By Christy Sillman
23 Oct

ACHA ACHD Program Accreditation is NOT a Competition

Monday, October 23, 2017

Historically, when searching for appropriate cardiology care, either as a child or an adult, we’ve had to rely on national “rankings” through lists like U.S. News Reports & World Report rankings, or through our own analysis of the transparent information presented in the ACHA program directory. It’s no wonder then, that when the first wave of ACHA ACHD Accredited Programs were announced, many patient’s first reaction was to view these accredited programs as a sort of ranking comparatively to other programs. I saw many comments on social media that included sentiments such as “I can’t believe ____ program wasn’t included!” or “where is _____ program, this doesn’t seem fair!”

Viewing program accreditation as a ranking system is not an accurate representation of the purpose of ACHA ACHD Program Accreditation and isn’t fair to the many programs who are exploring or actively pursuing it.

The past few years have shown great advances in elevating the care of ACHD patients—through the development of guidelines on how to care for ACHD patients, the advent of formal ACHD fellowship training programs, and more recently, an official American Board of Internal Medicine subspecialty certification in adult congenital cardiology. Board specialty helps identify practitioners who are certified to have the knowledge basis to care for adult congenital patients, but this too is an evolving situation. Over the next few years we will continue to see growth in the number of board certified adult congenital cardiologists as currently practicing physicians sit for their board exams and newly graduated fellows become eligible to take the board exam.

However, it wasn’t enough just to ensure that the cardiologists caring for ACHD patients had a standardized expertise level; ACHA wanted to further standardize care within the programmatic framework. ACHA ACHD Program Accreditation serves to “set the bar” for structure and services within the ACHD program as a whole.

ACHD programs come in various packages and structures. They can be “housed” in children’s hospitals, they can be “housed” in adult hospitals, or they can be within an integrated adult and children’s hospital system. These various frameworks can affect care delivery, so one of the main goals of ACHA ACHD Program Accreditation was to ensure that regardless of the hospital system that the ACHD program belongs to, the expertise and services are available to the patient across the board.

The goal is to bridge the gap between the children’s hospital with CHD expertise and adult hospital with adult care expertise. This involves all levels of care—from equipment size to nursing education and collaborating non-cardiac services.

The ACHA ACHD Program Accreditation requirements are robust with a holistic, multidisciplinary approach to ACHD care in mind. Stanford was a pilot site for ACHA ACHD Program Accreditation and we worked together with ACHA and other pilot sites to help evolve the accreditation application process. It was exciting, exhausting, and really an honor to be a small part of the process.

As other programs in the United States prepare to apply for ACHA ACHD Program Accreditation, they must evaluate their current framework, devote resources, and potentially evoke framework change institutionally to meet requirements for application. This may take some time and just like with board certification, I know we will all watch as the numbers of accredited programs rise and the landscape of ACHD care is changed.

So, I’m asking everyone to remember that this will take time, it is not a competition, and ACHA ACHD Program Accreditation is not a ranking—it’s setting the standard of care for patients. It is something a program can be proud of and at The Adult Congenital Heart Program at Stanford, we are honored to be among the first wave of accredited programs.

It’s important to talk to your cardiologist or ACHD team member about their programmatic goals for ACHA ACHD Program Accreditation. You may learn that they are already in the process or that they are preparing to apply for the next round. You may also be the spark that encourages them to devote the resources to achieving this standard of care. Ultimately, we can’t change the landscape of care without the patient support. ACHA is an organization for ACHD patients and so your support of ACHA ACHD Program Accreditation is imperative to its success.


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