1. CoARC Update
11/16/2009
Commission on Accreditation for Respiratory Care
Update on Revisions to the CoARC Standards for the Profession of Respiratory Care
The presenter will begin with a brief explanation of the process for revision of the CoARC standards. Attendees will then be provided with an overview of the proposed new accreditation standards and their implications for programs and the profession. Emphasis will be placed on the most significant differences between the current and new standards. Strategies for implementing programmatic changes to address compliance with the new standards will also be discussed. Time will be allotted for questions and comments from members of the audience.
Allen N. Gustin Jr., MD, FCCP
Chair, CoARC Accreditation Policies/Standards/Bylaws Committee
2009 AARC BOD Meeting

2. Conflict of Interest
I have no real or perceived conflict of interest that relates to this presentation. Any use of brand names is not in any way meant to be an endorsement of a specific product, but to merely illustrate a point of emphasis.

3. Presentation Overview
CoARC Update
11/16/2009
Presentation Overview
Attendees will be provided with an overview of the proposed 2015 accreditation standards and its implications for programs and the profession.
The presenter will focus on the most significant differences between the current and revised standards.
Strategies for implementing programmatic changes to address compliance with the revised standards will also be discussed.
2009 AARC BOD Meeting

4. Objectives Purpose of Accreditation Standards Brief History
CoARC Update
11/16/2009
Objectives
Purpose of Accreditation Standards
Brief History
Overview of Revision Process
The 2015 CoARC Standards – What’s Different?
Transition Timeline
Ongoing Review
Questions and Answers
2009 AARC BOD Meeting

5. CoARC Update
11/16/2009
Purpose of Standards
Outlines the minimum requirements to which an accredited first-professional (entry into practice) respiratory care program is accountable.
Used for the development, evaluation, and self-analysis of first-professional respiratory care programs.
Provides the basis on which the CoARC confers or denies program accreditation.
CoARC Policy A First-Professional Degree Program is an educational program designed to provide students who possess no prior competence in respiratory care, with the knowledge and clinical skills required to function competently as a registry-eligible respiratory therapist. Conferral of the first professional degree requires completion of a program that meets all of the following criteria: completion of the academic prerequisites to become a registry-eligible respiratory therapist; requires at least two years of college-level study upon completion of the program; and is awarded after a period of study such that the total registered time to the degree, including both pre-professional and professional study, is equivalent to the acceptable level required of an associate’s degree. A first-professional degree program must adhere to the CoARC Accreditation Standards for the Profession of Respiratory Care. A first professional degree in respiratory care is generally required by law or custom to practice the profession.
2009 AARC BOD Meeting

6. History of Standards Initially adopted in 1962
CoARC Update
11/16/2009
History of Standards
Initially adopted in 1962
Revisions in 1972, 1977, 1986, 2000, 2003, and 2010
(JRCRTE in 1970; CoARC in 1997)
A report entitled, "Essentials for an Approved School of Inhalation Therapy Technicians," was adopted by sponsor participants (AAIT, ACCP, AMA, and ASA) at an exploratory conference in October The AMA's House of Delegates granted formal approval in December 1962.
JRCRTE in 1970
2009 AARC BOD Meeting

7. CoARC Update
11/16/2009
The Revision Process
As part of its 5-year review cycle, CoARC developed progressive drafts of its 2015 Standards over the past year.
Comments were received from a variety of communities of interest and have been used to develop the first draft of the 2015 Standards.
Additional drafts following input from this meeting are anticipated and will be published for further feedback from the communities of interest..
2009 AARC BOD Meeting

8. CoARC Update
11/16/2009
The Revision Process
Standards Committee of the Board met several times monthly via web-based Go-To-Meeting.
Reviewed the data collected from all evaluation instruments and all correspondence received by CoARC regarding the 2010 Standards and first-draft of the 2015 Standards;
Identified Standards determined to have greatest concerns;
Made recommended revisions to the drafts.
Following July 2013 CoARC Board meeting:
Blast programs as well as place an announcement on the CoARC web site and on AARC web site announcing the second draft of the revised Standards. Disseminate a call for comment (with September 1, 2013 deadline for comment) to all communities of interest* and outline the procedure for those wishing to provide input to the CoARC Accreditation Policies/Standards/Bylaws Committee.
Use CoARC web site and Survey Monkey [Update survey link] to collect data and feedback from communities of interest (validity, ease of interpretation, potential issues, positives and negatives regarding second draft of new Standards).
CoARC Accreditation Policies/Standards/Bylaws Committee (Sept 2013 – Oct 2013):
Review the data collected from all evaluation instruments.
Review any correspondence, s, or telephone calls received by CoARC regarding the proposed Standards.
Identify Standards determined to have greatest concerns.
Make revisions to Evidence of Compliance.
Make recommended revisions to the second draft for review by Full Board at Nov 2013 meeting.
At November 2013 CoARC Board meeting:
Review, discuss, and approve changes to the second draft of new Standards.
Following November 2013 CoARC Board meeting:
Blast programs as well as place an announcement on the CoARC web site and on AARC web site announcing the final draft of the revised Standards. Disseminate a call for comment (with February 1, 2014 deadline for comment) to all communities of interest* and outline the procedure for those wishing to provide input to the CoARC Accreditation Policies/Standards/Bylaws Committee.
Use CoARC web site and Survey Monkey [Update survey link] to collect data and feedback from communities of interest (validity, ease of interpretation, potential issues, positives and negatives regarding final draft of new Standards).
At 2013 AARC International Congress (San Diego, CA):
Hold a Standards Open Hearing (time and location TBD).
CoARC Accreditation Policies/Standards/Bylaws Committee (Feb 2014 – Mar 2014):
Review any correspondence, s, or telephone calls received by CoARC regarding the proposed Standards and Evidence of Compliance.
Begin Revisions to the Interpretive Guidelines.
Identify Standards and Evidence of Compliance determined to have greatest concerns.
Make recommended revisions to the final draft for review by Full Board at March 2014 meeting.
At March 2014 CoARC Board meeting:
Review, discuss, and approve changes to the final draft of new Standards.
Following March 2014 CoARC Board meeting:
Send the final version of the Standards to the CoARC’s collaborating organizations (AARC, ATS, ASA, and ACCP) for adoption as per CoARC Bylaw In the event each of the CoARC collaborating organizations provides their written consent to the proposed Standards, then the proposed Standards will be approved and adopted. In the event the collaborating organizations do not provide written consent or written objection to the proposed Standards within sixty (60) days after presentation, the Standards will be approved and adopted.
The adopted 2015 Standards will be posted on the CoARC web site and will go into effect on July 1, An announcement will be distributed to all communities of interest.
CoARC Accreditation Policies/Standards/Bylaws Committee (May 2014 – June 2014):
Make recommended revisions to the final draft of Interpretive Guidelines for review by Full Board at July 2014 meeting.
At July 2014 CoARC Board meeting:
Approve final draft of revised Interpretive Guidelines.
Provide workshops to key personnel on implementing the new Standards.
Following July 2014 CoARC Board meeting:
CoARC Site Visit Review Committee (September 2014 – October 2014):
Make recommended revisions to site visit documents for review by Full Board at July 2014 meeting.
CoARC Quality Assurance Committee (September 2014 – October 2014):
Make recommended revisions to self-study and related documents for review by Full Board at July 2014 meeting.
At November 2014 CoARC Board meeting:
Review, discuss, and approve changes to the revised documentation.
Provide webinars to key personnel and site visitor retraining on implementing the revised Standards (November 2014 – July 2015):
Begin assessing compliance with the new Standards as part of the regular on-site and annual report of current status process (July 2015). Programs with self-studies due on or after July 1, 2015 will be required to demonstrate compliance with the 2015 Standards.
2009 AARC BOD Meeting

9. CoARC Update
The Revision Process
Between July and Nov 2013, the Standards Committee will:
Review the data collected from all evaluation instruments and any correspondence, s, or telephone calls received by CoARC regarding the proposed Standards by September 1.
Identify Standards determined to have greatest concerns.
Make revisions to Evidence of Compliance.
Make recommended revisions to the second draft for review by Full Board at Nov 2013 meeting.
Following July 2013 CoARC Board meeting:
Blast programs as well as place an announcement on the CoARC web site and on AARC web site announcing the second draft of the revised Standards. Disseminate a call for comment (with September 1, 2013 deadline for comment) to all communities of interest* and outline the procedure for those wishing to provide input to the CoARC Accreditation Policies/Standards/Bylaws Committee.
Use CoARC web site and Survey Monkey [Update survey link] to collect data and feedback from communities of interest (validity, ease of interpretation, potential issues, positives and negatives regarding second draft of new Standards).
CoARC Accreditation Policies/Standards/Bylaws Committee (Sept 2013 – Oct 2013):
Review the data collected from all evaluation instruments.
Review any correspondence, s, or telephone calls received by CoARC regarding the proposed Standards.
Identify Standards determined to have greatest concerns.
Make revisions to Evidence of Compliance.
Make recommended revisions to the second draft for review by Full Board at Nov 2013 meeting.
At November 2013 CoARC Board meeting:
Review, discuss, and approve changes to the second draft of new Standards.
Following November 2013 CoARC Board meeting:
Blast programs as well as place an announcement on the CoARC web site and on AARC web site announcing the final draft of the revised Standards. Disseminate a call for comment (with February 1, 2014 deadline for comment) to all communities of interest* and outline the procedure for those wishing to provide input to the CoARC Accreditation Policies/Standards/Bylaws Committee.
Use CoARC web site and Survey Monkey [Update survey link] to collect data and feedback from communities of interest (validity, ease of interpretation, potential issues, positives and negatives regarding final draft of new Standards).
At 2013 AARC International Congress (San Diego, CA):
Hold a Standards Open Hearing (time and location TBD).
CoARC Accreditation Policies/Standards/Bylaws Committee (Feb 2014 – Mar 2014):
Review any correspondence, s, or telephone calls received by CoARC regarding the proposed Standards and Evidence of Compliance.
Begin Revisions to the Interpretive Guidelines.
Identify Standards and Evidence of Compliance determined to have greatest concerns.
Make recommended revisions to the final draft for review by Full Board at March 2014 meeting.
At March 2014 CoARC Board meeting:
Review, discuss, and approve changes to the final draft of new Standards.
Following March 2014 CoARC Board meeting:
Send the final version of the Standards to the CoARC’s collaborating organizations (AARC, ATS, ASA, and ACCP) for adoption as per CoARC Bylaw In the event each of the CoARC collaborating organizations provides their written consent to the proposed Standards, then the proposed Standards will be approved and adopted. In the event the collaborating organizations do not provide written consent or written objection to the proposed Standards within sixty (60) days after presentation, the Standards will be approved and adopted.
The adopted 2015 Standards will be posted on the CoARC web site and will go into effect on July 1, An announcement will be distributed to all communities of interest.
CoARC Accreditation Policies/Standards/Bylaws Committee (May 2014 – June 2014):
Make recommended revisions to the final draft of Interpretive Guidelines for review by Full Board at July 2014 meeting.
At July 2014 CoARC Board meeting:
Approve final draft of revised Interpretive Guidelines.
Provide workshops to key personnel on implementing the new Standards.
Following July 2014 CoARC Board meeting:
CoARC Site Visit Review Committee (September 2014 – October 2014):
Make recommended revisions to site visit documents for review by Full Board at July 2014 meeting.
CoARC Quality Assurance Committee (September 2014 – October 2014):
Make recommended revisions to self-study and related documents for review by Full Board at July 2014 meeting.
At November 2014 CoARC Board meeting:
Review, discuss, and approve changes to the revised documentation.
Provide webinars to key personnel and site visitor retraining on implementing the revised Standards (November 2014 – July 2015):
Begin assessing compliance with the new Standards as part of the regular on-site and annual report of current status process (July 2015). Programs with self-studies due on or after July 1, 2015 will be required to demonstrate compliance with the 2015 Standards.

10. CoARC Update
11/16/2009
Transition Timeline
Anticipate final draft approval in spring 2014 with effective date of January 1, 2015.
Provide webinars to key personnel and site visitor retraining on implementing the revised Standards (November 2014 – July 2015):
Begin assessing compliance with the new Standards as part of the regular on-site and annual report of current status process (July 2015). Programs with self-studies due on or after July 1, 2015 will be required to demonstrate compliance with the 2015 Standards.
2009 AARC BOD Meeting

11. What’s Different? www.coarc.com CoARC Update 11/16/2009
2009 AARC BOD Meeting

12. CoARC Update
11/16/2009
What’s Different?
CoARC will continue its outcomes-centered approach to the accreditation review process;
Given the significant shifts to a competency-based approach to accreditation, revisions in the 2015 Standards reflect an increased emphasis on student learning outcomes that focus on the competencies and attainment levels reached by respiratory care students upon completion of their first professional degree program.
2009 AARC BOD Meeting

13. What are Competency-Based Standards?
CoARC Update
11/16/2009
What are Competency-Based Standards?
Competency-based accreditation standards focus on the requisite competencies needed for entry into a profession, allow flexibility in the curriculum to achieve competencies, and establish criteria to assess achievements and deficiencies by monitoring outcomes.
CoARC defines competencies as the “written statements describing the measureable set of specific knowledge, skills, and affective behaviors expected of graduates” (CoARC, 2010, p. 10).
Traditionally, accreditation standards included a set of recommended or mandated courses of instruction that are based on the traditions, priorities, and values of the particular profession. Over time, the curriculum is slowly modified to accommodate new content in an attempt to keep pace with the rapidly changing, technology-driven health care environment.
2009 AARC BOD Meeting

14. Why the Emphasis on Competencies?
CoARC Update
11/16/2009
Why the Emphasis on Competencies?
Increasing shift from a traditional, curriculum-centric approach of defining required courses to an outcomes-centric approach that establishes requisite competencies as the primary means to assess the achievement of expected student learning outcomes.
Increased demand for allied health professionals who offer a wider range of clinical skills, greater experience in independent practice, more flexibility in adapting to various practice settings, and who are culturally sensitive, team-focused, and possess interpersonal and listening skills (O' Neil & Pew Health Professions Commission, 1998, p. 47).
The movement to competency-based education began in the 1970s and has since gained considerable momentum, particularly in the past decade due largely to growing concerns about patient safety (Institute of Medicince, 2001). Furthermore, educators recognized the value of using the competency approach to guide educational program design—to develop specific learning objectives for each competency (AAMC-HHMI Committee, 2009). In today’s knowledge economy, it is not sufficient for a graduate to demonstrate adequate basic cognitive skills and professional competencies. The nature of the health care field also requires that the graduate be able to work in teams, be a creative problem solver, and communicate with a diverse set of colleagues and patients. Employers and higher education institutions have “become more cognizant of the role that such so-called ‘soft’ or non-cognitive skills play in the successful performance in both academic and nonacademic arenas” (Swyer, Millett, & Payne, 2006, p. 14).
Calls by the public and policymakers for increased transparency and accountability as well as heightened consumerism have also influenced the shift to a competency-centered, outcomes-based approach to accreditation and the emphasis for accreditors to focus their standards on assessing the degree to which the professions are creating a skilled, competent, and globally competitive workforce. In December 1998, the Pew Commission on the Health Professions published the report, Recreating Health Professional Practice for a New Century, that outlines a number of recommendations aimed at transforming the health professions workforce (O' Neil & Pew Health Professions Commission, 1998). Among the recommendations was a call for health professions programs to “realign training and education to be more consistent with the changing needs of the care delivery system”.
To assist in this process, the Pew Commission revised its 1993 competencies and identified twenty-one competencies for a changing health care system:
Embrace a personal ethic of social responsibility and service;
Exhibit ethical behavior in all professional activities;
Provide evidence-based, clinically competent care;
Incorporate the multiple determinants of health in clinical care;
Apply knowledge of the new sciences;
Demonstrate critical thinking, reflection, and problem-solving skills;
Understand the role of primary care;
Rigorously practice preventive health care;
Integrate population-based care and services into practice;
Improve access to health care for those with unmet health needs;
Practice relationship-centered care with individuals and families;
Provide culturally sensitive care to a diverse society;
Partner with communities in health care decisions;
Use communication and information technology effectively and appropriately;
Work in interdisciplinary teams;
Ensure care that balances individual, professional, system and societal needs;
Practice leadership;
Take responsibility for quality of care and health outcomes at all levels;
Contribute to continuous improvement of the health care system;
Advocate for public policy that promotes and protects the health of the public;
Continue to learn and help others learn (O' Neil & Pew Health Professions Commission, 1998, pp ).
2009 AARC BOD Meeting

15. Standard I – Program Administration and Sponsorship
CoARC Update
11/16/2009
Standard I – Program Administration and Sponsorship
Institutional Accreditation
Consortium
Sponsor Responsibilities
Program Location
Substantive Changes
Affiliate Agreements
Institutional Accreditation – regional and national accreditors
Consortium - responsibilities
Sponsor Responsibilities - expanded
Program Location – equivalency
Substantive Changes – Section 9 of P&P Manual
Affiliate Agreements – must have formal agreements or MOUs for each
2009 AARC BOD Meeting

16. Standard II – Institutional and Personnel Resources
CoARC Update
11/16/2009
Standard II – Institutional and Personnel Resources
Institutional Resources
Personnel Resources
Key Program Personnel
Program Director
Director of Clinical Education
Medical Director
Instructional Faculty
Administrative and Support Staff
Institutional Resources – fiscal, academic, and physical regardless of location
Personnel Resources – sufficient number to meet goals
Key Program Personnel – FT PD, FT DCE, and MD
GO TO DOCUMENT
Program Director – responsibilities, valid RRT, and licensed, min Bac degree, 4 yrs as an RRT, 2 yrs clinical, 2 yrs teaching, reg contact
Director of Clinical Education - responsibilities, valid RRT, and licensed, min Bac degree, 4 yrs as an RRT, 2 yrs clinical, 2 yrs teaching, reg contact
Medical Director – ensures direct physician interaction; Board certified and licensed and credentialed.
Instructional Faculty – sufficient faculty; appropriately credentialed; clinical rotations student to faculty cannot exceed 6:1
Administrative and Support Staff – sufficient to meet goals
2009 AARC BOD Meeting

17. Standard III – Program Goals, Outcomes, and Assessment
CoARC Update
11/16/2009
Standard III – Program Goals, Outcomes, and Assessment
Statement of Program Goals
Assessment of Program Goals
Assessment of Program Resources
Student Evaluation
Assessment of Program Outcomes
Reporting Program Outcomes
Clinical Site Evaluation
Statement of Program Goals – Prepare RRT/SDS; Advisory Committee responsibilities and composition
Assessment of Program Goals – formal plan; distance education assessed
Assessment of Program Resources – Annually; RAM
Student Evaluation – sufficient frequency/remediation; equitable; inter-rater reliability
Assessment of Program Outcomes – annually using CoARC surveys; min thresholds (national cred exam entry practice, retention/attrition, employer and grad satisfaction; job placement
Reporting Program Outcomes – annual report
Clinical Site Evaluation - comparable evaluation processes
2009 AARC BOD Meeting

18. Standard IV– Curriculum
CoARC Update
11/16/2009
Standard IV– Curriculum
Minimum Course Content
Minimum Competencies
Length of Study
Equivalency
Clinical Practice
Content NOT courses!
GO TO DOCUMENT
Define and list competencies required for graduation, communicated to students
Minimum Course Content – oral/written, social/behavioral, biomedical/natural sciences (anatomy/physiology, chem physics micro and pharm); reviewed and revised in accordance with NBRC content matrix
Minimum Competencies –interpersonal and communication skills; problem solving strategies
Length of Study – sufficient to acquire knowledge and skills; two years
Equivalency – learning experiences are substantially equivalent for all students
Clinical Practice – sufficient quality and duration to meet goals
2009 AARC BOD Meeting

19. Standard V– Fair Practices and Recordkeeping
CoARC Update
11/16/2009
Standard V– Fair Practices and Recordkeeping
Disclosure
Non-discriminatory Practice
Safeguards
Academic Guidance
Student Identification
Student Records
Program Records
Disclosure – publications must accurately reflect program offered; link to CoARC website; GO TO DOCUMENT (a-n)
Non-discriminatory Practice – all activities of program; appeal procedures; faculty grievance procedures; clearly defined admissions; no students securing own clinical sites and preceptors; advanced placement policies
Safeguards – health and safety of those associated with educational activities and learning environment; students not used for clinical, instructional or administrative staff; no clinical coursework completed while an employee at a clinical site
Academic Guidance – availability; equivalency with other students; access to counseling
Student Identification – clear identification in all clinical settings
Student Records – records for admission, advisement, counseling and evaluation; records on file for 5 years (electronic or hard copy)
Program Records – RCS, syllabi, RAM surveys, clinical affiliate agreements and schedules, advisory committee minutes; records on file for 5 years
2009 AARC BOD Meeting

20. CoARC Update
11/16/2009
Ongoing Review
The ongoing review of the Standards will occur as needed, but no less than every five (5) years.
Review process/public notice will be the same.
The CoARC Policies/Standards/ Bylaws Committee, a standing committee of CoARC, is responsible for reviewing the Standards at least every five years and recommend revisions, if any, to the Board. The CoARC may review and make revisions to the Standards sooner than the five year period if CoARC determines, at any point during its systematic program of review, that it needs to make changes to the Standards, CoARC will initiate action within 12 months to make the changes and will complete that action within a reasonable period of time. Before finalizing any changes to the Standards, CoARC will provide advance public notice of proposed revised Standards. CoARC will provide adequate opportunity for broad comment from the academic community and the public prior to adoption of proposed changes to CoARC Standards. The need for a CoARC interpretation of a Standard or Standards will be included in CoARC's Standards Interpretive Guide to be maintained on the CoARC web site.
2009 AARC BOD Meeting

21. CoARC Executive Office
CoARC Update
11/16/2009
CoARC Executive Office
Questions and Answers
1248 Harwood Road
Bedford, TX
(817) ext 101
2009 AARC BOD Meeting