CHAA, CHAM credentials revised, updated
Aim is 'legally defensible' program
The National Association of Healthcare Access Management (NAHAM) credentialing programs for patient access services managers and front-line staff are being completely revised and updated, with new certification examinations to be offered beginning in October 2008, says Holly Hiryak, RN, CHAM, chair of the Washington, DC-based organization's Certification Commission.
"We decided about a year ago that we needed to 'up the ante' and improve our certification process," Hiryak adds. "The tests were a little outdated, and we needed to make sure we had products that were [in credentialing terms] 'legally defensible.'"
That means that the examinations have gone through a rigorous development process that ensures their validity as testing tools, she explains.
The Certification Commission, established at the May 2007 NAHAM conference, was charged with creating a "valid, credible, and sustainable certification program," according to a posting on the organization's web site, separate from the mission of the NAHAM Education Committee, which traditionally had overseen certification matters along with other educational responsibilities.
NAHAM contracted with the international testing company Schroeder Measurement Technologies (SMT), which is helping guide the process, Hiryak notes.
To establish a blueprint for the new exams, the commission put out a call for two groups of volunteers one for the CHAA credential and another for CHAM and "started from scratch" the process of creating test questions, she says.
"We looked at the old outline of our study guide and used that as the basis for moving forward," Hiryak says. "We eliminated some topics, added some, and then sent a survey to our membership and to anyone who had been certified. We asked them to review the outline and indicate the relevance of the topics we had [proposed] as a blueprint."
After receiving feedback from members and from others who have the CHAA and CHAM certifications, she adds, the group met again to review those responses. "We realized we were on target. We made some adjustments, but not many."
At that point, the actual writing process began, Hiryak notes, with participants spending almost three days "just sitting in rooms and writing questions. People would volunteer for [subject] areas in which they were most comfortable."
Once the questions were written, they were submitted to the facilitator of each group and then put up on a screen to be analyzed for appropriateness, she says, by project participants who represented various regions of the country. Each question was either accepted by the group or thrown out, Hiryak adds, with SMT providing support in determining whether a question was relevant nationally or limited to a particular area.
"That was a long and rigorous process, and once we completed that we had a good start on a databank," she says. A little further tweaking was set for an early session at NAHAM's annual conference in May, Hiryak notes, and an electronic SMT process allowed the on-line submission and review of questions.
SMT is "a full-service test development company, which means that they offer support for all the steps in a standard certification process," adds Ellen Moore, vice president of education and program services for SmithBucklin Corp., the management firm that runs NAHAM. Moore serves as the certification expert for the CHAM and CHAA credentialing program.
The process begins with an assessment of the type of program needed, she says, and continues with a job analysis "outlining the tasks and skills necessary to perform in the job." In this case, Moore notes, an analysis was done for two positions health care access manager and health care access associate.
"The job analysis gives us an established body of knowledge and helps create a blueprint for the content and requirements for the job we're going to certify," she adds.
Further steps include development of test specifications, test development, test administration, cut score (the pass-fail point), and score reporting (giving candidates information on how they did on the test), Moore says.
Grading is not done on a curve, and the cut score is not at all arbitrary but determined very deliberately, she points out. "Subject matter experts help us set the [cut] score."
The old CHAA and CHAM exams were used at the conference and through the end of May 2008, Hiryak says, and then testing was to be suspended from June 1 to Sept. 30, 2008. Testing will begin again, with the new exams, on Oct. 1, 2008.
The break is needed, she explains, "to build up a pool of people to test, so we can set the baseline. From there, we are making some changes to the process in terms of prerequisites and frequency of test offerings."
The strength of the new exams, she points out, lies in the "quality and validity of information. These are not just questions off the top of your head, but are research-based." People who served as "item writers" for the tests, she adds, were required to provide a resource for the information they provided.
The intent was not to make the examinations harder, but to accurately test the knowledge base of those in the access field, she says. "Because these are cleaned-up, valid questions with resources, I think we will see an increase in the pass rate because the information is more relevant to what they're doing."
Continuous revision process planned
"For instance, in the previous tests, there was a heavy focus on coding and medical records," Hiryak notes. "We limited that [in the new versions] because it's not really that relevant. We adjusted [content] based on what the membership told us was relevant in their day-to-day jobs."
When the CHAM and CHAA tests are re-launched in the fall, Moore says, 15 "extra" questions will be added, and there will be "a continuous process in which we are always updating and revising questions."
Each question, she adds, will be looked at from several perspectives: "Is it well written? How do people do on that question? Are their answers well-formulated?"
As with any certification program, Moore says, the intention is that "the person who passes this test meets the minimum industry standards" for the job. "If someone were to question NAHAM, or the candidate, we can go back and show the rigorous process we put in place."
Having such a credential is valuable for many reasons, she contends. "It helps elevate the profession. It helps [those who attain it] to have a certain level of professional achievement."
In addition, Moore says, "more and more facilities are requiring [certifications] for promotions or using them as hiring criteria for certain levels in jobs."
[Editor's note: Holly Hiryak can be reached at [email protected]. Ellen Moore can be reached at [email protected].]
The National Association of Healthcare Access Management (NAHAM) credentialing programs for patient access services managers and front-line staff are being completely revised and updated, with new certification examinations to be offered beginning in October 2008.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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