NATIONAL CERTIFICATION THE ALBERTA EXPERIENCE Susan Jacka, IPC, Alberta Health Sue Lafferty, IPC, Alberta Health Services Catherine Williamson, MDR, Alberta Health Services CAMDR Conference 18 October, 2014 Winnipeg MB No disclosures or conflict of interest to declare! ALBERTA HEALTH The Road to Certification Infection Prevention and Control (IPC) in Alberta Timeline Issues with reprocessing of medical devices AHW, HQCA reported review of all HAs and RBs IPC policies and programs IPC strategy and Cleaning, Disinfection and Sterilization Standard released and came into effect Provincial monitoring for compliance to Standards commenced Revised Cleaning, Disinfection and Sterilization Standard released with mandatory MDRT certification Certification requirement for requirement MDRTs comes into effect March 2007 April-July 2007 January- February 2008 April 2008 October 2012 April 2015 1
How the IPC Standards are Implemented in Alberta A Ministerial Directive Issued under Section 8 of Alberta s Regional Health Authorities Act. Provides the Minister with the ability to direct Health Authority to provide health services to achieve the best health outcomes. HA is required by law to comply with all directives. Advantages: fairly quick, and has flexibility to be responsive to revision and rescission. Standards for Cleaning, Disinfection and Sterilization of Reusable Medical Devices for all Health Care Facilities-2008 Section 12.1 All reprocessing personnel and all reprocessing supervisors shall have qualifications as defined by Alberta Health and Wellness. Revising the Standard The Alberta Infection Prevention and Control Cleaning Standards Revision Expert Group was established in May 2011. The group was comprised of internal Alberta Health experts (IPC, Compliance, Legal etc) and external experts from AHS (IPC, MDR, ID physicians etc). Revision was completed after extensive collaboration including face-to-face meetings. Alberta Health provided an IPC Training and Education Grant with the intent of building MDRT capacity for education, training and certification. Standards for Cleaning, Disinfection and Sterilization of Reusable Medical Devices for all Health Care Facilities-2012 10. Education and Training 10.1. Personnel employed to work in MDR Areas, endoscopy departments or any department performing Sterilization of Reusable Medical Devices shall be certified in one of the following recognized certification programs: 10.1.1. CSA Certification for Certified Medical Device Reprocessing Technicians; or 10.1.2. International Association of Healthcare Central Service Material Management Certification for Certified Registered Central Service Technicians. (IAHCSMM) http://www.health.alberta.ca/health-info/prevent-infections.html 2
Application of the Cleaning Standard This standard applies only to AHS and third parties contracted by AHS and not to personnel who reprocess outside of AHS/contracted providers such as independent business owner/operators (i.e. Dentists) However, Alberta Health has collaborated with CSA to develop education and training resources for community healthcare settings including: User Handbook for Medical Device Reprocessing in Community Health Care Settings elearning Course on reprocessing reusable medical devices. Role of Alberta Health Services in Implementing Alberta Health MDR Standards 3
What was needed? Learning opportunities Tools Learning Opportunities Facilitate manager attendance at national/international conferences Facilitate attendance at annual Alberta Association MDR Conference Provide MDR Certification preparation classes/sessions for general reprocessing and endoscopy staff Plan and host Provincial AHS MDR conference March 2013 for all AHS reprocessing staff Learning Tools Centralized/Decentralized Medical Device Reprocessing Training videos created for reprocessing staff who reprocess medical devices Section 1 - Introduction Section 2 - Quality Systems Section 3 - Infection Prevention Section 4 - Workplace Health Section 5 - Decontamination Process Section 6 - High Level Disinfection Section 7 - Assembly Section 8 - Sterilization of Devices Section 9 - Flash Sterilization Section 10 - Storage and Transport Section 11 - Flexible Endoscopes Section 12 - Loans, Trialed and Damaged Devices http://www.albertahealthservices.ca/6853.asp 4
Manufacturer s Instructions CSA Standards Purchase province wide online subscription to One Source data base for manufacturer s reprocessing instructions http://www.onesourcedocs.com/aboutonesource.html Purchase province-wide online subscription to access all Canadian Standards Association reprocessing standards Computer Access Purchase computer hardware (computers, monitor screens, printers) for MDR departments to enable staff to view videos, manufacturer s instructions, and other educational materials August 2012 - Meeting with AUPE Alberta Union of Public Employees 5
Documentation Provided Briefing Note (with rationale) Copies of Letters to be sent to Employees Information pertaining to accepted Courses/Colleges List of Areas that would be affected Total number of Employees affected (FTE) We encouraged staff to think of this as the first step to becoming recognized as a professional body. Also indicating that it would be a strong bargaining tool for more money! Staff Response? Mostly one of Despair! Why do we want everyone to be a qualified Surgical Processor? Who is included? What is the difference between being a qualified graduate of a Surgical Processor course or program, and Certification? Do I need both? FAQ What are the timelines for achieving the required education? Why was this date chosen? What are the benefits to becoming qualified or certified? What if I do not become certified? FAQ 6
Can I be grandfathered in? Will I receive financial support? Will I be paid while I m taking a course or preparing for certification? Will I have to go to school to take a course or program? FAQ Where will I write the certification exam? What happens if I don t take advantage of the grant money and then decide to take a course or become certified? What happens if I am unsuccessful in my attempts to pass the course or exam? What will happen if I am on an approved extended leave? Will I be paid extra money if I have certification? FAQ Moving on next steps! Created a Provincial Job Description Sent Letters to all Employees with quarterly reminders March 31, 2015 The deadline is fast approaching! Posters go up each week reminding staff of the deadline! i.e. Reclassification for Employees working in Endoscopy (were lower classification) March 2014 saw only 4 employees in the Edmonton Zone non-qualified having to accept different positions days remaining before certification becomes mandatory in Alberta. 7
Questions? 8
What is Certification? Personnel Certification and Alberta Experience Cathy Esposito October 18, 2014 Personnel Certification is the assessment and formal recognition through certification of an individual s competence in meeting identified criteria for the safe handling, operation and supervision of certain products and services. ISO 17024 (2003), General requirements for bodies operating certification of persons, formalizes this process. PRESENTATION AGENDA Purpose of Certification 1. What is Certification? 2. Purpose and Benefits 3. CSA Standards Model 4. Effects of Regulation 5. Lessons Learned The Certified Medical Device Reprocessing Technician (CMDRT) Personnel Certification Program is intended to: Ensure the competency of Canadian Medical Device Reprocessing Technicians Promote Public Health by improving the safety of reprocessed medical devices Create a national standard for Canadian medical device reprocessing technicians Facilitate the employment process and credibility of the profession Reduce the number of hours needed for on-the-job training. 4
Benefits 1. Positive patient outcomes 2. Improved practitioner health and safety 3. Labor force mobility 4. Quality Assurance Personnel Certification Value Value of CSA Personnel Certification Programs Independent Verification 5. Increased performance 6. Greater career opportunities Training Defined Knowledge & Skills Examination Certification 7. Human resources support Accreditation Process CSA Standards Model Scheme Committee Understanding the Needs Stakeholder Engagement Advisory Services Standards Development Consensus Standards Non-consensus Standards and documents CMDRT Certification Scheme Committee Applying Standards Personnel Certification Education and Training Application Tools Job Task Analysis Examination Development Policies and Procedures
Regulation Works Lessons Learned CMDRT Certifications per year Alberta Health Initiative Where the certification is voluntary the uptake is low. Financial support from the healthcare facility and government encourages certification. Regulation guarantees it! 2009 2010 2011 2012 2013 9 11 Alberta Leads the Way! Certified MDR Technicians by Province ON 17% Rest of Canada 10% BC 23% AB 50% 10
PRESENTATION AGENDA THE QUEBEC EXPERIENCE Ghislaine Morency October 18th, 2014 1. A NEW DIPLOMA IN MDR 2. TRAINING FOR EMPLOYEES IN THE FIELD 3. CERTIFIED MDR TECHNICIANS 4. NEXT STEP HISTORY OBJECTIVES 2001 Francoeur s Report 2002 Bill 113 2003 Job Task Analysis by Cégep CSL 2004 Diploma in MDR Develop a standard training for all Medical Device Reprocessing workers in the province of Quebec Establish a new job title for staff members who have graduated the AEC program. 2009 Job Task Analysis by MSSS 1
CONTINUING EDUCATION AFFILIATED COLLEGES Program Length Certification Conditions of admission $ AEC in MDR RAC Endoscopy course 975 hours Around 2 years part time 60 hours AEC AEC 3 College Crédit High school diploma Adult, out of school since at least 1 year Adult with at least 2 years experience in MDR Working experience Free Free 2 $/hour Chicoutimi 2007 Lévis-Lauzon 2007 Thedford Mines 2006 Cégep de Saint- Laurent 2004 Saint-Jérôme 2006 Saint-Jean 2014 Drummondville 2015? AEC & RAC GRADUATES IN MDR TESTIMONIAL AEC in MDR since 2004 28 groups Program updated twice 372 graduates RAC since 2011 13 graduates 18 in the process «More than 70% of our staff are graduates of the program. Our triennial plan of continuous improvement was highlighted and congratulated during the last visit of Canada Agreement. In addition, the involvement and awareness of our personnel with training has great impact on the daily work at the MDRD. There is a ripple effect on the rest of the staff in place.» - Hôpital Maisonneuve-Rosemont, Montréal 2
TESTIMONIAL TRAINING FOR WORKFORCE «When we see new graduates of the AEC in MDR who are motivated and willing to share their knowledge in the workplace it provides a great source of motivation for the staff in place...» - Medical Device Processing Attendant, - MUHC, Montréal Public sessions Reprocessing of flexible endoscopes Implementation and writing of policies and procedures Quality Insurance in MDRD E-learning Training in MDR for staff in employment Quality assurance in reprocessing of endoscopic devices Made to Measure MDR and Endoscopy update Conferences for physicians and sales staff Symposiums E-LEARNING IN MDR OBJECTIVES 2009 First meeting with different stakeholders at the AQRDM Convention 2010 Identification of needs by the MSSS & establishment of partnerships and collaboration 2012 First group 2013 Translation to English by CSA 2014 To this day, nearly 700 people have attended the training in French Standardize the services (MDR process and quality of the service rendered to the customer) provided by: Attendants in MDR who have learned on the job and Attendants who have acquired a college education (AEC) in MDR 3
CMDRT Certifications RESULTS EMPLOYMENT REQUIREMENTS Participant s desire to better understand their working environment Better understanding of the importance of their role and liability Improvement of practices and better performances in their duties High School Level Secondary V Diploma (DES) Attestation of college studies (AEC) in Medical Device Reprocessing French and English, spoken and written CMDRT CERTIFICATIONS PER YEAR CMDRT CERTIFICATION Since 2009 16 14 12 10 8 6 4 2 0 2009 2010 2011 2012 2013 2014 The Cégep partialy refunds students who have succeeded, ($150 of the total $263) HOWEVER Certification is not required by employers and at the ministry level The title of technician is not yet recognized The students have to pay before the exam and does not always have the money available. 15 4
NEXT STEP We expect government intervention to decide on: Reclassification for Employees working in MDR Adjustment of the salary scales 5