ENHANCING PROFESSIONAL DEVELOPMENT THROUGH CERTIFICATION. Ingrid Parry MS, PT Shriners Hospital for Children, Northern California

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1 ENHANCING PROFESSIONAL DEVELOPMENT THROUGH CERTIFICATION Ingrid Parry MS, PT Shriners Hospital for Children, Northern California

2 PATH TO CLINICAL EXCELLENCE

3 OBJECTIVES Discuss the value of specialist certification Describe the models of specialty certification currently available to OTs and PTs Discuss considerations for a Certified Burn Therapist specialty certification (for workshop discussion) Review the results of recent needs assessment survey with current burn therapists

4 THANKS! Katie Cantrill Jon Niszczak Michael Serghiou Derrek Murray Reg Richard

5 PREMISE OF CERTIFICATION The knowledge and experience required to successfully fulfill certification requirements exceed entry-level competency.

6 PURPOSE OF A BURN SPECIALTY CERTIFICATION Recognize Experts through a reliable and valid method Inform Consumer (patient) Health Care Community (referral) Governing bodies (accreditation, verification) Outside agencies (insurance, legal) Promote Excellent care Ongoing development of science and art underlying specialty practice

7 IMPACT OF CERTIFICATION McConnell, 1984 credentials are indicators of what an individual should be able to do and not what they can or will do.

8 DOES CERTIFICATION IMPROVE PERFORMANCE? Ramsey et al ABIM certified MDs v. noncertified MDs Certified physicians scored higher on examination (77.2 v 59.9, p=.001) Certified MDs had higher ratings of clinical competence Clinical Management (p=.014) Management of Complex Cases (p=.021) Certification is a predictor of clinical competence

9 DOES CERTIFICATION IMPROVE PERFORMANCE? Hart et al Pressure ulcer staging using NDNQI Certified v. non-certified nurses Certified nurses ĸ=0.66 (SE=0.04) Non certified nurses ĸ=0.54 (SE=0.03) Certification can improve the accuracy of pressure ulcer data collection

10 DOES CERTIFICATION IMPROVE PATIENT OUTCOME? Kendall-Gallagher, 2009, Kendall-Gallagher, 2011 Improved Safety Outcomes # of certified nurses: incidence falls and skin breakdown RN certification= lower 30-day mortality and failure to rescue rates

11 IS CERTIFICATION GOOD FOR BUSINESS? Williams et al Affordable Care Act hospitals rewarded for good patient outcomes Centers for Medicare and Medicaid Services require mandatory certification for dialysis technicians

12 IS CERTIFICATION GOOD FOR BUSINESS? Hart, 2000 Orthopaedic Clinical Specialist in Physical Therapy 258 adult patients OCS therapists more efficient Fewer visits (9.1 v. 11.2) Less cost ($949 v. $1238)

13 IS CERTIFICATION GOOD FOR BUSINESS? Retention as a financial marker Piazza et al empowerment job retention Hunt, 2009 Recognizing and rewarding superior performance Supporting career development = Less staff turnover

14 IS CERTIFICATION GOOD FOR THE PATIENT? Stromborg et al.,2005 Higher levels of patient satisfaction when cared for by a certified nurse AACN Certification Corporation, 2003 Certification provide patients and families with validation that the nurses caring for them have demonstrated experience and knowledge that exceeds that which is assessed in entry level licensure examinations.

15 IS CERTIFICATION GOOD FOR THE EMPLOYEE? Pradel, Pharmacists with certification: 62% felt improved competence 50% felt increased marketability 34% financial or career gains (promotion, bonus, raise) Cary, Nurses with certification: 72% received one or more benefit from certification Recognition, financial gain, promotions, job security 77% sense of personal growth 67% job satisfaction

16 MOTIVATIONAL THEORY Based on Vroom s Expectancy Theory, 1964 OUTCOME (REWARDS) VALENCE EFFORT Ellison, 1997 Sports Certified PTs: -personal achievement main factor INSTRUMENTALITY (Certification) EXPECTANCY (Training) (PERFORMANCE) Cary, 2001 Certified nurses: confidence MOTIVATION = EXPECTANCY x INSTRUMENTALITY x VALENCE

17 CURRENT SPECIALTY CERTIFICATION OPTIONS FOR THERAPISTS Use as certifiers? Models for use?

18 OT AOTA NATIONAL CERTIFICATION members 5 years, portfolio $525 Board Certification Gerontology Mental health Pediatrics Physical Rehabilitation Specialty Certification Driving and Community Mobility Environmental Modification Feeding, Eating, Swallowing Low Vision School Systems

19 OT NATIONAL BOARD CERTIFICATION FOR OCCUPATIONAL THERAPY (NBCOT) Entry-level certification exam R = Registered $500 Every 3 year renewal (optional) $ 65 CEUs required Areas of Practice Emphasis 24 CEUs minimum Check the box

20 OT STATE BOARD OF LISCENSURE Public health board Set criteria for licensure and renewal for state Pass NBCOT exam 41/50 states have CEU requirements for license renewal Fee based (annual or biennial)

21 OT STATE LEVEL CERTIFICATIONS California Advance practice (Physical Agents/ Modalities, Hand, Swallow) New Hampshire Board certification in Physical Agents is mandatory in order to use them in practice

22 PT APTA BOARD OF SPECIALTIES members $800+ exam Fee ($515 renewal) 10 years 2000 Direct patient care hours (patient reports and supervisor verification) Additional certifications/ memberships AREAS OF SPECIALTY : Cardiovascular and Pulmonary Clinical Electrophysiology Geriatrics Neurology Orthopaedics Pediatrics Sports Women s Health

23 PT APTA BOARD OF SPECIALTIES Burn Certification? Petition Minimum $7500 application fee Share cost of practice analysis and test development Justify number of therapists that would seek specialization (113 PTs/ ) OT separate certification

24 OTHER CERTIFICATIONS AVAILABLE TO THERAPISTS Hand Therapy Certification (HTCC) PT or OT 4000 direct patient care hours Exam based - $500 5 year renewal, fee and CEUs NDT neurodevelopmental training OT, PT, SLT Course based Adult and Pediatric 3 years Child Passenger Carseat Assistive Technology Sensory Integration

25 CONSIDERATIONS FOR A BURN THERAPIST CERTIFICATION

26 CERTIFIERS?

27 TRAINING PROCESS? Certification by examination Study guide Certification by portfolio Documenting and confirming hours Certificate Program Like ABLS? Internship Paid v. Nonpaid

28 EXAMINATION PROCESS? Content of material Standardization Consensus on knowledge and skills that define an expert burn therapist Practice analysis How is the content developed/ written? Who writes the content Committee v. Contract How is the exam administered Online v. In person

29 RENEWAL PROCESS? Fees Re-examination Continuing education requirements

30 CERTIFICATION

31 THE POWER OF KNOWLEDGE

32 ?BURN THERAPY CERTIFICATION? NEEDS ASSESSMENT SURVEY ABA NATIONAL LEADERSHIP CONFERENCE 2014 Michael A. Serghiou, OTR, MBA Shriners Hospitals for Children Galveston

33 PURPOSE To investigate whether there is an interest among burn therapists to pursue burn therapy certification and begin to examine the feasibility of embarking into such an endeavor.

34 DEMOGRAPHIC INFORMATION 12 Survey sent to 197 therapists (OT/PTs), members of the American Burn Association. 100 therapists responded. Positions Held Staff Therapists Other Management Research Education Level Master Prepared Bachelor of Science Clinical Doctorate PHD Other

35 YEARS OF EXPERIENCE IN THE FIELD (OT/PT) VS. IN BURNS years burn therapy experience (TR=21) years In the Field > 5 years > 10 years years burn therapy experience (TR=28) In the Field 1-5 years > 5 years > 10 years > 10 years burn therapy experience (TR=51) In the Field 1-5 years > 5 years > 10 years

36 BURN THERAPY CERTIFICATION 23.30% 1.10% very interested (68/90) somewhat interested (21/90) not interested (1/90) 75.60% 62.9% (56/89), Single Certification inclusive of both OT & PT 79.3% (69/87) currently do not have a specialty certification

37 CERTIFICATION MODEL If interested, which credentialing option would you choose? Rating Count a. Certification by examination 35.6% (32) 41.1% (37) 23.3% (21) 90 b. Certification through portfolio c. Assessment-based certificate program 42.2% (38) 24.4% (22) 33.3% (30) % (20) 34.4% (31) 43.3% (39) 90 *Therapists with over 10 years of experience prefer; a (18/51), b (18/51), c (15/51).

38 CLINICAL INTERNSHIP Would you be interested in a clinical internship or residency with a verified burn center as part of the certification process? 55.2% NO 44.8% YES Would you be willing to participate in a clinical internship or residency if it was unpaid? 85.2% NO 14.8% YES

39 CERTIFICATION COST What would you be willing to pay for a specialty certification in burn therapy? 46.70% 1.10% $ (47/90) $ (42/90) > $800 (1/90) 52.20%

40 HOSPITAL SUPPORT FOR CERTIFICATION How will your hospital support the achievement of an individual certification? *89 responded to this question, some selected more than 1 response do not know reimburse me for the fees no reimbursement other pay a differential in salary clinical ladder distinction without pay differential

41 PRIMARY REASON FOR CREDENTIALING The primary reason for credentialing is to establish standards for the profession and to enhance quality of products and services provided. (47.8%)

42 SECONDARY REASONS FOR CREDENTIALING To enhance credibility for knowledge in subject. 55.1% To enable employees to identify qualified workers. 46.1% To provide greater internal regulation of practice to avoid externally imposed regulation from other bodies. 41.6% To provide additional career ladder opportunities. 37.1% To enhance health and safety of public. 34.8% To obtain recognition by other disciplines (i.e. physicians, nurses, etc.) 31.5%

43 WHERE DO WE GO FROM HERE?