Http://accahc.org . ACCAHC Mission Advance patient care through fostering mutual understanding and...
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http://accahc.orghttp://optimalintegration.org
ACCAHC Mission
Advance patient care through fostering mutual
understanding and respect among the healthcare
professions.
An organization and a project built to
Practice Collaboration in Order to Create Optimal Access & Integration
Context: Policy & Health System Change• Policy: Specific inclusion in federal
healthcare overhaul legislationWorkforce inclusionDelivery (medical homes, community health)Payment (non-discrimination)Research (comparative effectiveness)Health promotion & prevention
• Policy: “Real world” focus at NCCAMNew strategic plan focuses on health, outcomes, disciplines & integration
• Health systems 25% with some form of CAMMajor initiatives: VA, Allina, Beth Israel NY, Swedish, Duke plus
• Employers/payers/public healthCost, over-treatment, painPrimary care potential
Patient choice
ACCAHC Core Disciplines5 with federally-recognized accrediting agencies, plus …
CAM Disciplines: Expansion, Maturation, Recognition
Updated from ACCAHC’s Clinicians’ & Educators’ Desk Reference on the Licensed Complementary & Alternative Healthcare Professions (2009)
Profession Accrediting Agency
Established
US Department of EducationRecognition
RecognizedSchools or Programs
Nat’lExam
Created
StateRegulation
TotalLicensed
Practitioners
Acupuncture and Oriental medicine
1982 1990 54 1982 44 25,000
Chiropractic 1971 1974 16 1963 50 70,000
Massage therapy
1982 2002 85 1994 43 250,000
Direct-entry (homebirth) Midwifery
1991 2001 12 1994 26 1200
Naturopathic medicine
1978 1987 7 1986 15 4500
Power through CollaborationBuilding the ACCAHC Platform
• 4 Councils of Colleges/Schools• 5 Accrediting Agencies• 3 Certification and Testing Organizations• 4 Traditional World Medicines/Emerging
Professions organizations• Council of Advisors with leading MD/RNs
in health systems, academic medicine
16 Member Organizations
ACCAHC: By the Numbers
• 16 national organizations• 350,000 licensed practitioners– 100,000 DC, LAc, ND only
• 183 accredited schools/programs • 20,000 students (DC/LAc/ND only)• Yoga teachers/therapists• 7 MD/RN advisers
DC-LAc-ND alone are 95% of the certified or licensed integrative practice workforce
Integrative Care Workforce: Comparison• Fellows, American Board of Integrative
and Holistic Medicine• Fellows, Arizona Center for Integrative
Medicine• Board Certified Holistic Nurses
________________________
• Integrative MD/RN with specialty standards
• Licensed DC/ND/LAc
1500
500
900______
2,900
100,000
Context: CAM Disciplines Stepping Up
• Integration themes for ACC-RAC and AAAOM in 2011
New integration themed DC-led journal (Topics)• Integration in institutional missions
Northwestern, Bastyr, NUHS, NYCC, SCUHS• Initial accreditation activity exploration
Integration, co-management, referral• Partnerships with academic health centers• Major initiatives with VA, DoD
DC, LAc, other modalities
Membership commitment and participation In ACCAHC
ACCAHC: Some External Accomplishments2005-Present
• Network with MD/nurse academics– Collegiality, contacts, barrier removal, discipline
respect in IM definition• Publish ACCAHC CEDR-disciplines book
– Disciplines versus therapies focus• Place CAM disciplines on 2 IOM panels
– Health focus, CAM participation, collaboration • Move CAM disciplines into national
interprofessional education (IPE) dialogue– Getting CAM disciplines to the table
• Help shape NCCAM Strategic Plan– Increased focus on CAM disciplines; more $$ to
CAM schools for EBM, research participation
ACCAHC: Establishing Strategic Priorities2006-Present
• 2006 – Decide to form organization• 2007 – Bylaws, dues, RWG formed• 2007 – RWG formed, via Standard Process
2008 – Incorporate, form EWG/CWG • 2009 – Planning retreat; focus on integration• 2009 – RWG, NIH R-25 evidence in education• 2009 – Begin Competencies• 2010 – Finish Competencies; begin ACT• 2010 – RWG led, influence NCCAM plan• 2010 – Endorse Center for Optimal Integration
2011 Forward – COI Web Portal+ as encompassing vehicle for ACCAHC
mission
Identified Self-Care for the CAM Disciplinesto Foster System Inclusion
•Competencies •Evidence
(as language of integration and as practice improvement )
• Forge optimal care that respects patient choice
• Activate & support educators, students, researchers, clinicians & administrators
• Influence other stakeholders• Create access
Become accepted parts of care teams
COI: Methods• Aggregate useful information– Templates, tools, models, how-to,
curricular components• Organize activity– Newsletters, communities of interest– Educate on key policy issues
• Online course(s)– Competencies, possible certification
• Stimulate leadership
Major Content Area #1:
Competencies for Optimal Practice in Integrated Environments
Competencies Overview
•11 month process (Sept. 2009-August 2010)•50 professionals from 8 disciplines•All ACCAHC Working Groups plus Board of Directors•5 major competency areas•28 competency elements
“I wish all providers had these competencies .”
Administrator, Department ofIntegrative Medicine, Beth Israel Hospital (NYC)
Major Content Area #1:
Competencies: Adopt a Competency Task (ACT) Project
ACT Overview•Begun September 2010•ACCAHC educator leaders “adopt” an element as volunteer faculty •Goal: Develop 1-2 hour course module for each competency element•Phase 1: Course objectives, reading list, syllabus/outline•Phase 2: Complete/post (power-point, voice-over powerpoint, other)
Quality content indevelopment on 18 of 28
Major Content Area #1:
Competencies: Envisioned Next Steps*
•Contract professional team•Develop online course•Bring in conventional partners•Seeks formal endorsements•Explore potential certification•Seek CE recognition•Add interactive components•Develop teams for onsite CE•Continuous quality improvement
* Requires significant COI funding
Major Content Area #2:
Evidence: The Language of IntegrationKey Audiences
•Door opener•Medical directors•In-service presentations•Grand rounds•One-on-one referrals
Key Attitudes/Skills•Research literacy•Comfort with science•Non-defensive •Articulate about strengths and weaknesses
Evidence-Based Healthcare and Evidence Informed Practice:Key ACCAHC Competency Domain
Major Content Area #2:
Evidence Opportunity: Partnership for Dissemination of Exceptional Learning from NIH-Funded Programs
Overview of “R-25s” ProgramsFunded by NIH to:
•Expand role of evidence in education in CAM schools•Foster research literacy•Stimulate research interests•5 DC schools, 2 ND schools with NIH funded programs
– All are represented in ACCAHC•Requirement to disseminate
185 ACCAHC-affiliated, accredited programs have never had educational
support in this areas.
Major Content Area #2:Partnership for Dissemination: Sample Content Areas
• Defining evidence-related competencies– Clarity on what EBM is*
• Strategies to engage institutional leaders in culture change– Faculty– Board/Trustees
• Share best practices/proven strategies• Role of librarians• Engage dialogue on challenges of evidence
& research in whole practice fields
Major Content Area #2:Partnership for Dissemination: Envisioned Additional Steps
• Continue to urge NCCAM to increase funding for evidence
• Develop and support networks of CAM science educators– Web-based communities
• Deliver programs at key conferences
• Convene meetings on evidence challenges/strategies in CAM fields
• Publish white paper(s) to help policy makers on whole practice and discipline evidence
COI: Additional Envisioned ProgramsTraining Leadership in Optimal Integration
•Use experts in leadership•Use experts on team care•Train individuals •Train local teams
Top interest of ACCAHC Board
Create Communities in Optimal Integration
•Accrediting agency issues•Delivery issues•Payment issues•Policy issues
Convening/white papers
• ACCAHC strategy is an organizer’s– Make plans based on resources available
• Basic requirements: $105,000 over 3 years ($315,000)– Fundamental level of 2 key projects– Some staffing, web, consulting, writing,
organizing, content development• Resources for excellence: Numerous
major project opportunities
Societal value of optimal integration is tremendous. What we achieve will rest on what we can bring to
the work.
An organization and a project built to practice collaboration in order to create optimal access and integration.
Thank-you!