
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Major Content Categories
I.
II.
III.
IV.
V.
VI.
Identification of Infectious Disease
Processes
Surveillance & Epidemiologic
Investigation
Preventing/Controlling Transmission
of Infectious Agents
Program Management &
Communication
Education and Research
Infection Control Aspects of
Employee Health
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Detailed Content Outline
Example
III. Preventing/Controlling the
Transmission of Infectious Agents
A.
B.
Develop IC policies & procedures
Identify IC strategies:
1.
2.
3.
4.
for handwashing and antisepsis
related to cleaning, disinfection, and
sterilization
for specific in-patient care settings (e.g.,
nursing units, specialty units, respiratory
therapy, operating room
for nonpatient care departments (e.g.,
environmental services, nutritional services)
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Pitfall – trap or danger
Continuing Education
IS NOT
the same as
demonstrating current
competency!
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Changing Healthcare System
Continuing advances
Technology
Treatment
Increasing cost
Decreasing resources
Workforce shortages
Demands
Employers
External regulations
Public
No oversight system to demonstrate
continued knowledge, skills, &
performance
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Is an ICP
certified in
1982
competent to
deal with issues
in today’s HC
system?
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Citizen Advocacy Center (CAC)
Developed Road Map to Continuing
Competency Assurance: “Maintaining and
Improving Health Professional Competence”
“ Assuring the continuing competence of
health care practitioners is an essential
element in any program to improve patient
safety and health care quality”
Final destination is the institutionalization of
meaningful, periodic continuing competency
assessment and assurance for all health care
professionals
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CAC Recommendations
Develop national consensus
definition for competency
Pass state laws requiring periodic
competency assessment tied to
licensure
Use only evidence based programs
Adopt higher standards for
enrollees in CE courses to include
post-testing
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Norcini et al. Medical Education, Sept. 2002, Certifying examination
performance & patient outcomes following acute MI
“Various studies have added
to evidence supporting the
validity of the certifying exam.
These lend support to the
concept that
fund of knowledge
is related to
quality of practice
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Avoiding the Pitfalls
CBIC agrees with the growing body
of evidence that:
Continuing education does NOT
demonstrate competence
Demonstrating competence is an
ongoing process requiring repeat
measurement
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What is CBIC?
Voluntary, autonomous,
multidisciplinary board
Administrators of the certification
process for infection control and
applied epidemiology
Accredited by National Commission
for Certifying Agencies (NCAA)
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Objectives of Certification
Provide a standardized measurement
of current knowledge
Encourage individual growth and
study, promoting professionalism
among ICPs
Formally recognize ICPs who fulfill
the requirements for certification with
the CIC credential
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Pearls – items of great value
CBIC believes a competent
ICP is a pearl of great
value!
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Validity of the CBIC
Examinations
Developed under the guidance of
Applied Measurement Professionals
(AMP)
AMP - an independent testing agency
AMP oversees scoring of the exam
Each test item undergoes both expert
and statistical scrutiny before use
Passing scores are calculated to
compensate for item difficulty &
differences between exams
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NCCA Accreditation
National Commission for Certifying
Agencies (NCCA) is the accrediting
agency for certification programs
Requires the highest standard possible
for certification programs
Assures a valid, reliable, & secure
certification process
is NCCA Accredited
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2005 JCAHO – Standard IC.7.10
The infection control program is
managed effectively.
Note: Qualifications may be met
through ongoing education,
training, experience, and/or
certification (such as offered by the
Certification Board for Infection
[CBIC] in the prevention and
control of infections.
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CBIC requires recertification
by examination
NOT
continuing education!
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Certification Process
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Eligibility for Certification
Minimum of 2 years practice in
infection control with a minimum of
800 hours worked prior to the date
of the examination
Practice requirements may not be
waived
Practice must be current – within 5
yrs
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Eligibility for Certification, cont.
A current license or registration as a
medical technologist, physician, or
registered nurse;
OR
A minimum of a baccalaureate degree
Contact CBIC Executive Office for information
on educational waiver requirements
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Eligibility for Certification, cont.
Candidates who are self-employed
or who work in non-traditional
settings must submit additional
documentation (See Candidate
Handbook for details)
Candidates with lapsed
certification also must meet the
practice requirements
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Initial Certification
Computer Based
Testing (CBT) only
150 questions
Test at any time
World-wide sites
Results:
USA - Available at end of
test
International – sent via
mail
Valid for 5 years
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Eligibility for Recertification
Individuals who are currently
certified are automatically
eligible for recertification
every 5 years.
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Recertification
Required every 5 years to maintain
certification
Two ways to test
CBT
SARE (Self-assessment
Recertification Examination)
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SARE
Similar in content to the CBT with
150 multiple choice items
developed from the Content
Outline
Self-administered (non-proctored)
at a location of one’s choosing
May be taken over a longer period
of time
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SARE
Can be used for:
CIC® re-certification
Study and self assessment
Must have successfully completed
CBT certification to be eligible
Can be taken every 5 years for recertification
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Applying for CBIC Certification
Obtain a Candidate Handbook online at
www.cbic.org
Contains everything you need to
know about the application process
Computer sites may be found online
Special international information
found on online
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Preparing for the Exam
Review current IC reference
books, journals and standards
APIC Text of Infection Control and Epidemiology, Volume 2
2002
APIC Text of Infection Control and Epidemiology, Volume 3
2005
Bailey/Scott’s, Diagnostic Microbiology, 11th ed., 2002
Bennett, JV and Brachman PS. Hospital Infections.
Philadelphia: Lippincott-Raven Publishers. 1998; 4th ed.
Brooks, Kathy, Ready Reference to Microbes, 2002, APIC.
CDC/MMWR Recommendations and Reports, June 29,
2001. Vol. 50 (RR11); 1-42.
CDC/MMWR Recommendations and Reports
Friedman, Candace, Infection Control in Ambulatory Care.
2004.
Heymann, David. Control of Communicable Diseases
Manual. Washington, D.C.: American Public Health
Association. 2005; 18th ed.
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Preparing for the Exam
References, cont .
Lippincott Williams & Wilkins, Designing Clinical Research,
2nd ed., 2001.
Mandell, GL, Bennett JE, Dolin R. Principles and Practice
of Infectious Diseases. New York: Churchill Livingstone.
2000; 5th ed. volume 1
Mayhall, Glen C., MD, Hospital Epidemiology and Infection
Control, 3rd ed., 2004.
Red Book: Report of the Committee on Infectious
Diseases. Elk Grove Village, IL: American Academy of
Pediatrics. 27th ed.(also available on CD ROM 27th ed.,
2006).
Rhinehart E, Friedman MM, APIC INFECTION CONTROL IN
HOME CARE, Maryland: Aspen Publication. 1999.
Taber’s Electronic Medical Dictionary: Cd-Rom, v. 2.0.
Rothrock, Jane C., Alexander’s Care of the Patient in
Surgery, 12th ed., 2003.
Wenzel, RP. Prevention and Control of Nosocomial
Infections. Baltimore: Williams and Wilkins. 1997; 3rd ed.
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Preparing for the Exam, cont.
Solicit support from your local
APIC Chapter.
Form a study group among your
peers
Utilize the content outline
CBIC Online Practice Exam
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Online Practice Exam
Same format as CBT
Consist of 70 questions (many
used on previous exams)
Familiarize you with computerized
testing process
Help assess knowledge level
Cost $50.00
Available at www.cbic.org
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CBIC International Testing
CBT testing now available in many
sites around the world
English only
Eligibility is the same
Results are sent via mail
See International Testing section at
www.cbic.org
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Proper Use of the CIC®
Credential
Only individuals who have
successfully passed the
certification exam and have
maintained current
certification, may use the
CIC® credential.
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CBIC Executive Office
P.O. Box 19554
Lenexa, KS 66285-9954
Voice: 913/599-4174
Fax: 913/599-5340
E-mail: [email protected]
Web site: www.cbic.org
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