Joint Accreditation Research Articles

In the Midst of Dealing With Changes in Continuing Education: A Mental Model to Support Well-Being and Action.

Continuing education (CE) professionals are experiencing continuous changes in their practice, including situations where they see a need for change but feel overwhelmed with change implementation. This article is a reflection on our experience of (1) transitioning from independently operating health professions CE units in medicine, nursing, and pharmacy to becoming a Joint Accreditation provider of interprofessional CE and (2) developing and using a Diversity, Equity, and Inclusion Toolkit for Accredited Continuing Education. We examined these instances of substantial change to identify what made them achievable and supported our well-being throughout the process. We also considered a social cognitive theory, a schema theory, and a normalization process theory. As a result, we identified five steps of the CE planning and implementation process to be our trusted mental model and the key factor in making the changes doable for our team and supporting our resilience and a sense of well-being. Interviews with three clinician-learners, which were conducted in search of additional insights, reminded us that positive reinforcement occurs when we see the desired result. Thus, measuring the CE change and its impact on learners and their patients is also a tool to sustain emotional comfort during the turbulence of a change cascade, given the measures show progress in a desired direction. We hope this article will stimulate peer discussions, reflections, and sharing of lessons learned from similar journeys.

Historical Perspective and Current State Review: Advancing Lifelong Learning and Continuing Professional Education in Nutrition and Dietetics to Expand Opportunities, Equity, Access, and Future Transformations

Lifelong learning has been integral to advancement of the nutrition and dietetics profession and its practitioners. Both the United States (US) Commission on Dietetic Registration (CDR) and the Academy of Nutrition and Dietetics (Academy) advocate for continuous skill development and professional growth. Responding to evolving environmental trends and diverse practice perspectives, the CDR joined the Joint Accreditation for Interprofessional Continuing Education organization in 2020, and the CDR is transforming its own continuing professional education (CPE) requirements and prior-approval program. This paper presents a historical perspective and a current state narrative review, chronicling past and recent developments in nutrition and dietetics CPE in the US, including opportunities for reflective learning and interprofessional continuing education (IPCE). Also explored are the establishment and expansion of the Joint Accreditation organization and its standards, as well as applicable case examples. Additionally, this paper outlines the CDR and the Academy’s strategies for advancing inclusion, diversity, equity, and access (IDEA) within the profession and identifies how CPE advancements may facilitate accessible and equitable CPE for an increasingly diverse membership of practitioners. Nutrition and dietetics professionals stand to benefit from a more comprehensive understanding of changes in CPE and the opportunities they may bring to the future of the profession.

Leveraging an Interprofessional Continuing Education Approach to Empower Preceptors.

In July 2022, a large multi-state health care organization received Joint Accreditation, making the organization one of the elite 150 organizations internationally. Joint Accreditation offers continuing education using one succinct accreditation process. Interprofessional continuing education versus a siloed continuing education approach is essential in providing high-quality patient care and improving organizational outcomes. Completing a comprehensive needs assessment led to discovering potential educational opportunities and awareness that precepting interprofessional teams was an opportunity for interprofessional continuing education. This column will discuss how nursing professional development practitioners in the health care system with Joint Accreditation can address the need for interprofessional preceptor development. [J Contin Educ Nurs. 2023;54(7):293-296.].

Benchmarking of survival outcomes following Haematopoietic Stem Cell Transplantation (HSCT): an update of the ongoing project of the European Society for Blood and Marrow Transplantation (EBMT) and Joint Accreditation Committee of ISCT and EBMT (JACIE)

From 2016 EBMT and JACIE developed an international risk-adapted benchmarking program of haematopoietic stem cell transplant (HSCT) outcome to provide individual EBMT Centers with a means of quality-assuring the HSCT process and meeting FACT-JACIE accreditation requirements relating to 1-year survival outcomes. Informed by previous experience from Europe, North America and Australasia, the Clinical Outcomes Group (COG) established criteria for patient and Center selection, and a set of key clinical variables within a dedicated statistical model adapted to the capabilities of the EBMT Registry. The first phase of the project was launched in 2019 to test the acceptability of the benchmarking model through assessment of Centers’ performance for 1-year data completeness and survival outcomes of autologous and allogeneic HSCT covering 2013–2016. A second phase was delivered in July 2021 covering 2015–2019 and including survival outcomes. Reports of individual Center performance were shared directly with local principal investigators and their responses were assimilated. The experience thus far has supported the feasibility, acceptability and reliability of the system as well as identifying its limitations. We provide a summary of experience and learning so far in this ‘work in progress’, as well as highlighting future challenges of delivering a modern, robust, data-complete, risk-adapted benchmarking program across new EBMT Registry systems.

Advancing Teamwork in Health Care Through Continuing Education Joint Accreditation.

Teamwork is a necessity for effective care of patients in the current health care environment. Continuing education providers are best positioned to teach health care professionals about teamwork. However, health care professionals and continuing education providers largely operate in single-profession-based environments and thus need to change their programs and activities to achieve team improvement education goals. Joint Accreditation (JA) for Interprofessional Continuing Education is designed to advance teamwork to improve quality care through education programs. However, achieving JA requires significant changes to an education program that are multifaceted and complex to implement. Although challenging, implementation of JA is an effective way to advance interprofessional continuing education. Here, we discuss numerous practical strategies that can aid education programs to prepare for and achieve JA, such as attaining organizational alignment and provider adaptation to expand curriculums, reinventing the education planning process, and implementing tools to help manage the joint accredited program.

THE CURRENT STATUS OF ARCHITECTURE EDUCATION IN TURKIYE AND ITS VARIATIONS

Architectural education is constantly evolving and changing. Aim: This study aims to reveal the differences between all architectural education institutions in Turkiye. Course contents, course hours, studio hours, elective course hours, interdisciplinary courses, IT-based courses, number of students and faculty members, part-time faculty members, teaching languages, geographical locations, international connections, achievements and accreditation status of universities were analyzed. Results: According to the results, it was observed that the unbalanced increase in the number of faculty members, especially in foundation universities, was met by externally supported part-time faculty members. Although this situation provides a solution in the short term, it negatively affects the quality of education in the long term. In addition, the inability of architectural education institutions in Turkiye to achieve international accreditation leads to a loss of prestige in the international arena. Conclusion: The study identifies the shortcomings of architectural education and profession in Turkiye and offers recommendations for educational development. Among these recommendations is that all universities should undergo a joint accreditation process and become members of the national accreditation platform, MİAK. It is then suggested that MİAK should move to an international level by providing a global co-operation. It is also suggested that the duration of architectural education in Turkiye be increased to six years and a new curriculum be proposed. These steps are thought to help improve the quality of architectural education in Turkiye and make it internationally competitive.

Celebrating the Culture of Interprofessional Collaboration in Athletic Training

Celebrating the Culture of Interprofessional Collaboration in Athletic Training

Effect of COVID-19 Pandemic on Hematopoietic Stem Cell Transplant Activity: Experience of a JACIE-Accredited Center.

The adoption of international quality and accreditation standards is important for the success of transplant centers. Guidelines from the Joint Accreditation Committee ISCT-Europe and EBMT (JACIE) have enabled quality management of the operations of clinical units of cellular therapy centers, including cell collection and processing, thus minimizing errors and adverse events. COVID-19 has had significant implications for immunocompromised patients, particularly hematopoietic stem cell transplant recipients, as well as their donors and caregivers. Here, we retrospectively examined measures, taken in our transplant center in Turkey during the pandemic period between March 2020 and October 2021, to investigate how JACIE accreditation has affected patient, donor, product, and employee safety. We analyzed data on transplant activity, as well as donor, patient, product, and employee safety, during the pandemic in 3 separate 6- month periods. The measures were analyzed starting from March 2020, when the first COVID-19 case was seen in Turkey. Since the beginning of the pandemic, 140 patients have undergone stem cell transplant in our center. Stem cell transplant was delayed in 22 patients because of the pandemic. Transplant was also postponed due to COVID-19 positivity in 6 patients, and 2 patients died due to COVID-19 infection during the transplant process. Unrelated donor activity continued to be performed safely throughout this period. COVID- 19 infection developed in 12 of the 52 personnel working in the bone marrow transplant unit, one of whom needed intensive care due to severe pneumonia. In terms of quality management activities, the impact of the pandemic was greatest during the first month. Results from our retrospective study examining the impact of JACIE accreditation in a stem cell transplant center during the COVID-19 pandemic showed that, when national and international guidelines are followed, JACIE accreditation can facilitate adaptation to changing conditions in transplant centers.

Validation plan of bone marrow collection, processing and distribution using the failure mode and effect analysis methodology: a technical report

Background aimsBone marrow (BM) is commonly used in the pediatric and adult setting as a source of hematopoietic stem cells (HSCs). The standards of the Joint Accreditation Committee of the International Society for Cell & Gene Therapy & European Society for Blood and Marrow Transplantation (JACIE) include specific requirements regarding BM collection, processing and distribution. To run this process, each transplant team develops a series of JACIE-compliant procedures, customizing them with regard to local settings and paths. Moreover, JACIE standards require that transplant teams validate and periodically revise their procedures to keep the entire process under control. In this article, the authors describe the methodology adopted in our center to fulfill the aforementioned JACIE requirements. MethodsThe authors developed a validation plan based on the failure mode and effect analysis (FMEA) methodology. According to the FMEA approach, the authors carefully revised activities and procedures connected to BM collection, processing and distribution at our institution. The entire process was initially divided into five main phases (assessment of donor eligibility, perioperative autologous blood donation, preparation of BM collection kit, BM harvesting and BM processing and distribution), comprising 17 subphases and 22 activities. ResultsFor each activity, one or more failure modes were identified, for a total of 28 failure modes, and a risk priority number (RPN) was then assigned to each failure mode. Although many procedures were validated, others were subjected to substantial changes according to the RPN rating. Moreover, specific indicators were identified for subsequent monitoring to contain the risk of failure of steps emerging as critical at FMEA. ConclusionsThis is the first study describing use of the FMEA methodology within an HSC transplant program. Shaping the risk analysis based on local experience may be a trustworthy tool for identifying critical issues, directing strict monitoring of critical steps or even amending connected procedures. Overall, the FMEA approach enabled the authors to improve our process, checking its consistency over time.

Is It Possible to be a Stem Cell Donor for the Second Time: A Single-Center Report of 12 Consecutive Procedures.

The use of unrelated donors as a source of stem cells for patients with blood disorders continues to increase. Approximately 5% to 7% of unrelated stem cell donors are asked to donate stem cells a subsequent time to the same or a different patient. We investigated donors who accepted to be a donor for the second time between 2015 and 2021; donors were evaluated in terms of procedure-related complications, product quality, and donor follow-up in a JACIEaccredited (Joint Accreditation Committee of the International Society for Cellular Therapy and European Society for Blood and Marrow Transplantation). Stem cell collections were performed in accordance with relevant standard operating procedures from healthy volunteer donors. Data on sequence of peripheral blood stem cell, bone marrow, and donor lymphocyte collection procedures; presence of complications during procedures; time between 2 donations; need for granulocyte colonystimulating factor again; and first and second donation types were noted. Data on donor and stem cell products were determined using the hospital information management system. Our study included 12 donors (9 men and 3 women) who donated a second time within the specified date range. In the evaluation of the second donation types, 7 were lymphocyte collection donations, 4 were peripheral blood stem cell donations, and 1 was a bone marrow stem cell donation. In shortterm and long-term follow-ups, there were no complications among the donors. In the second donations, targeted product values were reached. Although it is safe to have a second donation from a donor for the same patient, collection centers may collect more products than requested from eligible donors.

Predictors of Transplant-Associated Thrombotic Microangiopathy in Patients With Overlap or Chronic Graft-vs-Host-Disease

Recent data suggest that novel biologic agents are associated with increased risk of thrombotic microangiopathy (TMA). Ruxolitinib, an approved treatment for graft-vs-host-disease (GVHD), has been associated with thrombocytopenia of unclear etiology. We investigated factors and outcomes associated with transplant-associated thrombotic microangiopathy (TA-TMA) in patients with GVHD. We retrospectively enrolled consecutive allogeneic hematopoietic cell transplantation recipients with overlap or chronic GVHD at our Joint Accreditation Committee ISCT-Europe & EBMT-accredited unit (January 2016-June 2019). Ruxolitinib has been administered off-label since 2016. Among 160 patients with GVHD, 18 were diagnosed with TA-TMA. TA-TMA developed at a median of 150 posttransplant days (range, 98-3013). Among pre- and posttransplant factors, TA-TMA was associated only with ruxolitinib administration and severe GVHD. Interestingly, these 2 variables did not correlate with each other. In the multivariate analysis, both were independent predictors of TA-TMA. Time-dependent analysis confirmed ruxolitinib's association with TA-TMA. With a follow-up of 38.4 months (4.6-83.9) in surviving patients, 5-year overall survival was 52.9%, independently predicted by TA-TMA, severe acute GVHD, and CD34+ cells infused. Ruxolitinib was not associated with survival outcomes. Our data suggest that ruxolitinib and GVHD severity are associated with TA-TMA. Given the expanding use of ruxolitinib in GVHD and ongoing trials on chronic GVHD, further studies are warranted to confirm these findings.

The 47th Annual Meeting of the European Society for Blood and Marrow Transplantation: Quality Management Group – Oral Session (O175-O178)

Background: JACIE (Joint Accreditation Committee ISCTEurope & EBMT) standards define continuous training as a requirement for nurses working in accredited transplant units. Obtaining continuous education can be difficult, so our center decided to implement their own accredited training course. Since 2008 a specific training course, accredited by regular authorities, free of charges in the workplace and held by staff nurses, has been organized. Through all these years, the structure has been modified according to the needs and opinions of the attending nurses. Currently, it consisted of 10 sessions that take place through the year;each session was held at two or three different times (depending on the availability of the speaker), and so nurses from all shifts could attend. At the beginning of the pandemic caused by SARS-COVID 2, in March 2020, we had to suspend the program and reconsider how we could maintain the educational sessions. Methods: From June to November we reinitiated the course. Now, several options were offered to participate: (a) in person, since in our country meetings were restricted to ten people, with previous registration required, (b) synchronously through the Zoom platform, and (c) deferred, as all sessions were recorded so nurses were able to access through the internal training platform of our center. To justify attendance and get the accreditation, when the session was viewed in a delayed manner through the platform, three questions about the viewed session were required to be answered. The course has been accredited by our national system of accreditation. Results: 91 nurses participated in the course. 63.8% of the attendance was virtual. At the end of the course, a satisfaction survey was carried out among the participants. The average score of the questions was 9,25. The lowest score was 8,57 and, the highest, 9,53. There was also a final question in an open format to make comments and suggestions for future editions. Conclusions: Offering quality and up-to-date training to nurses in hematological transplantation wards is one of the JACIE's standards that sometimes is difficult to achieve due to the difficulty of combining nursing schedules and shifts, and the lack of economic resources. The appearance of the pandemic has been an added challenge in order to be able to maintain continuous training as it was established in our center. It was not easy initially to organize it, but it helped us that our center already had a training platform, the availability of online streaming platforms and our background in offering training courses. The high participation and satisfaction of the attendance nurses encourage us to explore and continue new training formats for highly specialized nurses.

Dual Degree Training: Balancing Clinical Aptitude and Medical Licensure Requirements

Dual Degree Training: Balancing Clinical Aptitude and Medical Licensure Requirements

University of Wisconsin School of Medicine and Public Health.

University of Wisconsin School of Medicine and Public Health.

Autologous haematopoietic stem cell transplantation in multiple sclerosis and other immune-mediated neurological diseases: guidelines and recommendations of the European Society for Blood and Marrow Transplantation and the Joint Accreditation Committee of the International Society for Cellular Therapy (4540)

Autologous haematopoietic stem cell transplantation in multiple sclerosis and other immune-mediated neurological diseases: guidelines and recommendations of the European Society for Blood and Marrow Transplantation and the Joint Accreditation Committee of the International Society for Cellular Therapy (4540)

Improving undergraduate medical education in Nigeria: Insight into the past

The first three in the series of Society of Gynaecology and Obstetrics of Nigeria (SOGON) lectures on “Frontiers in Medical Education,” in honor of Professor Linus Ajabor, had focused on internship and postgraduate medical education. This fourth lecture is about the evolution of undergraduate medical education in Nigeria from its rudimentary beginning in 1930 to the present. Lessons from the past include the desirability of tailoring medical education toward meeting national needs, doing proper needs assessment before planning and implementation, setting minimum standards for training institutions, and enforcing these standards through a credible process of accreditation. Recommendations for the future include a harmonization of the guidelines on minimum standards published by the Medical and Dental Council of Nigeria (MDCN) and the minimum academic standards published by Nigeria's National Universities Commission (NUC), and the conduct of joint accreditation by both agencies to maximize efficiency and reduce waste. There should also be mandatory training in pedagogy for clinician teachers, periodic curriculum reviews must be enforced, and simulation laboratories should be provided in all accredited medical schools.

Kadrovska organizacija/struktura i funkcionisanje centara za transplantaciju matičnih ćelija - kako optimizovati program transplantacije?

There are four stem cell (SC) transplant centers in Serbia that carry out their activities within the European Group for Blood and Marrow Transplantation (EBMT). They are positioned in the Clinical Center of Serbia, Military Medical Academy, Institute for Mother and Child Healthcare "Dr. Vukan Čupić" and in the Clinical Center of Vojvodina. The aim of this paper is to analyze the basic approaches and aspects, as well as main parameters and guidelines - related to the optimization of the functioning of SC transplantation centers. The existence of a competent and motivated professional employees of the transplant center, as well as an adequate operational locality/area and up to date equipments are imperative for the successful performance of this specific and complex procedure. The current tendency - and in the near future an obligation or requirement - is for each transplant center within the EBMT to be fully staffed and structurally equipped and ready to be included in the accreditation process by the Joint Accreditation Committee International. Begining the accreditation process implies, in addition to the implementation of education and training of employees, the establishment and implementation of specific quality control standards (ISO 9001: 2015, ISO 13485, ISO 13485: 2016, ISO 15189: 2007, ISO 17025, ISO / IEC 7025: 2005). The activity indicators of every transplant center have to be transparent and presented by: the number of treated patients, the rate of transplant mortality, the duration and quality of patient's lives. Also important parameters are various methods of economic analyses - different specific cost-benefit analyses. In conclusion, in order to achieve consistent/comparable therapeutic effects and outcomes for patients globally - it is imperative that transplant centers and related organizations work together on the quality system assurance, using a continuous and adequate "educational and organizational-structural models".

Editorial introductions

Editorial introductions

Management of adults and children undergoing chimeric antigen receptor T-cell therapy: best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE).

Chimeric antigen receptor (CAR) T cells are a novel class of anti-cancer therapy in which autologous or allogeneic T cells are engineered to express a CAR targeting a membrane antigen. In Europe, tisagenlecleucel (Kymriah™) is approved for the treatment of refractory/relapsed acute lymphoblastic leukemia in children and young adults as well as relapsed/refractory diffuse large B-cell lymphoma, while axicabtagene ciloleucel (Yescarta™) is approved for the treatment of relapsed/refractory high-grade B-cell lymphoma and primary mediastinal B-cell lymphoma. Both agents are genetically engineered autologous T cells targeting CD19. These practical recommendations, prepared under the auspices of the European Society of Blood and Marrow Transplantation, relate to patient care and supply chain management under the following headings: patient eligibility, screening laboratory tests and imaging and work-up prior to leukapheresis, how to perform leukapheresis, bridging therapy, lymphodepleting conditioning, product receipt and thawing, infusion of CAR T cells, short-term complications including cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, antibiotic prophylaxis, medium-term complications including cytopenias and B-cell aplasia, nursing and psychological support for patients, long-term follow-up, post-authorization safety surveillance, and regulatory issues. These recommendations are not prescriptive and are intended as guidance in the use of this novel therapeutic class.

The Origin of NCCT International School Accreditation in China

This article is a condensed translation from Chinese of the original PhD thesis by Dr Mo Jingqi and illustrates how international accreditation was introduced in China during a time of rapid government structural change. The article is valuable from three perspectives: first, it provides a rare insight into the means for introducing change in the education system in China; secondly, it describes the evolution of the role of the National Center for Curriculum and Textbook Development, a non-governmental organization, and how it became authorized by the Ministry of Education to implement education policy in China; and thirdly, the idea of transplanting into China a joint accreditation system for international schools is by itself a major historical change, the model of which may one day expand to other types of schools in China. It should be noted that the titles of Chinese references have not been translated as they can be found only in Chinese language. In addition, during those years of rapid change, the titles and roles of many government organizations also changed, including that of the National Center for School Curriculum and Textbook Development (NCCT). It is important to appreciate the challenges of language translation as many of the concepts have different meanings in Chinese and have changed during that time period. This includes the meanings of ‘international school’ and ‘accreditation’.