There sure is a lot going on around here lately. Anybody else feel like it’s hard to keep up? Anyway, this could be two separate blog posts but I’m putting them together because they’ve got a common theme: safety data. Which I like to geek out on and I know you do too, comrades.
1) Recent events in Utah have led to a lot of discussion, both on and off-line. If you haven’t read it yet, please check out Elaine’s analysis over at The Acupuncture Observer.
Last week I followed up on the Utah meeting with a phone call with Mina Larson and Kory Ward-Cook of the NCCAOM. We agreed that it’s important to get some clear information out into the community about what the NCCAOM does and doesn’t do. I sent them some questions about the NCCAOM, credentialing, and data, and they’ve promised to respond in writing, which is very convenient for blogging. So stay tuned for a series of blog posts here about understanding the NCCAOM.
In our conversation, though, we were able to clear up what I and others felt like was an area of confusion at the Utah meeting, which is the NCCAOM’s relationship to collecting safety data, particularly about adverse events, and how that relates to credentialing initiatives. This is what I learned:
The NCCAOM primarily collects two kinds of data: demographic information from diplomates when they re-certify, and the KSA (knowledge, skills, abilities) data gathered through their Job Task Analysis.
The NCCAOM does not collect any data about public safety or adverse events. The creation of new credentials, like the herbal credential, are based on requests from within the acupuncture profession, not on data that shows that there is a public safety problem with, say, acupuncturists prescribing Chinese herbs.
The NCCAOM’s mission is to assure the safety and well-being of the public and to advance the professional practice of acupuncture and Oriental medicine by establishing and promoting national evidence-based standards of competence and credentialing. “Evidence-based” refers to the data gathered via their Job Task Analysis, not public safety data. The safety part of their mission is addressed through asking safety-related questions in their JTA.
Everybody clear on that? I was confused, but now I’m not.
It all comes down to the JTA.
2) Something that is common in other health professions but missing from the acupuncture profession is the practice of voluntarily reporting adverse events and errors. There are many excellent reasons for a profession to adopt this practice.
I can’t remember exactly when I started wishing that we had an AERD — an Adverse Events and Errors Database — for acupuncture, especially community acupuncture. It’s been a few years now. After the meeting in Utah, though, I realized how critically important it is — particularly for POCA — to take the responsibility of collecting our own safety data.
Anyway, huge thanks to Gloria Jacobs (POCA volunteer), Wade Phillips (POCA IT wizard), and Suzanne Morrissey (professor of medical anthropology at Whitman College) for making it happen. Whitman College kindly loaned us the use of their Institutional Review Board for this project.
This AERD will be maintained by students and volunteers of POCA Tech. We feel that this is something POCA Tech can do for the POCA Cooperative as a whole, something that benefits both patients and practitioners. It’s an opportunity for POCA Tech students not just to learn the habit of reporting adverse events and errors at the same time that they’re learning to do acupuncture (Wade already put a link to the AERD into our EHR, so it’s right there when we’re all charting), it’s an opportunity to develop critical thinking and leadership skills as we use the AERD to produce reports on safety practices, particularly trauma-informed safety practices.
Since there is no other AERD for acupuncture, we’re figuring this out as we go along. You can send us feedback through the AERD site, and for POCA members, here’s a thread on the forums where we’ll be discussing its use. We’ll need to tinker with the site and the survey as we go, but we won’t know what to change until folks start using it, so please don’t hesitate, there’s no time like the present!