Adapting to Increased Complexity: A Conversation with Lori Tinkler, MBA, CEO of the National Board for Respiratory Care

The National Board for Respiratory Care, Inc. (NBRC) named Lori M. Tinkler, MBA, as chief executive officer effective January 1, 2018. Tinkler has a 27+ year tenure with the organization and succeeds Gary A. Smith, who served in various leadership roles during his 34 years with the NBRC, including his position as CEO for the last 16 years.

Tinkler joined the NBRC in 1991 and served as chief operating officer since 2002. She also led and helped grow the NBRC subsidiary, Applied Measurement Professionals, Inc. (AMP), a national assessment company. Since the sale of AMP in 2015, the NBRC has focused solely on its mission of developing high-quality examinations and awarding credentials for the respiratory care profession.

In 2008, Tinkler was named one of the Top 25 Women Who Mean Business in Kansas City by the Kansas City Business Journal. In addition, Tinkler volunteers on several local boards, including the Johnson County Community College Foundation and the Mayor’s Christmas Tree Fund for the City of Olathe (Kan.), which she chaired for the 2016-17 campaign. Tinkler chaired the Olathe Chamber of Commerce in 2011 and 2012, and she remains active as a mentor for young professionals within the greater Kansas City business community.

We spoke with Tinkler on the increasing complexity of accreditation as the industry grows, why protecting your intellectual property is now more important than ever, shifts and changes other organizations should be aware of and more.

From Pencil and Paper to Mousepads and Computers

What is the biggest change you have seen in the industry in your career?

For me, it seems rather basic, but it is the innovation that has occurred in the industry. The move from paper and pencil testing to computerized testing was a huge change for the credentialing industry; almost 20 years ago now for our organization. This also changed the expectations of our constituencies– demanding more expeditious service in all aspects of our offerings.

Accreditation: The Gold Standard, with Increased Complexity

What do you believe the future of accreditation holds? What should organizations prepare for and what trends should we pay attention to as we establish future goals?

Our organization is somewhat unique. We are the longest running accredited organization by NCCA. We were accredited in 1977 and were one of the first four credentialing boards to achieve this recognition. Accreditation means something different to organizations; we are different in that we are the only credentialing board in respiratory care. We don’t have any competition, which is uncommon for some organizations that are becoming accredited today. Many have competition in one way or another and accreditation is very important for them; it sets them apart from their peers and competitors.

We view accreditation as the gold standard. It is a way for us to express to our constituencies that we hold ourselves to a very high set of standards. We are an education-based entry into the profession of respiratory care; all education programs are held accountable to accreditation standards, so it makes it easier for us to explain the importance of accreditation for our organization.

I believe accreditation in the future will have more and more complexities that go along with it, especially as NCCA looks to accredit varying types of organizations, not just traditional stand-alone credentialing boards. I believe it will likely become more difficult for NCCA to develop standards that speak to best practices, quality and fairness without becoming too prescriptive in how an organization should operate. I was involved in the last standards revision and it is hard to have a one-size-fits-all accreditation standard. I think that will be more and more difficult as time goes on.

Credentialing trends continue to be focused on technology — the challenges or trends surrounding the dissemination of information and distribution of information, and keeping up with technology. Constituent expectations are “faster, better, cheaper.” Everyone wants services quicker, at the lowest possible cost, but they also want it to be the best possible product. Realistically, you can’t have it all. You can produce a great product but it will cost something for the consumer to have that. If we all want to have the very best examination programs, there is a cost associated with that outcome. Continuing to produce high quality exams that ultimately protect the public is what we are all about.

Safeguarding Your Intellectual Property

What do you believe are some of the most pressing challenges certifying organizations face today? What is your organization doing to tackle these challenges?

For us, right now, one of our most pressing challenges is protecting our intellectual property, trademarks and copyrights. With social media and technology today, there is much to do to ensure your information is not being disseminated inappropriately or illegally. It requires a significant amount of time to scour the Internet to see if persons are posting content that they somehow harvested, whether it is from a live exam, from self-assessment or practice exams or brain-dumps of information after taking a test. Before the Internet, unauthorized dissemination of information was usually something more confined if you had a situation, and those situations were rare.

We have staff checking the Internet, social media sites, etc. to see what’s out there. There are so many websites, like Quizlet and Exam Certify, as well as Facebook groups and other channels including online prep courses, and we have to do our due diligence to ensure they aren’t using our trademark, infringing on our copyrights or violating terms and conditions they have agreed to as an examination candidate. It’s taking a lot of time and effort, but we have to protect copyrights, trademarks and intellectual property. It’s an ongoing challenge.

Many organizations are not aware these sites exist, and while you might not think your organization’s information would be that valuable to the general public, you might be surprised to find what is out there and online. It can take on a life on its own for an organization to keep up with.

Being Prepared to Shift and Adjust

What are some of the opportunities coming down the pipeline that certifying agencies should be aware of and preparing for?

Three areas our organization is viewing as opportunities are continuing competency — changes around our credential maintenance program — innovations in technology, and changes in generational patterns.

Continuing competency, in general, is seeing a shift. Many organizations are discussing and implementing new programs to ensure continuing competence. We are working hard to change our program for a roll out in 2020. It takes a lot of time to develop and maintain a program that is meaningful to achieve not only the goals of accreditation, but the goals of the respective entity and the larger profession.

With continued innovations in technology, there will be opportunities for organizations to critically look at how and what they are doing. For instance, look at how exams are administered. We’ve gone from paper and pencil to computer-based testing in brick and mortar locations. The introduction of remote proctoring or being able to take a test at your desk will cause organizations to think about the expediency with which they provide their services and more. I see it as an opportunity but also as a challenge in terms of safeguarding your intellectual property and balancing convenience and accessibility. When testing vendors approach credentialing boards with these options, organizations will need to think long and hard about the balance of being customer service focused without sacrificing the need to protect intellectual property. It will be an interesting road over the next 5-10 years.

With respect to generational expectations, in our profession, we are just starting to see the first wave of retirement — the baby boomers. The new generation of millennials have different expectations about how you communicate with them, how they perceive the value of the credential(s) and how they perceive the value of the organization. These are issues that all certifying organizations need to stay on top of and be aware of. We can’t just do things the way we’ve always done them. We need to be willing to be innovative and try new things — both internally with our boards and committees and externally with our constituencies.

Leading with Strength in Numbers

What advice do you have for other CEOs – or those aspiring to the position?

Surround yourself with a great team. Be sure you have the experts you need inside your organization that can lead the charge in their respective areas. Stay focused on the big picture, strategy and vision for your organization. Be well-rounded in your business knowledge beyond your specific industry. Rely on your experts but also know a little bit about every aspect of running a business.

How do you garner that knowledge? For me, it is having a good peer group to bounce ideas off of, share ideas/information and/or ask questions/seek advice. Get involved, whether with ICE, a peer group, a local community network or other business professionals.

Help the next generation by mentoring others and imparting what you know. It’s not only great for your position but also helping those aspiring to lead an organization at some point.

Have good relationships, with staff, board, and peers. Relationships are the key to a successful CEO.

Related Resources

RESEARCH: Methods for Ensuring Continuing Competence, Part 1 & Part 2 

EXECUTIVE WEBINAR: Evaluating Your Continuing Competence Program

RESEARCH: Continuing Competence Framework Document  

EXECUTIVE WEBINAR: Leveraging ISO/NCCA Accreditation as a Marketing Tool 

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