Center Task Forces Study Specific Areas for Recommendations

In the wake of the disussion stimulated by the recent Pew Health Professions Commission reports, Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century and Reforming Health Care Workforce Regulation: Policy Considerations for the 21st Century, the Center for the Health Professions has formed several taskforces that are exploring reform efforts and opportunities in specific discipline areas.

• Taskforce on Accreditation of Health Professions Education
  
• Taskforce on the Impact of Managed Care on Physician Assistant Education, Practice and Regulation
  
• Taskforce on Midwifery
  
• Taskforce on the Impact of Managed Care on Pharmacy Practice and Education
  
• Taskforce on the Impacts of Affirmative Action on Health
  

In 1996, the Center for the Health Professions, with support from The Pew Charitable Trusts, established a national task force to examine specific issues related to health professions education accreditation as part of the overall deliberations of the Pew Health Professions Commission. The goal of the Task Force is to improve accreditation processes so that they better meet evolving social needs. The specific focus of the work of the Task Force is on specialized and professional accreditation in the health professions, but with consideration of the broader context both of non-health specialized accreditation and of regional accreditation. The objectives of the Task Force are:

• to identify current and emerging issues associated with the system of accreditation of health professions education;
• to engage in broad community discussions;
• to propose specific strategies to improve accreditation's role in improving education for the health professions; and
• to recommend specific actions for improvement by key stakeholders.

The Task Force identified issues associated with the current system of accreditation through internal discussions and public briefings with a number of interested organizations. Two national forums were held in May 1997 to engage the broad community of interest, including educators, accreditors, professionals, consumers, and government. A series of key issues emerged from these discussions, including clarification of the essential values of accreditation, minimizing duplication and waste in accreditation processes, the linkage of regulation and accreditation, interdisciplinary accreditation, and the reconceptualization of accreditation as a model for educational assessment and improvement.

This dialogue has prompted a number of presentations to professional groups by members of the Task Force, and has also stimulated a series of working papers, which is available now on this site.

Through multiple conversations with stakeholders and other information collection, the Task Force identified four areas for change to improve health professions education accreditation, given the evolving health care system:

• Social factors - to address values and demonstrate public accountability;
• Governance - to resolve and clarify authority and control issues, and expand collaboration among accrediting agencies;
• Structure - to revise standards, increase flexibility of criteria to accommodate innovation, encourage interdisciplinary approaches, expand use of technology, and enhance the professionalism of site visits; and
• Process - to focus on outcomes, facilitate an improvement orientation, and streamline activities to minimize waste and duplication

1. Link the educational process to the changing demands of the public, employers, professional bodies and students

• Accreditors can facilitate the establishment of competencies through a collaborative approach among educators, professional organizations and employers and an on-going assessment of changing practice needs
• Evaluate student achievement in light of these competencies and create threshold performance levels for educational programs

• Provide a framework to reconceptualize accreditation as an activity of "intentional improvement", relying upon a systems thinking approach to gain and apply knowledge to the systematic improvement of academic programs
• Integrate self-assessment techniques and use of results into routine activities

• Agree upon and implement five common criteria which are outcome/competency based, allowing collection of comparable data

• Suggested criteria are:
  • Process of connecting with the community of practice and the public to meet needs and prepare the workforce for the unique needs/contexts/assets of relevant communities
  • Faculty development and evaluation
  • Assessment of student and graduate competencies and achievement
  • Process of continuous self-assessment, planning and improvement
  • Provision of accurate information and representation of program to its public(s) for consumer choice and accountability

• Each profession/specialized accreditor will then create one additional unique criteria to reflect their discipline

• Streamline the accreditation process to increase accountability, minimize duplication and waste, by collecting common data elements across programs and institutions, accessible through a common source
• Increase flexibility, offer greater electronic communication and other resource-conserving approaches

• Focus program review to become a lever for accelerating change by modifying approaches to increase self-assessment and decrease reliance on site visits
• Expand professional training of site visitors to increase assessment and consultation capabilities

The Task Force welcomes your comments and suggestions about these recommendations. For further information, conact Sherril Gelmon.

The Center for the Health Professions convened a task force charged with examining the implications of managed care on the education, practice and regulation of Physician Assistants. The Executive Summary and Recommendations of the Task Force's final report are available on this site.

This eight-member task force, chaired by Ruth Ballweg, P.A.-C of the University of Washington, consisted of representatives from physician assistant educational institutions, care delivery organizations, and academia. The task force performed a review of the literature and AAPA databases to determine four main components of the profession: its history, demographics of practitioners, professional education and the regulation practice.

Next, the roles of PAs in managed care systems were examined, looking at best practices, the possible use of outcomes data in practice settings, as well as utilization analysis. Qualitative data was obtained through site visits and some quantitative analysis was used to examine outcomes and utilization practices. The final report includes case studies examining the relevant issues that PA's face in a variety of managed care settings.

Midwifery, one of the health care professions dedicated to caring for women before, during and after pregnancy, has had a unique history in America. Following their near monopoly as the attendant of choice for childbearing women for centuries, American midwives lost this position after the turn of the 20th century when organized medicine-and obstetrics as a specialty-entered the scene. Recent years have witnessed both an increase in number of practicing midwives and an increase in number of births attended by midwives, although the percentage of total births attended by midwives remains a fraction of the number delivered by physicians.

What role has market-driven reform of health care delivery and reimbursement systems played in this re-emergence and how will managed care affect midwives in the future?

The goal of the task force is to bring together experts in the field, identify the current and future issues facing the profession, and collectively recommend strategies to position the profession to take advantage of the opportunities afforded it by the changes as well as to raise the awareness of challenges likely to confront it. A national taskforce of eight experts is meeting to discuss the issues and to write a report by the Fall 1998/Winter 1999 that captures the group's concerns and recommendations. The Center will print and disseminate the final report through its communications division..

For further information, contact Catherine Dower at the Center.

The Center has joined with the American Association of Colleges of Pharmacy (AACP) in creating this task force to examine issues related to the implications of moving to managed care in pharmacy practice and education. The eight-member task force, chaired by Dr. Mary Ann Koda-Kimble, of University of California, San Francisco, has performed case studies to identify and illuminate the changing role of the pharmacist in a variety of settings influenced by managed care, including chain stores, independent pharmacists, hospital settings, staff models and other managed care settings. The task force will complete its final report in early 1998.

In collaboration with the UCSF Institute for Health Policy Studies, the Center for the Health Professions is seeking to understand the possible linkages between affirmative action and health status. Starting with a definition of affirmative action as efforts to increase participation of historically disadvantaged people in institutions or societal activities, the project will focus on the established links between 1) affirmative action efforts and health status, particularly among historically underserved populations; 2) affirmative action efforts and health professions diversity; and 3) the relationship, if any, between health professions diversity and health status of historically underserved populations. Specific project objectives include:

• Developing a conceptual model that will help understand and describe direct and indirect effects of affirmative action on health status;
• Conducting a literature review on the topic of affirmative action and health care, including references to mediating factors;
• Preparing a report that summarizes the work done and recommendations made to date; and
• Identifying the areas where additional research is needed and the questions that might be helpful in framing that research.