1. Credentialing - What do I look for? Christine Shettel RN BSN CHWS MAPWCA PWRC

2. Professional Growth  Continuing Education  Certification  Professional Societies  Research  Consulting

3. Certification  Exam Qualifies for Certificate of Added Qualification : CAQ

4. Importance to Patients  Patients benefit from a physician’s focus on the core competencies for quality care by receiving:  Better communicative relationships built on listening and sharing  Improved sensitivity to their needs and concerns  Demonstrated clinical knowledge concerning their medical condition  Coordinated care from inter-professional teams and integrated systems of care

5. ABWH.net

6. The purpose and function of the ABWH:  To improve the quality of the clinical practice of wound care and hyperbaric medicine  To establish and maintain high standards of excellence in the specialties of wound care and hyperbaric medicine  To evaluate specialists who apply for initial certification

7. Professional Society Endorsement  The examinations offered by the American Board of Wound Healing are the only examinations endorsed by several professional societies: American Professional Wound Care Association American College of Hyperbaric Medicine

8. Why have a Board?  Professional Standards to Specialty  Validation of Knowledge Base  Demonstration of Candidates commitment to practice to the highest standard  Maintain level of knowledge and demonstration

10. American Professional Wound Care Association  AAPWCA – Associate of APWCA  DAPWCA – Diplomat of APWCA  FAPWCA – Fellowship of APWCA  MAPWCA – Masters of APWCA

12. About ABWH  The American Board of Wound Healing (ABWH) provides a pathway for certification to wound care and hyperbaric practitioners who meet established educational, professional, clinical and examination standards.  ABWH certification is available to a variety of clinicians, including physicians, nurses, technicians and other allied health professionals.  Successful completion of an ABWH examination is recognized by a Certification of Added Qualification. The ABWH is not a membership association. Clinical Pathway for Certification ABWH is a Certifying Body not a Membership Organization

13. About ABWH  To provide a process to recognize continued clinical competence via recertification  To grant and issue to qualified practitioners Certificates of Added Qualification and other recognition of established advanced knowledge and clinical skills in wound care and hyperbaric medicine, as well as to suspend or revoke the same when necessary  To serve the public, professional societies, hospital credentialing committees, and licensing boards by providing status verification of diplomates certified by the American Board of Wound Healing

14. To Serve  To serve the public, professional societies, hospital credentialing committees, and licensing boards by providing status verification of diplomats certified by the American Board of Wound Healing  Credentialing Consistency : ACHM Consensus Paper

15. Difficulty and Inconsistency in Hospital Credentialing in Hyperbaric Medicine. Serena T, Gelly H,Bohn G, Niezgoda J The American College of Hyperbaric Medicine Consensus Statement on Physician Credentialing for Hyperbaric Oxygen Therapy Adv Skin Wound Care 2014 27: 349-51

16. Novitas proposed LCD Requirements Was to require any physician to be Board certified or Certified through ABWH Certification of Added Qualification. Most physicains are in their mid to late career would be required to leave practice and serve fellowship

17. Certification in HBO Medicine  ABPM/UHMS closed the practice Track to Board Certification  1 Year Fellowship required  The Majority of HBO practicing physicians are not certified or fellowship qualified to sit for examination  Only a few fellowship training programs

18. Hyperbaric Medicine Fellowships - 18  Hennepin County Medical Center - 1  Louisiana State University New Orleans - 5  Palmetto Richland Memorial Hospital - 1  SUNY Upstate Medical University - 1  University of California San Diego - 1  University of Pennsylvania Medical Center - 2  Duke Undersea and Hyperbaric Medicine - 4  Utah Undersea and Hyperbaric Medicine - 2  CRESE University of Buffalo -1

19. Level of Care in Centers Varies  HBO physician credentialing should be commensurate with the level of care and scope of practice of the providers in the clinic  Capacity of care is determined by the equipment available, acuity of patients training and experience of the staff  Policies and procedures of the facility should be developed according to the capabilities and scope of practice

20. Core Privileges  Identify and evaluate patients who would benefit from HBO therapy, develop and communicate effective treatment plan  Medically assess for safe and effective treatment  Provide Therapeutic Management of HBOT  Provide consultation and documentation for HBOT  Order diagnostic procedures related to diagnosis and treatment  In Multiplace setting, provide oversight of safe operations for patients and inside attendants.

21. Credentialing Requirements  Residency and Board certification outlined in local standards  State Medical License  Current Certification in ACLS  Fellowship Training

22. Credentialing Requirements  If not Board Eligible, Within 2 years Seek certification through Physician Certification in Hyperbaric Medicine ABWH Hyperbaric Physician UHMS American Osteopathic Conjoint Committee of UHM

23. Credentialing Requirements  40 Hour Course approved by ACHM, UHMS, Department of Defense  CMS DCD require provide documentation of course completion to bill for services  ACHM Suggests retake course if more than 2 years has elapsed and 25 treatments per year not met  Training 25 proctored treatments and 100 chart reviewed

24. Re-Appointment  15 category 1 CME in Hyperbaric Medicine every 2 yrs  Evidence of 25 treatments/yr (50/2yrs)  Ongoing Self Assessment  Knowledge, Cognitive Skills, Publications, Posters, Grand Rounds, presentations.

25. ABWH Examinations  Physician Certification in Hyperbaric Medicine -  Exam format: 160 questions Certification duration: 10 years  This exam is available to all MD & DO physicians. All candidates must:  Have an active valid US physician medical license  Have attained a primary board certification in an ABMS approved specialty  Provide verification of supervision of a minimum of 300 hyperbaric patient treatments within the prior 2 years  Have attended a primary training program approved by either the American College of Hyperbaric Medicine, the Undersea and Hyperbaric Medical Society, the US Department of Defense, or completed an approved hyperbaric fellowship  Provide a letter of Verification from program Medical Director or hospital administrator documenting good standing and active status of professional credentialing  Have an active membership in good standing with the ACHM

26. ABWH Examinations  Physician Certification in Wound Care - FAWPCA  Exam format: 165 questions Certification duration: 7 years  This exam is available to all physicians (MD, DO, DPM). The physician must:  Have a current State Medical License  Provide verification of a minimum of two years clinical experience in wound care  Provide verification of completion of at least 20 hours of wound care based continuing medical education credit  Provide documentation of membership in a professional wound care society (Optional- Members of the APWCA can qualify for fellow status)  The exam will focus on the principles involved in the diagnosis, assessment, and management of complex acute and chronic wounds. Subject Matter Domains:  Diagnosis and Management of Diabetic Ulcers, Venous and Arterial Insufficiency Ulcers, Pressure Ulcers, Surgical and Traumatic Wounds, and Atypical Wounds  Physiology of Wound Healing  The Diagnosis and Management of Wound Infection  Appropriate Utilization of Advanced Modalities  Medical-Legal Aspects of Wound Care, Documentation

27. Positions Eligible to Apply for Examination: CHWS, CHS, CSWS – Multi-disciplinary Positions Eligible to Apply for Examination: CHWS, CHS, CSWS – Multi-disciplinary  Hyperbaric Technician  Diver Medical Technician  Medical Assistant  Respiratory Therapist  Certified Nurse Aide  EMT Paramedic  Life Support Technician  Physician Assistant  Registered Nurse or LPN  Nurse Practitioner  Physician  Veterinarian  Podiatrist

28. Certified Hyperbaric and Wound Specialist (CHWS)  Exam format: 150 questions - Certification duration: 5 years  Prior to applying for certification the candidate must have met the following requirements:  A minimum of two years of experience in a hospital setting or outpatient facility as a Hyperbaric Technician with cross training as a Wound Care Assistant or equivalent clinical position  A minimum of 500 hours of clinical experience per year for the prior 2 years, with time shared between hyperbaric chamber operations and actual participation in wound related patient care and management (at least 25% of time must be dedicated to wound care)  Completion of a 40-hour introductory hyperbaric medicine course or 40-hour primary training program approved by either the American College of Hyperbaric Medicine, the Undersea and Hyperbaric Medical Society, or the US Department of Defense  Completion of Core Competencies in Hyperbaric Therapy and Wound Care, verified and endorsed by your employer, Medical Director or Program Manager validating your clinical experience detailed in the Core Competency Checklists

29. Certified Hyperbaric Specialist (CHS)  Exam format: 125 questions, Certification duration: 5 years  Prior to applying for certification the candidate must have met the following requirements:  A minimum of 500 hours of clinical hyperbaric training and active practice experience per year for the prior 2 years, successfully completing a Hyperbaric Technician Preceptorship in a hospital setting or outpatient facility.  Completion of a 40-hour introductory hyperbaric medicine course or 40-hour primary training program approved by either the American College of Hyperbaric Medicine, the Undersea and Hyperbaric Medical Society, or the US Department of Defense  Completion of Core Competencies in Hyperbaric Therapy, verified and endorsed by your employer, Medical Director or Program Manager validating your clinical experience detailed in the Core Competency Checklists

30. Certified Skin & Wound Specialist (CSWS)  Exam format: 125 questions - Certification duration: 5 years  Prior to applying for certification the candidate must have met the following requirements:  A minimum of 500 hours of clinical wound care training and active practice experience per year for the prior 2 years (this experience can include hours earned in a training role or position).  Copy of education certificate demonstrating completion of at least 10 hours of wound care training and education (CME/CEU certificate) during each of the prior 2 years.  Completion of Core Competencies in wound care, verified and endorsed by your employer, Medical Director or Program Manager, validating your clinical experience detailed in the Core Competencies Checklists.

31. Professional Growth  Continuing Education  Certification  Professional Societies  Research  Consulting

32. Preparation  Wound Care Symposiums  Professional Societies  Prep Courses  On line Hyperbaric and Wound Care Education

33. Thank You…