The Competency & Credentialing Institute (CCI) has been certifying operating room nurses for more than 35 years. Two years ago, CCI hired a new CEO to build on the organization’s success and plan for the future in a rapidly changing industry. Credentialing Insights caught up with Jim Stobinski, CCI’s CEO, to learn more about how this growing certifying body is preparing for change.
What is the biggest change you have seen in the industry in your career?
First, I must confess my career in certification is likely much shorter than many of the CEOs in the industry. Although I have had many years of experience as a volunteer with the certification organization for perioperative nurses, I have only been in a senior management role on the program side for about seven years and CEO for less than two years. During that time, however, I have seen many changes. The single biggest change is the emphasis on establishing the value proposition for our certifications and other credentialing related products.
When I first came to the certification industry in 2011, we did not put much thought into the value our certifications provided. I think we assumed that these long-standing models, which were successful over many years, provided value. Certainly, we believed that was the case for the certificants and I think we also assumed that to be the case for other stakeholders, such as the patients served by our certificants and for employers.
At professional meetings and in brainstorming with peers, questions emerged regarding the value we provided. A seminal event in the nursing field was the Future Directions of Credentialing Research in Nursing Workshop conducted by the Institute of Medicine in 2014. That event, and the subsequent summary of the workshop proceedings, opened the gate on the question of value. The American Board of Nursing Specialties (ABNS) and the Institute for Credentialing Excellence (ICE) have devoted considerable energy and resources to the issue of the value proposition over the last few years.
This questioning about the value we provide with certification has raised some foundational issues which can be quite unsettling. There have also been recent legal challenges for certification and some legislative efforts over the last two years which are, at least tangentially, related to the value of certification question. These things combined make for some anxious times for our industry.
What do you believe the future of accreditation holds? What should organizations prepare for and what trends should we should be paying attention to as we establish future goals?
In response to the question about the value of certification mentioned earlier, the accreditation processes for these programs will also need to evolve and demonstrate value to the stakeholders. Ultimately, as certification and accreditation processes for certifying organizations change, and we continue to ask these questions about value, we will become stronger over the long term. I know that our programs at CCI are made much better through the accreditation process. We are very much attuned to staying current with the accreditation standards.
A similar process has occurred in healthcare accreditation processes over the last decade or so. For many years, one entity dominated accreditation processes for American healthcare facilities, but then fundamental questions were raised about the basic precepts of the accreditation process. Those questions also revolved around the value provided by accreditation and whether the process achieved its intended purpose. That questioning led to changes in healthcare accreditation and ultimately brought more competition into the industry. American healthcare standards or requirements have become better through this process and I believe the overall quality of care has improved.
As for trends at the intersection of accreditation and certification, two stand out. First, the NCCA accreditation standards revisions of 2016 has caused considerable change for certification organizations to include my organization. At CCI, we had to reorganize and reassign duties to establish the clear division between our products and certification work. The need for a clear separation of these functions weighs heavily into our business decisions and we are still adjusting to those changes. Secondly, I see the demand for certification programs expanding as stakeholders recognize the value and opportunities that certification provides. In nursing, we are seeing more demand for certifications for small specialties, and subgroups within those specialties. Having a certification helps to establish and validate the work of these groups.
What do you believe are some of the most pressing challenges certifying organizations face today? What is your organization doing to tackle these challenges?
The pace of change is certainly a challenge, with both the knowledge base which must be tested and also with our base of certificants. New industries are springing up, as are new specialties within our professions. For my specialty, the textbooks which are foundational to our practice now are in a continual cycle of revision with new editions coming out about every three years. The guidelines for clinical practice are now published annually and have quarterly updates.
The aging of our certificant pool is a significant challenge as we are seeing a decided increase in those retiring their credentials. Concurrently, new nurses are entering the profession in record numbers. Those are significant challenges as we must adapt our business model to this changing pool. In response to these challenges, we are spending much more energy and resources in strategic planning with a distinct business orientation. We are also spending more time learning all that we can about the nurses entering the profession who hold different attitudes about professionalism and certification. We are adjusting to their needs versus just maintaining the status quo in our business.
To circle back to the question of value and certification, as well as the challenges that come with it, CCI has recently started up a 501(c)(3) foundation that has a mission to develop nurse researchers who will address questions regarding the value of nursing certification and how it impacts outcomes. We hope to share our findings with the industry and perhaps provide some direction.
What are some opportunities coming down the pipeline that certifying agencies should be aware of and preparing for?
There are a myriad of opportunities for those in the industry who are open to change and have the capacity to adapt. There is a demand for the service we provide with certifications and we should be able to capitalize on that. Developing new certifications, programs and products are all possibilities. At CCI we are restructuring our recertification processes to better meet the lifelong learning needs of our certificants. We are re-evaluating the utility of some of our long-used methods as the pace of change accelerates. We are reconfiguring our processes to meet the needs of our certificants while aligning with the accreditation processes. With the pace of change we cannot afford to stand pat.
What advice do you have for other CEOs given your experience?
It is very important to be engaged with the certification and accreditation communities. I have done extensive volunteer work since coming to this industry and my organization has benefited significantly. I have also grown considerably, and my career has benefited. Attendance at professional meetings reaps tremendous benefits and is well worth the investment. Meetings and volunteer service will expand your perspective and expose you to the best work being done in the field.