Commission on Accreditation for Respiratory Care

1. Commission on Accreditation for Respiratory Care Update on Post-Professional Education (Degree Completion and Advanced Practice Respiratory Therapist (APRT) Kathy Rye, EdD, RRT, FAARC President

2. Presentation Overview • The presenter will: • Describe CoARC activities regarding development of standards for Degree Completion Programs and Advanced Practice for Respiratory Therapists (APRTs); • Describe advantages for seeking voluntary accreditation for APRT and Degree Completion Programs; • Discuss the implications of advanced practice on national credentialing and state licensure. www.coarc.com

3. CoARC Post-Professional Education Committee Update • The Committee charges are: • Develop Accreditation Standards for degree completion (DC) and Advanced Practice Respiratory Therapist (APRT )programs; • Develop and maintain post-professional competencies for DC and APRT programs; • Review DC and APRT program Standards at least every five years and recommend revisions, if any, to the Commission; • Review/evaluate/advise Commission on developments regarding DC and APRT programs; • Work with Accreditation Policies/Standards/Bylaws Committee to develop and review accreditation policy and processes for DC and APRT programs. www.coarc.com

4. CoARC-NBRC-AARC APRT Workgroup Update • Workgroup addressing the following: • Interest in developing APRT programs; • Revisions to draft CoARC APRT Standards; • Meeting with other key stakeholders; • Credentialing examination/certification of competency issues; • Reimbursement issues: • Who will pay? • Licensure issues: • Respiratory Care/Medical Practice Act modification • Physician support www.coarc.com

5. Proposed Definition of an APRT • Advanced practice respiratory therapists (APRTs) function as mid-level providers, who assess patients, develop care plans, order and provide care and evaluate and modify care based on the patient's needs and response to therapy.  The APRT will provide and direct care under the guidance of a supervising physician, often directed by clinical protocols. www.coarc.com

6. Proposed Roles of an APRT • Serve as a physician extender  in both pulmonary medicine and critical care; • Provide access to cost effective, quality care by: • Facilitating implementation of clinical respiratory treatment protocols • Facilitating management and weaning of patients from mechanical ventilation • Improving timeliness, coverage and efficiency of respiratory patient care • Reducing length of stay and hospital readmission • Ensure delivery of best practice of respiratory care which will: • Improve patient clinical outcomes • Improve patient safety • Optimize allocation of respiratory care www.coarc.com

7. Proposed Description of an APRT • APRTs are formally trained to provide diagnostic, therapeutic, critical care and preventive care services, as delegated by a physician. • APRTs work in multiple settings across the health care spectrum including acute (ED or urgent care) and critical care, sub-acute, preventative care, and chronic care and ambulatory care. • Working as members of the health care team, they take medical histories, examine and treat patients, order and interpret laboratory tests and imaging studies, order respiratory care diagnostics and provide acute, critical and chronic care to patients. www.coarc.com

8. Eligibility • Programs with a strong focus on advanced clinical education are eligible for accreditation.   • Sponsors must apply for program accreditation as outlined in CoARC’s Accreditation Policies and Procedures Manual; • All APRT students must be graduates of a CoARC-accredited Entry into Respiratory Care Professional Practice degree program and hold the Registered Respiratory Therapist (RRT) credential prior to entry into the program. All APRT students must be geographically located within the United States for their education. www.coarc.com

9. Purpose of Standards • Outlines the minimum requirements to which an accredited program is accountable. • Used for the development, evaluation, and self-analysis of programs. • Provides the basis on which the CoARC confers or denies program accreditation. www.coarc.com

10. Standard A – Program Administration and Sponsorship • Institutional Accreditation • Consortium • Sponsor Responsibilities • Substantive Changes www.coarc.com

11. Standard B – Institutional and Personnel Resources • Institutional Resources • Key Program Personnel • Program Director • Director of Clinical Education • Medical Director • Instructional Faculty • Administrative and Support Staff • Assessment of Program Resources www.coarc.com

12. Standard C – Program Goals, Outcomes, and Assessment • Statement of Program Goals • Advisory Committee • Student Learning Outcomes • Student Evaluation • Inter-Rater Reliability • Assessment of Program Outcomes • Reporting Program Outcomes • Clinical Site Evaluation www.coarc.com

13. Standard D – Curriculum • Minimum Course Content • Curriculum Review & Revision to Meet Goals • APRT Core Competencies • APRT Professional Practice Competencies • Length of Study • Equivalency • Advanced Clinical Practice www.coarc.com

14. Competency Domains for the APRT • Patient Assessment • Perform history and physical • Order and evaluate laboratory testing (includes cardiopulmonary testing) • Order and evaluate imaging studies • Develop and carry out patient management plans (care plans) • Treat patients in the acute care setting (pneumonia, respiratory failure) • Treat patients in the ambulatory care setting (asthma, COPD) • Provide chronic disease management (cystic fibrosis, asthma, CHF, COPD) • Perform specific tasks and procedures (lines, airway, tests, consults) • Professional characteristics • Professionalism • Communication skills • Inter-professional practice • Practice management (calls, billing, office functions) www.coarc.com

15. Standard E– Fair Practices and Recordkeeping • Disclosure • Public Information on Program Outcomes • Non-discriminatory Practice • Safeguards • Academic Guidance • Student and Program Records www.coarc.com

16. 2015 APRT Standards Timeline • Following March 2014 CoARC Board meeting: • Disseminated a call for comment (with June 10, 2014 deadline) to all communities of interest and outline the procedure for those wishing to provide input on the second draft of the Standards; • Reviewed the data collected from all evaluation sources; • Revised Standards, Evidence of Compliance, and Interpretive Guidelines (incorporated into document); • Recommended revisions to the second draft will be reviewed by Full Board at July 2014 meeting; • Anticipate third draft release for public comment after July 2014; • Anticipate final draft approval of APRT Standards by mid 2015. www.coarc.com

17. Definition of Degree Completion • A degree completion program is an educational program designed specifically to meet the needs of the practicing respiratory therapist with an RRT who, having already completed an accredited respiratory care program with an earned entry into respiratory care professional practice degree is returning to school to obtain a higher degree. • The Degree Completion Standards are designed to recognize the competencies and value-added above and beyond the entry into respiratory care professional practice degree. www.coarc.com

18. Degree Completion vs Entry Into Profession • Degree completion programs are different from entry into respiratory care professional practice programs in purpose, design and content. • Entry into Professional Practice programs prepare individuals with no respiratory care professional background or experience with the competencies needed to enter the profession, whereas degree completion programs expand the depth and breadth of the applied, experiential, and propositional knowledge and skills beyond that of an RRT entering the profession.  www.coarc.com

19. Degree Completion Program Development • Development of an effective degree completion program depends on a thorough assessment of those education experiences typically offered at the entry into respiratory care professional practice degree level. • Degree completion programs include new and advanced, in-depth educational experiences designed to enhance the respiratory therapist's professional practice. www.coarc.com

20. Degree Completion Program Eligibility • Entry into respiratory care professional practice degree programs offering advanced standing to individuals who already have an ASRT or BSRT can apply for optional accreditation of their degree completion program. • Sponsoring institutions offering a free-standing degree completion program can also seek accreditation review. • All degree completion students must be graduates of a CoARC-accredited entry into respiratory care professional practice degree program and hold the RRT credential prior to entry into the program. www.coarc.com

21. Standard 1 – Program Administration and Sponsorship • Institutional Accreditation • Consortium • Sponsor Responsibilities • Substantive Changes www.coarc.com

22. Standard 2 – Institutional and Personnel Resources • Institutional Resources • Key Program Personnel • Program Director • Director of Clinical Education* • Medical Advisor • Instructional Faculty • Administrative Support Staff • Assessment of Program Resources www.coarc.com

23. Standard 3 – Program Goals, Outcomes, and Assessment • Statement of Program Goals • Advisory Committee • Student Learning Outcomes • Assessment of Program Goals • Student Evaluation • Inter-Rater Reliability • Assessment of Program Outcomes • Reporting Program Outcomes • Clinical Site Evaluation

24. Standard 4 – Curriculum • Curriculum Consistent with Program Goals • Curriculum Review & Revision to Meet Goals • Core Competencies • Continued Professional Practice Competencies • Length of Study • Equivalency • Clinical Practice www.coarc.com

25. Standard 5– Fair Practices and Recordkeeping • Disclosure • Public Information on Program Outcomes • Non-discriminatory Practice • Safeguards • Academic Guidance • Student and Program Records www.coarc.com

26. 2015 DA Standards Timeline • Following March 2014 CoARC Board meeting: • Disseminated a call for comment (with June 1, 2014 deadline) to all communities of interest and outline the procedure for those wishing to provide input on the first draft of the Standards; • Revised Standards, Evidence of Compliance, and Interpretive Guidelines (incorporated into document); • Recommended revisions to the first draft will be reviewed by Full Board at July 2014 meeting; • Anticipate second draft release for public comment after July 2014; • Anticipate final draft approval of Standards by mid 2015; • Anticipate accepting applications by mid 2015.

27. Questions and Answers www.coarc.com