AACVPR Program Certification: Be Successful

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AACVPR Program CertificationBe Successful!

• Cristy Baldwin, BSN
• MOKSACVPR Conference
• June 15, 2006

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Why be certified?

• Better customer service.
• Self-inspection process outside review.
• Demonstrates quality service.
• Increases program efficiency.
• Promotes safe program practices.
• National recognition of quality programs.
• Reimbursement connection.
• It just makes sense!

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Do it right the first time!

• Start now.
• Get a plan.
• Set aside time.
• Getting started.
• Yes/No questions.
• Documentation.
• Organize and polish.

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2006 Changes

• All documentation must be in order when the
  application is submitted.
• Yes/No questions must all be answered Yes or
  the application will be denied.
• The program must be in existence for one year.
• Revisions for policies will not be allowed after
  the application deadline date.

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Start Now.

• Documentation period
• September 1, 2005 December 1, 2006
• 2007 Application not available until September 1,
  2006 at www.aacvpr.org/certification.
• Policies procedures must be in place at time of
  application submission.

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Get a plan.

• Its never too early to start!
• Establish a timeline for completion.
• Use the 2006 application as a guideline.
• Set up a working notebook with all necessary
  tabs.
• Budget FY2007 for application fee.
• Collect the necessary resources.

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RESOURCES

• AACVPR Guidelines for Cardiac Rehabilitation and
  Secondary Prevention Programs, 4th edition, 2004.
• ACSMs Guidelines for Exercise Testing and
  Prescription, 7th edition, 2006.
• ACSMs Resource Manual for Guidelines for
  Exercise Testing and Prescription, 5th edition,
  2006.

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RESOURCES

• The Agency for Health Care Policy and Research
  Clinical Practice Guidelines for Cardiac
  Rehabilitation.
• AACVPR Core Competencies for Cardiac
  Rehabilitation Professionals (J. Cardiopulm
  Rehabil 19941487-92)
• AACVPR Consensus Statement Outcomes Evaluation
  in the Cardiac Rehabilitation / Secondary
  Prevention Programs (JCR, March/April 2004,
  Volume 24, Number 2, pp.68-79)

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ADDITIONALPR RESOURCES

• AACVPR Guidelines for Pulmonary Rehabilitation
  Programs, 3rd edition, 2004.
• AACVPR Clinical Competency Guidelines for
  Pulmonary Rehabilitation Professionals (J.
  Cardiopulm Rehabil 199515173-178)

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Set aside time.

• Mark your calendar for 1-2 hours per week.
• Identify key people to help you.
• Get everyone else on board as well.
• Talk about it often with all your staff.

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Getting started.

• Read the application.
• Read it again.
• Read it again.
• Get familiar with it.
• If you dont understand something ASK!
• Identify your deficiencies NOW and correct them
  by the submission deadline date.
• Note The CR PR applications are similar but
  not the same read each carefully!

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Yes/No Questions

• Read through each question carefully.
• Yes means in substantial compliance 85 of
  charts reviewed will meet the requirement.
• Not all questions require a documentation
  submission but must still be answered Yes.
• Use current No answers to identify weak areas
  you need to work on.
• Any No answer on final application is an
  automatic denial.

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Documentation.

• Read the requirements carefully and follow
  instructions closely.
• Adhere to the acceptable documentation date
  guidelines.
• Watch out for patient identifiers! (Name, MR ,
  SS , DOB, etc). This is a serious HIPPA issue!

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HELPFUL TIPS

• A brief narrative means a brief narrative.
• Remember the reviewers are not familiar with
  your program make it easy for them to
  understand what you are doing.
• Some documentation may need to be submitted under
  more than one Tab.

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• Blank forms are not acceptable when a completed
  form is requested.
• Choosing a patient for documentation purposes.
• Bold, highlight, increase font size, etc. to make
  information easy to identify.

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Tab 1 Staff CompetencySkills Assessment

• New employee orientation competency is not
  acceptable.
• Must have an annual assessment.
• Include list of competencies assessed.

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Tab 6 Informed Consent

• Should include evidence of
• risks
• benefits
• program explanation
• confidentiality
• required signatures

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Tab 7 Exercise Prescription

• Need evidence of physician review.
• Must include all EX RX components
• Mode
• Intensity
• Duration
• Frequency
• Progression
• Oxygen use titration (PR only)

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Tab 8 Medical Emergencies

• ACLS protocols alone are not acceptable.
• Can all be in one policy or in individual
  policies.
• Policy should be clear about exactly what your
  staff will do in each emergency situation.

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Tab 9 Emergency EquipmentDocumentation

• Days facility is closed (i.e. holidays, non-rehab
  days, bad weather days) should be justified and
  not left blank or crossed out.

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Tab 10 Medical Emergency In-services

• ACLS and BLS may be used ONLY if given as a
  department.

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Tab 11 Untoward Events

• AACVPR defines as ANY event that requires staff
  or physician intervention or cessation of an
  exercise session.

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Tab 12 Outcomes Assessment / Program Evaluation

• Must use the required table for health, clinical,
  behavioral domain data.
• Service domain data in narrative form only.
• A completed assessment tool for each domain is
  required.
• Refer to the AACVPR guidelines book for
  acceptable outcomes to assess.
• Data should reflect at least 10 of your annual
  total new patients.

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Tab 13 Risk Stratification

• Must explain in narrative how risk stratification
  is utilized with the patients plan of care
  i.e. staff supervision, length of stay, etc.

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Tab 17 Individualized Care Plan

• Completed plan of care required.
• Must show assessment, intervention, evaluation,
  and follow-up.
• If standard plan is used, must explain how it is
  individualized for each patient.
• Should include short and long-term patient goals
  for all listed domains.
• Domains Educational, exercise, psychosocial,
  nutritional.
• Note Not the same domains as under Tab 12!
• If specific risk factor not pertinent to the
  patient you should say so dont leave blank.

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Organize and polish.

• Complete the application checklist.
• Neatness counts! Use sturdy notebooks and tab
  dividers.
• Make submissions clear and easy to understand.
• Make enough copies and keep one for yourself.
• Check everything closely.
• Check everything again.
• Meet the submission deadline! No late submissions
  will be accepted.

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Now what?

• Applications are reviewed by the state
  association Program Certification committee
  first.
• Additional clarification information is requested
  if necessary.
• State committee makes a recommendation to grant
  or deny certification.
• Additional information recommendation is
  submitted to national committee.
• Final decision made by national Program
  Certification committee.

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• Finally
• Wait to hear that you have successfully achieved
  AACVPR Program Certification!
• Congratulate yourself and your staff! (Treat
  everyone to lunch!)

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• QUESTIONS?