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Certification, credentialing, accreditation, licensure — the number of pertinent case management evaluation terms can be overwhelming. Plus, the various words often are confused, according to the industry’s certification leaders. In fact, the recent Hospital Case Management Summit, a one-day conference offered by the Case Management Society of America that was held in San Diego, included a special panel discussion with the goal of clarifying some of the frequently used terms in this important vocabulary.
• Licensure. This is the process used by a government agency to grant permission to an individual to engage in a given occupation, upon finding that the applicant has attained the minimum degree of competency required to assure that the public health, safety, and welfare will be reasonably well-protected.1
Licensure is the most restrictive form of regulation, says Carrie Engen, RN, BSN, CCM, president of Advocare Inc. in Naperville, IL, and chair of the Commission for Case Manager Certification. It is a form of occupational regulation; the government can withhold a license and deny an individual the right to work or the right to call himself or herself a certain type of professional and earn money. She adds that it is illegal for any unlicensed person to engage in the activities defined by the scope of practice or to use the title normally conferred on licensed professionals. Licensure is usually predicated on education and/or work experience.
• Certification. This is a process by which a governmental or nongovernmental agency grants recognition to an individual who has met certain predetermined qualifications set by a credentialing agency.
Sometimes, the process is called "title control," although there are no laws requiring certification to use the title "case manager," Engen says. It’s normally a voluntary process, initiated by members of the occupation or professional group, and administered by an agency created to set standards and award recognition to those that qualify. "The No. 1 reason for certification is protection of the consumer. We want to identify practitioners who have met national standards," she explains, but the specific agency can determine its own particular set of standards. Certification generally relies on a testing instrument and is renewable after a certain period of time through continuing education or re-testing. Eligibility often depends on experience and education. Different agencies set eligibility requirements differently.
• Certificate. It can be awarded at the successful completion of an education program, usually through an institution such as a university nursing setting or a private company that, in a proprietary way, has decided to offer an educational program. It’s important to know the difference between a certification and a certificate, Engen says. "Many groups out there would have you believe they are certifying organizations," when in fact, they award to the candidate a certificate of completion for an educational program that may or may not be predicated on completion of an exam.
• Credential. This is the end product of certification. It refers to whatever is conferred on the individual, or organization, who has met eligibility requirements and successfully completed the examination process. The term can apply to either the accreditation or the certification process. The credentialing body is the organization that oversees the process of certification or accreditation, usually made up of voluntary professionals from the field.
• Accreditation. This is a process for applying standards across an industry, which grants recognition to programs or organizations, rather than to individuals. In this process, there is an association or agency that has been created to set the standards based on the services offered. Reviews take place periodically with evaluation, not an examination, as the determining factor for recognition.
• Registration. It is a listing of people or organizations who have met specific requirements that may or may not have anything to do with quality in the field. Registration is on the state level in some industries. There is typically no testing instrument, and sometimes a fee is required. The common goal of all health care regulatory and evaluation processes is to protect the consumer from substandard case management services.
[For more information, contact:
Carrie Engen, RN, BSN, CCM, Owner and President, Advocare, Naperville, IL; Chair, Commission for Case Manager Certification, Rolling Meadows, IL. Telephone: (630) 355-0001. E-mail: carriee@advocare inc.com.]
1. U.S. Department of Health, Education, and Welfare, Washington, DC.