Volume 78 - Spring / Summer 2001	Download

Accreditation and Approval Similarities and Differences by Susan E. Phelan, MHS, MT(ASCP) Chair, Programs Approval Review Committee

The members of the Programs Approval Review Committee (PARC) understand that their major role is to carefully communicate with program directors in an effort to enhance program quality. It is often necessary to clarify the differences between the accreditation and approval processes, and correlate those differences to the task of writing self-studies for program approval. It is the hope of committee members that the following information will be helpful in providing additional clarification.

Both accreditation and approval processes involve a careful review of programs. The objective of the review is to determine whether a program has been structured to assure that graduates possess minimum knowledge and skill to meet career entry level competencies. To accomplish this, programs are compared to a set of criteria that is consistent with career entry-level competencies. The set of criteria used to evaluate accredited programs is called "Essentials." The set of criteria used to evaluate approved programs is called "Standards."

Review committees are composed of a diverse group of clinical laboratory professionals from across the nation. The responsibility of the review committees is to determine if programs meet the published Essentials (accreditation) or Standards (approval) and to recommend action based on the review of each program to the NAACLS Board of Directors. This determination is made based on committee members' review of program materials. Program materials are submitted in the form of a self-study. Committee members carefully examine program materials submitted in the self-study and determine if the Essentials or Standards have been met.

Program materials are described in a narrative form in the self-study. To support the narrative, the writer of the self-study is required to include supporting documentation. For example, Standard/Essential 1 addresses sponsorship of the program, including a review of affiliation agreements. Copies of currently used affiliation agreements must be submitted as documentation to support the Standard or Essential. The reviewers read the description of the program's sponsorship in the narrative, and then review the documentation to determine compliance with the Standard/Essential.

The major difference between the approval process and the accreditation process is what occurs following the review of the program's self-study. The approval process does NOT include a site visit subsequent to the review of the self-study. In the accreditation process, the reviewers highlight areas of discrepancy or confusion and identify missing items. During the site visit, site visitors can ask program officials for clarification or explanation regarding areas of concern. The site visit is a face-to-face discussion between program officials and reviewers, facilitating two-way communication. Questions can be asked and answered very quickly, resolving points of clarification or confusion almost instantly. Program officials also have the benefit of immediate access to documentation, procedures, files etc. that can be produced to document/support verbal descriptions provided by program officials.

Approval committee members do not have the luxury of face-to-face communication nor immediate access to documents and files. Once program officials have described the details of program operation and supplied documentation to support the description via the self-study, program reviewers must compare the materials submitted to the Standards and determine if the program has satisfactorily met the Standards.

If the self-study is not well organized, or is poorly written, this process is extremely difficult for program reviewers. If the self-study is not accurately indexed, the task of finding information related to each Standard becomes almost impossible. Reviewers must ask program officials to supply narratives and/or documentation to address areas of concern or items not included in the self-study. Reviewers only do this after exhausting their efforts to locate the materials needed in the self-study document.

Since the approval process is performed primarily in the form of one-way written communication, it can be cumbersome for both program officials and committee reviewers. The process works best when program officials submit detailed narratives and documentation. One area of review that is particularly difficult to address is the relationship between Standards, program goals and objectives, and evaluation tools. The task of cross-referencing all of this information is extremely time consuming, both to write and review. In spite of this, it is the most effective method of assuring compliance with the Standards related to these issues.

Once committee members have reviewed the self-study, additional documentation for areas of concern and items missing are requested from the program. Submission of this second round of requested information is referred to as the Program's Response to the Review. If the materials submitted are still not acceptable, the reviewers may elect at this time to phone the program to clarify information requested by the reviewers. Phone requests, however, are usually reserved as a final strategy to assist the program to achieve compliance with a Standard.

Without the benefit of a site visit, the approval process becomes very dependent on written communication between the program being reviewed and the committee members assigned to review that program. The approval process, while paper driven as well as thorough, requires careful attention to details in description and documentation. To reduce the stress involved in submitting a program for approval and its subsequent review, program directors are well advised to write clearly, index accurately, and pay careful attention to detail in both narrative and documentation materials.

Program officials and NAACLS committee volunteers are all committed to the same goal - providing quality education programs for students of the clinical laboratory sciences. Working closely together to complete the process of approval or accreditation helps to insure the achievement of this goal.

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