Accreditation Essay Sample

Introduction

It is difficult to define accreditation because countries define the term differently. In American usage, accreditation is perceived as the mark of quality and is awarded through a process, where an educational institution provides information to a third independent party that evaluates that information and states whether the institution or program is qualified. In other words, the primary role of accreditation in the United States is to attest publicly to the worth of an academic program or educational institute (El-Khawas, 2001).
That said; to the Commission for Health Care (ACHC), accreditation is defined as the process of review that “healthcare organizations participate in to demonstrate the ability to meet predetermined criteria and standards of accreditation established by a professional accrediting agency” (ACHC, n.d). All organizations and institutions are represented as credible when accredited. In addition, accredited agencies and organizations are bound to comply with the highest standard of quality on an ongoing basis (ACHC, n.d.). The ACHC has formed collaborations with industry professionals to develop standards to make sure high quality is provided and maintained throughout the organization. For that reason, industry experts conduct on-site surveys every three years and review all aspects of the organization. These aspects include (1) Organizational structure, (2) leadership, (3) compliance with laws (local/state/federal), (4) policies & procedures, (5) patients’ rights & responsibilities, (6) human resource management, (7) fiscal operations, (8) care provision, (9) patient records, (10) performance improvement, (11) quality outcomes, (12) employee/patient safety, and (13) infection control (ACHC, n.d). During the survey, organizations show how they have managed to sustain continuous compliance with the standards of accreditation, as set by ACHC.
Moreover, DMEPOS (Durable Medical Equipment, Prosthetics, Orthodontics, and Supplies) agencies have to comply with the requirements established by the Centers for Medicare and Medicare Services, in order to be able to participate in the program of Medicare (ACHC). For particular services and programs, organizations have to become accredited by ACHC or any other accreditor, before participating in Medicare (ACHC).
In the field of education, accrediting agencies conduct institutional reviews and based on the information they collect from these reviews, make publicly-announced decisions as to whether an institution will be accredited or not. The consequences for the institution involved in the accreditation process are significant and determines their continuation of accreditation or not. In addition, becoming accredited means other institutions may allow credit/degree recognition, and that they can participate in particular government programs (El-Khawas, 2001). If the condition of the institution involved has deteriorated, then accreditation might be denied.

Difference between Accreditation and Licensure

Representatives from several credentialing organizations have agreed that a credible way to demonstrate one’s proficiency within a particular field is through professional credential (Marberry, Quist, & Decka, 2011). Someone committed to his or her profession and provides a tangible recognition of his or her experience and/or knowledge is identified by a credential. Credential is an umbrella term used for a variety of programs, such as certification, licensure, and accreditation. It is an “attestation of qualification, competence, or authority issued to an individual by a third party with a relevant or de facto authority or assumed competence to do so” (Marberry, Quist, & Decka, 2011).
On the other hand, licensure is a process by which an individual is granted permission for a limited amount of time to engage in a particular profession, after having verified that they have met the standardized criteria, usually including experience, education, and examination (Marberry, Quist, & Decka, 2011). A governmental agency only provides this permission. The point of licensing is to ensure that all licensees have the minimal degree of competency, in order to make sure that public welfare and/or health and safety are guaranteed. Those interested in becoming licensed have to meet some eligibility criteria and undergo an assessment that usually covers a wide array of both skills and knowledge, most frequently at the entry level. In addition, there are ongoing requirements that also have to be met if the licensee desires to remain licensed. These requirements include physical exams and retests, among others (Marberry, Quist, & Decka, 2011). Although only governmental agencies can grant licensure, professional associations may also become involved in licensure-related activities, such as partnering with agencies that are accountable for the administration and development of licensing. Finally, licenses are granted per one jurisdiction. If the individual works in several jurisdictions, they need to be licensed for each one of the jurisdictions they work in, with requirements varying from state to state. (Marberry, Quist, & Decka, 2011). At this point, it should be noted that the term licensure is often interchangeable with the term registration. For this reason, if an individual is a registered professional, it means they are licensed, in most cases.

The History of Accreditation in the United States

Throughout the last 30 years, governments the word over have raised new questions in regards the relevance and quality of their systems of higher education, showing a shift towards more formal systems of quality assurance. In the U.S, the history of accreditation goes way back. In the early 20th century, accreditations agencies were established, as a means to respond to the increasing numbers of institutions at the time. In addition, these agencies had to make sure academic standards were consistent across all organizations. Since those early years, the accrediting practice and overall policy have become more complex, because agencies responsible for quality assurance have to follow fair and transparent evaluation procedures, directed to crucial educational questions (El-Khawas, 2001).
Accreditation’s origins are traced in the concerns of numerous regionally based associations of universities and colleges, established in the 19th century. These associations took on accreditation functions later on. During 1885 and 1895, four regional associations were formed, with members from the Middle Atlantic states, New England, the Southern states, and the North Central states. In 1917, the North-West Association was established, as a means to build closer relations between secondary school administrators and college administrators, and set standards considering what would constitute sufficient preparation for college study. More and more young people wanted to enter college, which led to an increase in the number of colleges and state universities (El-Khawas, 2001).
Given that there was no approach as per how secondary level study should be organized, some colleges provided their own preparatory instructions and admissions requirements to potential students, although some New England colleges had implemented joint entrance examinations. However, after the colleges were unable to have personal knowledge of the applicants or the applicants’ preparation, given that the number of applicants kept rising, some parts of the country offered inadequate secondary preparation. Colleges were facing a problem. They had to decide whether applicants were adequately prepared for college study or not. This led to the formation of the North Central Association that took the lead and was responsible for accrediting and certifying secondary schools (El-Khawas, 2001).
The need to create stronger procedures for accreditation led to new initiatives. The North Central Association conducted a research project whose results were turning a page in accreditation. Each institution should be judged on a large array of activities, and qualitatively, as well as in accordance with its own stated purposes. This different approach was adopted by other regional accrediting associations and became the fundamental approach to accreditation in higher education (El-Khawas, 2001).
The next significant step in regional accreditation was after World War II, when the rapid boost in enrollments and number of institutions, asked for better accreditation. From 1950 and until the 1970s, regional accrediting agencies worked on their standards -modified and revised them- and altered the evaluation procedures numerous times. Until the 1990s, changes were still made, with a particular focus on whether students were high achievers in their studies. With that in mind, higher education emphasized in finding ways to make institutions deliver better instruction (El-Khawas, 2001).

Program Accreditation

In regards program accreditation or specialized accreditation, the initial development also occurred in early 20th century and aimed at helping universities and colleges prepare their graduates. According to Glidden (1983) “specialized accreditation was born out of the concern of a profession about the quality of educational programmes that were preparing its practitioners” (El-Khawas, 2001, p.32) Schools at that time were offering poor training, and the medical profession was the first to take lead. By 1903, medical colleges’ representatives had already created a register of schools that met the quality standards they had agreed upon. They also visited member colleges to assess quality. In the early 1900s, the American Medical Association shifted the leadership role and established a Council on Medical Education. In 1905, it developed the first rating system for medical schools that comprised of ten categories. In 1907, it issued a list of all acceptable schools, based on the findings of the inspection visits. The program accreditation in medicine had its basis in these actions of the American Medical Association and subsequent actions, as well (El-Khawas, 2001).
The focal point of accreditation programs was different from the regional accrediting agencies. The ones responsible for determining the quality of the educational programs used to prepare aspiring practitioners were individual members of the profession, who worked in tandem with one another while researching and inspecting the agencies. They not only developed the standards that defined good practice, but also made inspection to determine whether (and to what extent) the particular programs met the established standards. Their findings had a direct impact on the existing medical training programs and were made public (El-Khawas, 2001).
Other professional groups, such as law, dentistry, nursing, architecture, and collegiate business education, among others, followed a similar pattern of development, by 1930. By early 1950s, there were more than 20 program accredited agencies formally recognized. As with regional accrediting at its early forms, program accrediting methods were limited, during the first decades. Institutions were not obliged to perform self-studies nor were there inspection requirements to check on programs, despite the fact that there were occasional visits performed by staff members (El-Khawas, 2001).
The period following World War II signaled a fast expansion in the number of program accrediting agencies, as they doubled from 22 in 1950 to almost 50 by 1982. Enrollments increased significantly, especially in fields offering doctoral and master-level preparation for the professions. In addition, several allied health professions had an organization that accredited academic programs. The work of individual groups was coordinated by the Committee on Allied Health Education, by 1980 (El-Khawas, 2001). To sum up, practitioner groups were still setting the standards for accreditation and had other educator-based groups becoming involved in the process, as well, from time to time.

The Current and Future Challenges with Accreditation

The biggest challenge for accreditation right now is to provide guidance to academic institutions. Accrediting agencies will probably have to take a leadership role and help identify ways that instruction may change, as well as the problems that should be addressed if quality standards are not continuous. As of now, accrediting organizations have already taken some action to respond to this challenge. For example, individual accrediting agencies have already issued new guidelines (e.g. the International Association for Management Education has taken a first step dealing with distance learning-related issues by developing a statement that identifies these issues, in 1999) (El-Khawas, 2001). The government also has a concern, since it relies on the role of an accrediting expert to evaluate the quality of education and health care. For that reason, the government must be sure that the accredited agencies are competent to monitor, for example, distance learning.
As for the future of accreditation, there are two primary concerns in regards. Fifty years ago, there was no quality improvement and outcome measures were nor comprehended. Nursing, among other disciplines, will have to complete competency examinations in their practice discipline, in order to ensure quality and produce advanced competency ((Ryan, 1997). The other question is about the regulatory agent of accountability. It is still uncertain as to who will be that agent: the federal government, the state, the public stakeholders, or the professions? In addition, should the licensure and accreditation process be linked to credentialing to improve accountability? The licensure exam and the passing score are already national. The states serve as prime registers of records and recognize reciprocity with each other beyond state boundaries (Ryan, 1997).
Accreditation is not new in the United States. Throughout the years, developing accreditation has become the focal point of all institutions striving to provide their students with the best education and training so they enter the job arena with the best of skills and knowledge. There are many challenges involved in current and future accreditation that should be addressed and will puzzle the government, institutions, and agencies alike.

References

ACHC (n.d). What is Accreditation? Accreditation to the Commission for Health Care. Retrieved Feb. 2, 2015 from: http://www.achc.org/getting-started/what-is-accreditation.
El-Khawas, Elaine (2001). Accreditation in the USA: Origins, Developments and Future Prospects. International Institute for Educational Planning. Retrieved Feb. 2, 2015 from: http://unesdoc.unesco.org/images/0012/001292/129295e.pdf
Marberry, Sara, Quist, Carolyn, Decka, Donna (2011). Accreditation, Certification, Licensure, Registration. Healthcare Design. Retrieved Feb. 2, 2015 from: http://www.healthcaredesignmagazine.com/node/7818?page=1
Ryan, S., (1997). Accreditation for the Future: A Director's Perspective. Online Journal of Issues in Nursing. Vol. 2, No. 3, Manuscript. Retrieved Feb. 2, 2015 from: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol21997/No3Aug97/AccreditationfortheFutureADirectorsPerspective.html