Instructional Guide -‐ SSH Accreditation
Council for Accreditation of Healthcare Simulation Programs Accreditation Application Instructional Guide Accreditation Cycle 2011
Thank you for your interest in the Society for Simulation in Healthcare’s (SSH) Simulation Accreditation Program. We appreciate that you recognize the value of accreditation by SSH, an organization recognized around the world for its expertise in simulation in healthcare. Your commitment to meeting established standards of excellence in one or more of the areas of assessment, research, teaching/education, and system integration demonstrates your dedication to improving the quality of patient care and the overall education of health professionals through simulation. General Instructions for Completing the Application • The following documents are available at https://ssih.org/committees/accreditation: o SSH Accreditation Informational Guide o Accreditation Application Instructional Guide o Application Form pdf • You will also need o a Letter of Commitment from your institution o a $100.00 check for the application fee • In any written portion of the application 12-‐point font must be used. • Margins must be a minimum of 1-‐inch. • The application must be submitted in English. • Any video must be in .mov format or compatible with the latest version of Quicktime. • If a supporting document or section is referenced in either the Application Form or written response, please indicate the specific location of that document.
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Instructional Guide -‐ SSH Accreditation Instructions 1. Read SSH Accreditation Informational Guide at https://ssih.org/committees/accreditation 2. Determine if you are able to meet the criteria for the standards. 3. Decide in which area(s) you will be seeking accreditation (Assessment, Research, Teaching/Education, and Systems Integration). 4. Download PDF Application Form from https://ssih.org/committees/accreditation 5. Open form on your computer, electronically fill out the form, and submit the form via email to
[email protected]. 6. Print your completed PDF Application Form and obtain signatures where appropriate. 7. Scan both the completed Application Form and the Signature Page(s) and save for inclusion into CD of Documentation (See #9) 8. Obtain Letter of Commitment from your Institution and check for Application Fee. All checks must be made payable to “Society for Simulation in Healthcare.” 9. Prepare four (4) electronic CDs that will be identical. Include all the documentation needed to address each of the standards applied for. All documents should be in .pdf form. 10. Prepare each CD with organized folders, as appropriate or area (Core, Assessment, Research, Teaching, Systems Integration) create a pdf, with all required evidence, bookmarked as stated below. 11. Label each electronic folder and include, at a minimum, the following documents in each of the Sections (utilize Accreditation Standards and Measurement Criteria guide as a reference). If you choose to use the pdf format, please make sure to bookmark each section appropriately, as stated below. A. Application Materials 1) Completed PDF Application Form 2) Signature Page(s) 3) Institutional Letter of Commitment B. Section 1: Core Standards 1) Sub-‐folder or Bookmark 1: Mission and Governance a. Brief Summary b. Written copy of mission/vision statement c. Documentation of governance committees d. Minutes from last two (2) governance meetings 2) Sub-‐folder or Bookmark 2: Organization and Management a. Brief Summary b. Program organizational chart c. Description of budget construction process and review d. Copies of last 2 annual budgets
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Instructional Guide -‐ SSH Accreditation e. Job descriptions for each individual assigned to staff or support program f. Copy of strategic plan g. Copy of Policy and Procedure Table of Contents h. Copy of policy for Quality Improvement Process i. Copy of policy related to confidentiality procedures j. Evidence of mechanisms to protect and address physical and psychological safety of individuals involved in simulation 3) Sub-‐folder or Bookmark 3: Facilities, Application, & Technology a. Brief Summary b. Documentation of content expertise for each course offered and a description of the process the Program uses to access content experts c. Documentation of simulation expert(s) available for each course offered and a description of the process the Program uses to access simulation experts d. List of courses offered e. Narrative description of facility detailing the environment for education 4) Sub-‐folder or Bookmark 4: Evaluation and Improvement a. Brief Summary b. List of performance improvement activities identified in the last two (2) years. A minimum of three (3) improvements is required c. Documentation of quality improvement processes and performance improvement processes 5) Sub-‐folder or Bookmark 5: Integrity a. Brief Summary b. Documentation of complaint resolution process(s) specific to learners, instructor/educators, and employees c. If complaints have been filed, no less than one resolution process must be submitted for review 6) Sub-‐folder or Bookmark 6: Expanding the Field a. Brief Summary b. Provide a list of membership in professional societies of all staff of the Program with at least one(1) documented membership in a simulation society C. Section 2: Assessment Standards and Measurement 1) Sub-‐folder or Bookmark 1: Applications & Technology a. Brief Summary b. Documentation of the program providing substantial and ongoing assessment activities
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Instructional Guide -‐ SSH Accreditation c. The program describes how it provides orientation of the student to the environment and documentation of assessment evaluation tools 2) Sub-‐folder or Bookmark 2: Instructors, Educators, & Staff a. Brief Summary b. Documentation of a process in place to match the qualifications of the assessor to the characteristics of the assessment i. Description of Process ii. List of all assessment activities and associated assessors for the past two years iii. Biosketch of the two most active assessors c. Documentation of process in place to routinely evaluate assessors i. Description of Process ii. List of all assessor evaluation activities for the past two (2) years iii. Biosketch of the two most active evaluators d. Documentation of evaluation of assessors occurring annually, at a minimum 3) Sub-‐folder or Bookmark 3: Assessment Tools a. Brief Summary b. Examples provided of tolls used for varying levels of assessment 4) Sub-‐folder or Bookmark 4: Technical Support a. Brief Summary b. Demonstration of appropriate qualified human factors, psychometric, and statistical support 5) Sub-‐folder or Bookmark 5: Security a. Brief Summary b. Documentation of participant confidentiality document/policy D. Section 3: Research Standards and Measurement 1) Sub-‐folder or Bookmark 1: Mission a. Brief Summary b. Documentation of mission support through an organized, systematic program of research 2) Sub-‐folder or Bookmark 2: Research Expertise a. Brief Summary b. Policy and procedure related to self assessment c. Copy of tool provided to reviewers utilized for self assessment d. List of funded and unfunded research within the past three (3) years
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Instructional Guide -‐ SSH Accreditation e. List of research activities and presentations for the last three (3) years specific to simulation-‐related research f. Documentation of a process to match the qualifications of the researcher to the characteristics of the research i. Description of the process ii. List of all research activities and associated researchers for the past two (2) years iii. Provide biosketch for the two (2) most active researchers g. List of all individuals involved in research activities 3) Sub-‐folder or Bookmark 3: Director of Research a. Brief Summary b. Job description of position reflects designated, dedicated time to administration of simulation research 4) Sub-‐folder or Bookmark 4: Research Activities a. Brief Summary b. Documentation of specific research training and collaboration of instructors and educators 5) Sub-‐folder or Bookmark 5: Compliance a. Brief Summary b. Documentation of research policies and procedures including data storage policies and procedures E. Section 4: Teaching/Education Standards and Measurement 1) Sub-‐folder or Bookmark 1: Learning Activities a. Brief Summary b. List of education programs offered over the past two (2) years 2) Sub-‐folder or Bookmark 2: Qualified Instructors/Educators a. Brief Summary b. Documentation of a process in place to match the qualifications of the educator to the characteristics of the learning activities i. Description of process ii. List of all education activities and associated educators for the past two (2) years iii. Provide biosketch of the two (2) most active educators c. List of professional development courses made available to educators for past two (2) years, including at least one (1) annually d. Policy for educator orientation, training, and evaluation i. Provide a copy of training syllabus for new simulation educators, including instruction in feedback/debriefing techniques
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Instructional Guide -‐ SSH Accreditation ii.
The program describes how it provides orientation of the simulation educator to the environment and documentation of evaluation tools iii. The program describes how it provides orientation of the content expert, when appropriate, to the environment and documentation of evaluation tools e. Documentation of on-‐going education activities to improve simulation skills (at least 1 annually) f. List of all core educators 3) Sub-‐folder or Bookmark 3: Initial Curriculum Design a. Brief Summary b. Provide examples of 1-‐2 recently delivered courses c. Education materials and simulation follow developed learning objectives d. Course developed using simulation education theory or by a simulation expert 4) Sub-‐folder or Bookmark 4: Learning Environment a. Brief Summary b. Submit two (2) video examples of actual learning activities 5) Sub-‐folder or Bookmark 5: Ongoing curriculum feedback and improvement a. Brief Summary b. Documentation of course evaluation and follow-‐up surveys from participants and educators c. Documentation of evaluations from at least three (3) courses offered within the last year d. Evaluations are obtained from at least 80% of all courses offered e. Evaluations include meeting of education objectives 6) Sub-‐folder or Bookmark 6: Educational Credit a. Brief Summary b. List any provided CE/CME courses within the last year F. Section 5: Systems Integration & Patient Safety Standards and Measurement 1) Subfolder or Bookmark 1: Mission and Scope a. Brief Summary b. Mission statement must include the expressed intent to enhance the performance of individuals, teams, and organizations for improved outcomes c. Provide a description of the process linking systems integration and patient safety activities to the strategic plan of the healthcare system, including the roles of
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Instructional Guide -‐ SSH Accreditation those responsible for executing the plan to impact systems integration d. Provide a copy of the mission statement with required elements as described in the 2012 Standards. e. Provide evidence of the past two years documenting the simulation program being utilized as a resource by risk management and/or quality/patient safety with bi-‐ directional feedback f. Provide a letter (2 pages maximum) from organizational Risk Management, Safety, and/or Quality Improvement leadership supporting the Program’s role in achieving organizational risk, quality and/or safety goals g. Provide specific documentation of three examples of Simulation used in an integrated fashion to facilitate Patient Safety, Risk Management and/or Quality Outcomes projects/activities h. Provide evidence that demonstrates sustained (minimum 6 months), positive outcomes achieved by activities in which simulation was used, spanning multiple disciplines i. Provide evidence that demonstrates organizational leadership’s ongoing assessment out outcome metrics 2) Subfolder or Bookmark 2: Integration with Safety Activities a. Brief Summary b. Provide performance improvement committee rosters and minutes from at least two (2) meetings during the past 2 years to verify contributions of simulation personnel c. Demonstrate access to appropriate qualified human factors, psychometric, and/or systems engineering support or resources 12. Provide a written list of abbreviations used in your application or in any of the supporting evidence. Examples of abbreviations to be included are those specific to your institution or program.
13. Obtain appropriate signatures found at end of Application Form and include Business Cards 14. Make copies for you and your Institution
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Instructional Guide -‐ SSH Accreditation
15. Send all application materials to:
SSH Accreditation Office c/o Jennifer Manos 10747 Stone Ridge Way Harrison, Ohio 45030 Remember to opt for tracking of your package.
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