Author’s note: Part one of two, “Unraveling the mysteries of accreditation,” helps readers understand the many facets of accreditation and why it exists in its various shapes and forms. Part two will examine the benefits accreditation offers and how it can bring value to your dental services.
The COVID-19 pandemic has shown that adherence to international best practices is essential to reduce the risk of disease transmission and protect patient and staff safety. The systematic approach built into accreditation programs can result in clinical and nonclinical improvements for patients and staff now and in the future. But accreditation may be a mystery to dental professionals.
For the uninitiated, the word “accreditation” conjures visions of endless checklists, rules, and barriers instead of benefits that should be part of the health-care organization’s learning journey. Health care is changing and so is the approach to the business of dentistry. Accreditation plays a vital role in success.
The many definitions for accreditation
Stripped down to its most basic elements, accreditation is an independent third-party evaluation of compliance that uses an established set of systems and processes called standards. By comparing what currently exists to “what should be,” dental service providers can close the gap between the two. Add to this the benefits of accreditation, including the vitality your practice derives from collaboration with an accreditation partner, learning, and other beneficial results.
In dentistry, accreditation means many things to many people. For some, graduating from an accredited dental program is a prerequisite to licensure in their state or country. Others view it as an individual badge of excellence. Dental practices, clinics, and hospitals strive for accreditation as a symbol of national or international achievement.
Confusion often surrounds accreditation. A dental professional can be a graduate of an accredited educational institute and licensed in a particular state or country while also holding accreditation in a dental specialty. That person may also work in a dental practice, clinic, or hospital that is nationally and/or internationally accredited. Accreditations are mandatory or voluntary. All of these scenarios are accurate and represent some facet of accreditation.
The gatekeepers: Educational accreditation leading to licensure
In dentistry, accreditation often describes educational programs that meet certain criteria so that graduates are eligible to sit for licensing examinations, receive recognized degrees, and fulfill licensure requirements. The accrediting authority is typically an independent national organization, such as the US Commission on Dental Accreditation, with a mission of serving “the public and profession by developing and implementing accreditation standards that promote and monitor the continuous quality and improvement of dental education programs.”1
Similar organizations serve the same functions in countries around the world, including Canada,2 New Zealand,3 Australia,4 and the United Kingdom.5 In the Caribbean, accreditation is carried out on a regional level by the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP).6 These accrediting authorities serve the general public by ensuring continuous quality improvement in educational standards as well as a uniform, minimally acceptable standard of care among all licensed professionals.
Successful completion of programs accredited by these authorities is mandatory to engage in the practice of dentistry. These accreditations are the gatekeepers to the profession.
The badge of individual excellence: Accreditation for specialization
In some countries, including the US, dental professionals can become accredited by a professional educational organization. The American Academy of Cosmetic Dentistry (AACD) offers members the opportunity to demonstrate clinical excellence as accredited members.7 In Singapore, the Dental Accreditation Specialists Board is a governmental authority that oversees the requirements for a number of dental specializations.8
This type of accreditation generally requires years of practice before people demonstrate advanced clinical skills and knowledge. Written and/or oral exams may be required along with case studies or other experience. Individual accreditation as a specialist is voluntary; however, in some places dentists may not call themselves a specialist without having achieved the correct type of accreditation.
Seeking specialist accreditation encourages dental professionals to demonstrate proficiency, knowledge, skill, and a standard of care worthy of the badge of honor—a way to stand out in the crowd and, most likely, earn more money.
National accreditation programs for dental services: Carrots or sticks?
In the US, dental practices and clinics do not have to be accredited; however, the dental professionals working for those providers must be licensed graduates of accredited educational institutions. In countries where dental services are part of the public health system, accrediting the dental practice may be mandatory. This includes in Australia, where public dental clinics must be accredited by the Australian Commission on Safety and Quality in Healthcare.9 Private clinics in Australia are not required to be accredited if they do not provide services through the public health system.
Becoming accredited in India is voluntary, but it encourages dental practices, clinics, and hospitals to improve and outperform their competition. The country’s National Accreditation Board for Hospitals & Healthcare Providers focuses on patient safety, quality of care, clinical outcomes, and staff training.10
Whether mandatory or voluntary, government, nonprofit, and for-profit organizations offer national accreditation programs for dental practices, clinics, and hospitals either as a carrot to incentivize them to improve the quality of their services or as a stick and requirement to participate in a government reimbursement program. Both approaches work.
International accreditation programs: CQI rules
International accreditation programs require dental providers to have a Continuous Quality Improvement (CQI) system in place to qualify for accreditation. Dental professionals should be familiar with the principles of the CQI cycle: plan, do, check, act. CQI is the foundation of accreditation and a key to building successful practices. The accreditation standards can then be integrated into the business operations as guideposts to follow toward clinical and nonclinical improvements.
Four organizations offer US-focused or international accreditation programs to dental practices, clinics, and hospitals. The Accreditation Association for Ambulatory Healthcare (AAAHC) offers an accreditation program for dental services in the US under its ambulatory surgery centers program. It operates as Accreditas Global in Central and South America.11 The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)12 and Joint Commission International (JCI)13 offer accreditation to dental clinics as a subset of their ambulatory care programs. While AAAASF offers programs primarily for the US market, it also offers services internationally. JCI’s programs are for non-US providers only.
Temos International Healthcare Accreditation offers four programs created specifically for dental services to clients around the world, including the US.14 The program options are based on the type of venue—practice, clinic, or hospital—as well as whether patients are domestic, international, or a combination of both.
Part two about unraveling the mysteries of accreditation will explore international accreditation, including what it can and cannot do for your business and whether it is the right investment for you.
ELIZABETH ZIEMBA, JD, MPH, is the regional director for the Temos office, serving the US, Mexico, LATAM, and Caribbean. Ziemba has a passion for increasing the quality of and access to health-care services around the world. In addition to her work with Temos, she consults with governments and health-care providers to provide market research, marketing, and organizational development services. Contact Ziemba about accreditation by phone or WhatsApp at (857) 366-1315 or [email protected].
References
1. CODA Mission. American Dental Association. Accessed February 8, 2021. https://www.ada.org/en/coda
2. Commission on Dental Accreditation of Canada. Accessed February 19, 2021. https://www.cda-adc.ca/cdacweb/en/
3. Dental Council of New Zealand. Accessed February 19, 2021. https://www.dcnz.org.nz/
4. Australian Dental Council. Accessed February 19, 2021. https://www.adc.org.au/
5. The General Dental Council. Accessed February 19, 2021. https://www.gdc-uk.org/
6. Caribbean Accreditation Authority for Education in Medicine and Other Health Professions. Accessed February 19, 2021. https://www.caam-hp.org/
7. American Academy of Cosmetic Dentistry. Accessed February 19. 2021. https://aacd.com/
8. Dental Accreditation Specialists Board. Accessed February 19, 2021.https://www.healthprofessionals.gov.sg/dsab/about-us
9. Australian Commission on Safety and Quality in Health Care. Accessed February 19, 2021. https://www.safetyandquality.gov.au/sites/default/files/migrated/NSQHS-Standards-Guide-for-Dental-Practices-and-Services-November-2015.pdf
10. National Accreditation Board for Hospitals & Healthcare Providers. Accessed February 19, 2021. https://nabh.co/Dental.aspx
11. Accreditation Association for Ambulatory Healthcare. Accessed February 19, 2021. https://www.aaahc.org/
12. American Association for Accreditation of Ambulatory Surgery Facilities. Accessed February 19, 2021. http://www.aaaasf.org/
13. Joint Commission International. Accessed February 19, 2021. https://www.jointcommissioninternational.org/
14. Temos International Healthcare Accreditation. Accessed February 19, 2021. https://www.temos-worldwide.com/
