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Certification and credentialing are designed to ensure that health professionals in all roles are qualified, capable, and prepared to perform the services for which they are employed or given permission to provide. Credentialing is a process by which professionals provide evidence that they are qualified to perform designated clinical activities. Nursing is bound by both internal mechanisms (e.g., mission, values, position description, and practice standards) and external mechanisms (e.g., Code of Ethics, Practice Act, Board of Registration Rules and Regulations, and Standards of Practice) that define competent practice. Establishing systerns for assessing and affirming the competency of all providers is required of organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) by the Conditions of Participation for hospitals and facilities that receive Medicare reimbursement and increasingly by other third-party payers.
Although nurses know the full benefits of certification and credentialing, what does it really mean to patients? In a nutshell, it should be obvious that a high level of patient care is provided by a qualified provider who is knowledgeable about the patient's needs. But before patients are convinced that this is the case, nurses and health care providers must address a number of socioeconomic, environment, and political issues that have kept us from developing effective systems to assess competency. We must also unite to promote the benefits of certification and credentialing to patients, government organizations, insurers, and even within our own health care system.
Credentialing
As nurses, we are familiar with position descriptions and performance appraisals. Credentialing refers to the process by which individuals or institutions or one or more of their programs are designated by a qualified agent as having met minimum standards at a specified time (American Nurses Association [ANA], 1979). Credentialing is an administrative procedure to examine information about a practitioner's education, certification, training, continuing education, and experience or actions by the Board of Registration. Credentials relate to the qualification of an individual to practice in their state within the scope of practice for that individual's profession. Credentials are marks or "stamps" of quality and achievement communicating to employers, payers, and consumers what to expect from a "credentialed" nurse; specialist; course or program of study; hospital or health service; or health care product, technology or device. Unlike other...