National Accreditation System Research Articles

Physical Activity Programs in Long Day Care and Family Day Care Settings

IN THE PAST 10 YEARS the prevalence of childhood obesity has increased considerably and there is growing recognition of the need to establish positive attitudes to healthy lifestyle practices from an early age if this trend is to be reversed. Childcare centres provide ideal environments from which to develop these positive attitudes. A literature review conducted to identify best-practice physical activity programs and resources utilised by long day care (LDC) and family day care (FDC) found only one physical activity program directly targeting these settings. In addition, few references to physical activity were found in the National Childcare Accreditation Council Quality Improvement and Accreditation System and Family Day Care Quality Assurance systems. The literature also suggested limited research on the physical activity status of children attending LDC and FDC. Further developments to these areas will improve the delivery of Australian child care and assist in a healthy future for Australian children through LDC and FDC.

The Humidity Calibration Facility of the National Metrology Institute of South Africa (NMISA)

The NMISA Humidity Laboratory maintains the South African national measurement standards for humidity and provides traceability for commercial calibration laboratories. The laboratory performs both relative humidity and dew-point calibrations. The laboratory has been accredited since January 2004 for both parameters by the South African National Accreditation System (SANAS). Industries such as the pharmaceutical industry, power stations, and the food industry make use of the calibration services provided by the laboratory. The facilities and the measurement capabilities of the laboratory are presented in this paper. Two calibration methods are used for the calibration of relative humidity measuring instruments (RH meters). Depending on the type of instrument, they are calibrated against aqueous salt solutions or by comparison with reference RH meters. Measurements are performed over the humidity range 5–95 %rh (Best Measurement Capabilities: 0.4–1.4 %rh). Two chilled-mirror hygrometers are used as reference standards for dew-point calibrations over the range from −75°Cfp to +17°Cdp (Best Measurement Capabilities: 1.5°Cdp to 0.4°Cdp). The laboratory has participated in two international interlaboratory comparisons, one for each accredited parameter. The NMISA Humidity Laboratory is working to reduce its calibration uncertainties for relative humidity instruments: since first accredited in 2004, the best measurement capabilities have been improved from 2.1 %rh to 0.4 %rh for some humidity ranges.

What is an Allergist?: Reconciled Document Incorporating Member Society Comments, September 3, 2007

An allergist is a physician who has successfully completed both a specialized training period in allergy and immunology and a training period in either internal medicine, or a sub-specialty of internal medicine such as dermatology, pneumology, or otorhinolaryngology, and/or pediatrics. Subject to national training requirements, allergists are also partially or fully trained as clinical immunologists, because of the immune basis of the diseases that they diagnose and treat. In most countries, the approved period of specialty training in allergy and immunology will be two to three years of specific, intense training. Depending on national accreditation systems, completion of this training will be recognized by a Certificate of Specialized Training in Allergy, in Allergy and Immunology, or in Allergy and Clinical Immunology, awarded by a governing board. In some countries this will follow successful completion of a certification test, and in other countries by competencies being signed-off by a training supervisor. Fully trained allergists make an important contribution to designing local care systems and delivering the necessary care for patients with allergic diseases. Allergists act as advocates for patients, and support and argue the case for better education of the primary and secondary care physicians and other health care professionals who also care for allergic patients. Allergists should be available to provide care for the more complicated problems that are beyond the purview of well-trained primary and secondary care physicians and other health care professionals. The main defining characteristics of an allergist are the appreciation of the importance of external triggers in causing disease, and the knowledge of how to identify and manage these diseases, together with ex-pertise in appropriate drug and immunological therapies. This approach to diagnosis and therapy is a core value of the allergy specialist, and contrasts the allergist with many of the organ-based specialists whose patient bases may overlap with the specialty. The unique training requirements for an allergist are detailed in "Requirements for Physician Training in Allergy: Key Clinical Competencies Appropriate for the Care of Patients with Allergic or Immunologic Diseases: A Provisional Position Statement of the World Allergy Organization."[1] In that document, the levels of allergy training required of first-, second-, and third-level physicians are documented, differentiating the training and knowledge base of an allergy specialist from that of primary care physicians and organbased specialists. The American Academy of Allergy, Asthma and Immunology has also published guidelines: "Consultation and Referral Guidelines Citing the Evidence: How the Allergist/Immunologist Can Help."[2] The European Union of Medical Specialists Allergy Training Syllabus [3,4] is available online at the World Allergy Organization Web site:http://www.worldallergy.org/allergy_certification/index.shtml.

Recommendations From the Exploring Accreditation for State and Local Health Departments: Do We Have the Political Will?

Acting upon several years of related work from a variety of public health practice arenas, 4 leading public health organizations received funding to conduct a study of the desirability and feasibility of establishing a national voluntary public health accreditation system. The study was conducted by a 25-member Steering Committee, with representatives from public health organizations at the local, state, and federal levels. The study was advised by input from additional numbers of public health experts participating in workgroups, as consultants, or in public comment groups. Public health nursing was represented by 3 members of the Steering Committee, including the chair, and by 7 other nurses who served on work groups or as staff to the process. The report of the study committee, released in the fall of 2006, contained answers to 2 questions related to the desirability and feasibility of such a program. Additionally, the report contained recommendations regarding the program's initial implementation. This article summarizes those recommendations and discusses the policy implications for their implementation, with a special emphasis on the role of the public health nursing community in the establishment of a national voluntary public health accreditation system.

Recommendations on sub-speciality accreditation in cardiology: The Coordination Task Force on Sub-speciality Accreditation of the European Board for the Speciality of Cardiology

The purpose of the European Board for the Speciality of Cardiology (EBSC) Coordination Task Force on Sub-speciality Accreditation in Cardiology is to make recommendations on Sub-speciality Accreditation within Cardiology. EBSC aims to harmonize the process of accreditation of sub-specialities and thereby to provide uniformity of accreditation standards throughout cardiology. Certification in cardiology, for instance, the EBSC Diploma of European Cardiologist, is essential before an individual applies for sub-speciality accreditation. European accreditation standards within sub-specialities should be clearly defined, thereby assuring patients and other doctors the competence and skills of the accredited sub-specialists. This is increasingly important in times of developing mobility of doctors and patients in Europe in agreement with the basic EU principles of free movement. The process of sub-speciality accreditation of physicians in Europe has already been initiated by a number of sub-specialities. Those initiatives are based on similar principles and include theoretical (knowledge assessment) and practical (log books) assessments of the training and expertise in the field. These initiatives so far have not followed any specific configuration, mainly because no recommendations have yet been established by authorized scientific or regulatory bodies. It is the aim of this document to provide such a guideline. It is important that European accreditation of General Cardiology and sub-specialities is compatible with existing national accreditation systems. European accreditation aims to develop, enhance, and harmonize national assessment and assurance of competence. It is therefore foreseen that, in future, national accreditation systems will develop into a European accreditation system, as defined by the EBSC. Standardization of the process will foster future compatibility of accreditation systems within cardiology at European and national level. This document should be used as a template for future national/international accreditations. ### The European Board for the Speciality of Cardiology The European Board for the Speciality of Cardiology (EBSC) was set up in 1992 by the Union Europeennes des Medecins …

Financing and Creating Incentives for a Voluntary National Accreditation System for Public Health

Financing and Creating Incentives for a Voluntary National Accreditation System for Public Health

Working by the rules: early childhood professionals' perceptions of regulatory requirements

The regulatory environment in which long daycare centres are required to operate plays a key role in determining what early childhood professionals do and how they go about doing it. This paper reports findings from a state‐wide survey undertaken in New South Wales, Australia, which shows how early childhood professionals position themselves on four key aspects of the regulatory environment: the premises underlying regulatory requirements; its perceived support of them as professionals to provide quality care; how state regulations and the national accreditation system impact upon their daily practice; and the way these audit systems affect their professional esteem. Implications for job satisfaction are discussed. The paper concludes by asserting that regulatory requirements need to be evaluated in terms of their contribution to structural, process, contextual and work environment dimensions of quality.

Global Standards and Accreditation in Medical Education: A View from the WFME

Globalization of medicine is increasing, as manifested by the growing number of migrating doctors and cross-border education providers. In addition, new medical schools of dubious quality are proliferating. This situation accentuates the need to define standards and introduce effective and transparent accreditation systems. With this background, and reflecting the important interface between medical education and health care delivery, a World Health Organization (WHO)/World Federation for Medical Education (WFME) Strategic Partnership to improve medical education was formed in 2004. In addition to working on reform processes, capacity building, and evaluation of medical education at the regional and national levels, the partnership in 2005 published guidelines for accreditation of basic medical education. Only a minority of countries have quality assurance systems based on external evaluation, and most of these use only general criteria for higher education. The WHO/WFME Guidelines recommend establishing accreditation that is effective, independent, transparent, and based on criteria specific to medical education. An important prerequisite for this development was the WFME Global Standards program, initiated in 1997 and widely endorsed. The standards are now being used in all regions as a basis for improving medical education throughout its continuum and as a template for national and regional accreditation standards. Promotion of national accreditation systems will pivotally influence future international appraisal of medical education. Information about accreditation status--agencies involved and criteria and procedures used--will be essential to future databases of medical schools and will be a foundation for international "meta-recognition" of institutions and programs ("accrediting the accreditors").

Coming soon to your area: State and local health agency accreditation

State and local public health agencies throughout the country could one day be accredited via a national body, if the recommendations under development by a unique public health project come to fruition. A program, Exploring Accreditation, was instituted last year to determine whether a voluntary national public health accreditation system should be established and, if so, how it would be created, organized, and operated and what the implications and feasibility of establishing such a program would be. A number of states already have quality assurance, self-assessment, and even accreditation programs for their health agencies; information from these states is being evaluated. In addition, a multistate collaborative effort is studying innovative public health agency practices and accreditation programs to further identify and disseminate the best practices to the broader public health community. Through a national accreditation process, there is a tremendous potential to completely transform, strengthen, and improve the nation's public health departments.

The Regulatory Environment in Long Day Care: A ‘double-edged sword’ for early childhood professional practice

While early childhood professionals in NSW are accountable to a substantial collection of regulatory requirements, little research has explored the outcomes of this regulatory environment, both intended and otherwise. This paper presents findings from a NSW study and shows how early childhood professionals working in long day care centres perceive the regulatory environment to impact on their professional practice. Specific attention is given to the impact of the national Quality Improvement and Accreditation System and the NSW Children's Services Regulation. The notion of the regulatory environment as a ‘double-edged sword’ emerges as a useful conceptual metaphor to understand how early childhood professionals perceive these regulatory frameworks to impact on their practice. Findings show that the benefits afforded by accreditation and the Regulation are offset by unfulfilled intentions and unintended outcomes.

A Comparative Review of Canadian Health Professional Education Accreditation Systems

Canadian governments and various stakeholder groups are advocating greater interprofessional collaboration amongst health care providers as a fundamental strategy for enhancing coordination and quality of care in the health care system. Interprofessional education for collaborative patient-centred practice (IECPCP) is an educational process by which students/learners (or workers) from different health professions learn together to improve collaboration. The educational system is believed to be a main determinant of interprofessional collaborative practice, yet academic institutions are largely influenced by accreditation, certification and licensure bodies. Accreditation processes have been linked to the continuous improvement of curricula in the health professions, and have also been identified as potential avenues for encouraging educational change and innovation. The purpose of this paper is to summarize the characteristics of the national accreditation systems of select Canadian health professional education programs at both the pre- and post-licensure educational levels and to show how these systems support and/or foster IECPCP. A review of the educational accreditation systems of medicine, nursing, pharmacy, social work, occupational therapy and physiotherapy was undertaken through key informant interviews and an analysis of accreditation process documentation. The results of this comparative review suggest that accreditation systems are more prevalent across the health professions at a pre-licensure level. Accreditation at the post- licensure level, particularly at the continuing professional education level, appears to be less well established across the majority of health professions. Overall, the findings of the review also suggest that current accreditation systems do not appear to promote nor foster interprofessional education for collaborative patient-centred practice in a systematic manner through either accreditation processes or standards. Through a critical adult learning perspective we argue that in order for traditional uni-professional structures within the health professional education system to be challenged, the accreditation system needs to place greater value on interprofessional education for collaborative patient-centred practice.

The Impact of Regulatory Environments on Early Childhood Professional Practice and Job Satisfaction: A review of conflicting discourses

This article juxtaposes contrasting discourses concerning the impact that regulatory systems—such as the NSW Children's Services Regulation and the National Quality Improvement and Accreditation System—have on the professional practice and job satisfaction of early childhood professionals in NSW. Juxtaposing dominant government discourses with conflicting critical discourses raises theoretical and practical issues about how the regulatory environment is perceived, the place it holds in early childhood professionals' thinking about quality early childhood practices, and the impact it may have on their job satisfaction.

The Multistate Learning Collaborative, States as Laboratories

The Multistate Learning Collaborative on Performance and Capacity Assessment or Accreditation of Public Health Departments (MLC) is an initiative undertaken with the Exploring Accreditation Project (EAP). The EAP is jointly funded by the Robert Wood Johnson Foundation (RWJF) and the Centers for Disease Control and Prevention (CDC), and staffed collaboratively by the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO) to explore the implications and feasibility of a national public health accreditation system. The MLC, also financially supported through grants from RWJF, is designed under the auspices of the National Network of Public Health Institutes (NNPHI) and the Public Health Leadership Society (PHLS) to enhance the accreditation/assessment activities already underway in each of the grantee states; to promote learning among the states participating in the collaborative; to disseminate information to state and local health departments nationally; and to inform the work of the EAP. Five states with mature accreditation or assessment programs were selected from among 18 applicants. This article describes the ongoing work, including breakthroughs and challenges, in these natural "laboratories" so that this information may be a resource for other states as well as nationally.

Is Quality Certification Effective? Evidence from the Childcare Market

The ineffectiveness of a quality certification mechanism can be attributed to consumers' low willingness to pay for what certifiers consider high quality. Alternatively, it can be attributed to the inability of the certification status to provide consumers with information they do not already possess. I present a structural model of demand allowing consumers to infer quality from both the certification status and firm reputation. I then estimate this model to assess the effectiveness and the impact of the national accreditation system for childcare centers on consumer welfare. My results suggest that disregarding the endogeneity of firms' accreditation choices significantly underestimates the effectiveness of the accreditation system. Consumers do value quality as gauged by the accreditation agency, but on average they do not gain much information beyond what they have inferred from a firm's reputation. The estimates of structural parameters are then used to quantify the value of this information to consumers.

Impact of EU Organic-Certification Regulation on Organic Exports from China

Empirical studies have underlined the importance of technical trade barriers in the agricultural sector. For organic products, national differences in standards, certification and accreditation systems could act as a major non-tariff barrier for export-oriented countries, particularly developing countries, which could eventually fail to benefit from the increasing market opportunities for organic products in developed countries. This paper presents the results of a study on the impact of EU organic-certification legislation on organic exports from China, where the lack of an equivalent system forces Chinese organic exports to enter the international market through multi-certification or special import permits. This results in an increase in certification and transaction costs, as products accepted in one country may not be accepted in another. The paper also reports on the recent legislative developments to establish a national certification and accreditation system for organic products in China.

Establishment of a GLP compliance program for drug safety studies at SIMM

AbstractThe document ‘Good Laboratory Practice Regulations for Nonclinical Drug Safety Studies’ issued in China on 14 October 1999 was updated by China's State Food and Drug Administration (SFDA) and became effective as of 1 September 2003. In October 2003, SFDA started to commission Good Laboratory Practice (GLP) inspections. Since then, China has adopted a national GLP conformity accreditation system, and it became increasingly required that drug safety studies in China were to be carried out in accordance with the principles of GLP regulations. Development of a standardized safety study platform also plays an important role in the strategy ‘Establishing National Drug Innovation System in Knowledge Innovation’, led by Shanghai Institute of Materia Medica (SIMM), China Academy of Sciences. Demands from outside and inside SIMM required that a GLP compliance program for drug safety studies be established at SIMM. However, the establishment of a GLP compliance program was challenging. In this article, the strategies adopted and the progress made towards meeting the challenges of establishing a GLP compliance program for drug safety studies at SIMM are described. Copyright © 2005 John Wiley & Sons, Ltd.

El sistema de habilitación nacional: criterios y proceso de evaluación

This paper presents a detailed analysis of the current system for the assessment and recruitment of university professors in Spain. Specifically, assessment criteria, assessment process, reliability, validity and competitive/entrance procedures are examined. First, it is shown that there are not predefined assessment criteria since these criteria are established by the members belonging to the assessment boards. This explains that assessment criteria change from some boards to other ones, as some true-life examples will show. Second, although the assessment process is parlially regulated, it is quite ambiguous regarding the way of putting into effect the criteria. More imporlant is the fact that assessment boards work even when they consists of four members, that is, even when three members are missing, since they would consist theoretically of se ven members. These issues may genera te some problems in reliability and validity. Neverlheless, these limitations can be easily rectified, therefore the national accreditation system is considered a good system since it promotes that the university positions are reached with proper and clear procedures.

A survey of non-conformances raised during accreditation inspections of medical laboratories in South Africa.

Under the auspices of the South African National Accreditation System (SANAS) the South African medical laboratory accreditation programme was established in June 1999. This study reports the non-conformances identified during the assessment of 103 medical laboratories in South Africa between September 1999 and December 2001. Laboratories were assessed by SANAS, which is the single accreditation body in the Republic of South Africa. All documentation relating to the assessment of each laboratory was reviewed in detail by the authors to identify the numbers and classification of non-conformances under each of the 25 points of the check list. A total of 862 non-conformances were raised. The top five non-conformances identified were (1) quality management system, (2) test methods, (3) records and (4) quality control and laboratory safety. The deficiencies identified in South African medical laboratories should be viewed in a positive light and promote a culture of continuous quality improvement with appropriate allocation of resources. SANAS should continue to align its requirements and procedures relating to accreditation of medical laboratories with those of their international counterparts with whom mutual recognition agreements/arrangements exist.

Establishing quality assurance in the South African context

This paper provides perspectives on the unique challenges and opportunities facing the national auditing and accreditation system in South African higher education. In doing so, the quality assurance contexts of developed countries, Africa and South Africa are considered and the issues of uncertainty and conformity are highlighted. This is followed by a more in‐depth analysis of the policy developments, mandates and functions of the South African higher education quality assurance system, its impact, the challenges it is facing, and debates about future directions.

The accreditation of engineering programmes in Russia

The paper is devoted to the national accreditation system for engineering programmes in the Russian Federation. The procedure for the integrated assessment of university activities provided by the Ministry of Education is described. The paper examines licensing and attestation requirements for achieving the state accreditation. The procedure and criteria for professional accreditation of educational programmes in engineering and technology are presented, as well as the latest activities of the Russian Association for Engineering Education.