Project Supports Educators, Students, Clinicians and
Administrators toward Optimal Integration
DC, ND, LAc and Massage Educators Lead Effort
Contact: John Weeks 206-932-5799 (o), 206-851-1758 (c);
Release available here: http://accahc.org/images/accahc-coi-optimal-practice.pdf
Following a lengthy collaborative process involving academic leaders from 8 disciplines*, the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) has endorsed what it calls the Competencies for Optimal Practice in Integrated Environments. ACCAHC is presently focused on aggregating and creating content to develop a rich web-portal, the Center for Optimal Integration, (www.optimalintegration.org) to assist educators, practitioners and organizations of all types to move toward such competencies.
Mike Wiles, DC, MEd, Vice President and Provost at Minnesota-based Northwestern Health Sciences University, is among those leading the ACCAHC process. Wiles, co-chair of ACCAHC’s Education Working Group, explains the importance of the initiative: “The era of integration is here. Yet the educational standards and clinical models of the licensed integrative healthcare disciplines are generally not emphasizing integrative models of care. These competencies focus us all on the current and future needs of providers.”
The ACCAHC Competencies consist of 28 competency elements in 5 distinct fields:
- Institutional healthcare culture and practice
- Interprofessional education
- Communication and interprofessional relationships, and
- Evidence-based health care and evidence-informed practice.
A multidisciplinary group of over 50 professionals from ACCAHC’s Education Working Group, Clinical Care Working Group, Research Working Group, Council of Advisers, Board of Directors and member organizations participated in the multiple stages of the process that began in September 2009.
Marcia Prenguber, ND, is co-chair of the ACCAHC Clinical Working Group and director of integrative care for Indiana University Health Goshen, in Goshen, Indiana, where she also heads a residency program for naturopathic doctors. Prenguber, the past president of the Council on Naturopathic Medical Education, underscores that the focus is on “optimal” competencies rather than the minimal competencies in typical accreditation standards.
Prenguber states: “Our work on the Competencies is energized by the knowledge – which I see daily here in my health system – that creating optimal health care teams while at the same time honoring the diverse contributions of our practices amidst the challenges of healthcare delivery asks all of us to perform at our best. The document represents our identification of the kinds of knowledge, skills and attitudes that would do that.”
Next steps – toward a web portal
ACCAHC executive committee member Jan Schwartz, MA, who also serves as Wiles’ co-chair of the Education Working Group, notes that ACCAHC’s Board has chosen as its central focus from 2010 forward the development and hosting of an extensive body of resources that will assist educators, students, clinicians and administrators toward bettering patient care through the identified competencies.
Schwartz, a massage therapist and Past-Chair of the Commission on Massage Therapy Accreditation, is also an online education specialist. She states: “We are developing plans and looking for the resources to create what will be an extraordinary web portal. We will have more to report on this soon.” The site, in development, will be called the Center for Optimal Integration.
Prenguber’s co-chair of the clinical group, Jason Wright, MS, LAc, Dean of the Finger Lakes School of Acupuncture and Oriental Medicine of the multidisciplinary New York Chiropractic College, clarifies that “these competencies are not about the skills of current graduates to provide quality clinical services – our practitioners are well trained for that in our accredited programs.”
Wright, a member of the executive committee of the Council of Colleges of Acupuncture and Oriental Medicine, explains: “Our work with the competencies and providing web-based resources is at the heart of ACCAHC’s mission. This work supports our ongoing commitment to promote mutual understanding, collaborative activities, interdisciplinary health care education, and the delivery of optimal patient care.”
ACCAHC urges any institutions and organizations that share this mission to post, circulate and publish the competencies to their educators, students, clinicians and administrators. (Contact
for a separate PDF and introduction.)
*About the Academic Consortium for Complementary and Alternative Health Care (ACCAHC): ACCAHC is a 501c3 organization the mission of which is to enhance patient care through fostering mutual respect and understanding among diverse healthcare professionals and disciplines. ACCAHC’s basic work is funded 2/3 through philanthropic contributions and publications, with the remaining third from dues of core members: councils of colleges, accrediting agencies and certification and testing organizations from the 5 complementary healthcare professions with a US Department of Education-recognized accrediting body (DC, ND, AOM, massage therapy, direct-entry midwifery) plus some traditional world medicines and emerging professions that are engaging self-regulatory actions (Yoga therapy, Ayurvedic medicine, yoga teaching, homeopathic medicine). www.accahc.org
Competencies for Optimal Practice in Integrated Environments
Development initiated: September 2009
Approved by the ACCAHC Board of Directors: August 17, 2010
Preamble: Skills in team care are essential for all healthcare practitioners. Knowledge of other health care systems and the practices of colleagues in other fields provides a necessary beginning. Inter-and intra-professional education (IPE) that occurs in classes, clinics and research projects, for health care students and faculty, enhance the ability to collaborate. For members of the licensed integrative practice disciplines, education in these areas gains importance as patients form their own teams and as health systems open their doors to practice opportunities in interdisciplinary, inpatient and outpatient environments. These competencies and related knowledge areas are guides for collaborative efforts toward better patient care through enhancing mutual respect and understanding across healthcare professions. This document, which assumes that all practitioners are equipped with their own, discipline-specific clinical competencies, is meant to serve as a resource to all parties to these emerging healthcare teams.
Describe policy issues, structures, emerging clinical and economic models, and other factors that may impact clinical and financial decisions; discuss how cost, compensation models and incentive structures influence care decisions; summarize recent history of integrated care, including varieties of integrated care models; describe best practices, opportunities and challenges.
Institutional Healthcare Culture and Practice
Explain inpatient and outpatient health system accreditation standards and protocols; describe authority structures and decision processes; explain credentialing and privileging mechanisms; identify and discuss liability issues; contrast provider payment models; describe the clinical services and processes of care for other disciplines in a facility; identify and apply common medical terminology; appraise a medical record; select appropriate medical codes; define relevant short-hand and abbreviations; evaluate standard charting and documentation in both paper and electronic medical record formats.
Inter-Professional Education (IPE)
Describe the various health care systems in common practice including both conventional and the licensed complementary and alternative healthcare fields, as well as the emerging fields and traditional world medicines; discuss the emphasis each places on disease prevention, wellness and the therapeutic strategies engaged for health creation.
Communication and Inter-professional Relationships
Discuss concepts of one’s own discipline in terms appropriate for administrators and practitioners in other disciplines; role-play strategies useful for building appropriate consultation, referral and co-management relationships; identify decision processes in complex institutions; demonstrate public speaking and presentation skills to represent your discipline and practice to larger groups; produce written and presentation materials suitable for both consumer and professional audiences; identify leadership strategies useful in fostering institutional change; and integrate the knowledge, skills and values described in the practitioner-to- practitioner section of Health Professions Education and Relationship-Centered Care (Pew Health Commission, 1994, page 36; attached).
Evidence-based Health Care and Evidence-informed Practice
Discuss basic research principles and methodologies within the context of both clinical and mechanistic research; evaluate research; explain the role of scientific evidence in healthcare in the context of practitioner experience and patient preferences and apply evidence-informed decision making; describe and discuss the research base within one’s own discipline; relate contemporary issues in integrative practice research, including those relative to measuring whole practices, whole systems and health outcomes; identify and appraise the positive and negative interactions and contraindications for one’s own modalities and agents; and identify standard research methods and tools appropriate for assessing one’s field in a clinical setting.
Copyright © 2010 Academic Consortium for Complementary and Alternative Health Care
Practitioner to Practitioner Relationships in Relationship-Centered Care
From Health Professions Education and Relationship-Centered Care
Tresolini C.P. and the Pew-Fetzer Task Force. San Francisco, CA:
Pew Health Professions Commission.1994; p.36.
Elizabeth Goldblatt, PhD, MPA/HA
Beth Rosenthal, PhD, MBA, MPH
Joseph Brimhall DC*
Elizabeth Goldblatt, PhD, MPA/HA*
Guru Sandesh Khalsa, ND
Christa Louise, PhD
Morgan Martin, ND, LM
Cheri Monterastelli, RN, MS, LMT
Jo Anne Myers-Ciecko, MPH
Frank Nicchi, DC, MS
David O’Bryon, JD, Vice Chair*
Reed Phillips, DC, PhD, Founding Chair
Marcia Prenguber, ND*
Jan Schwartz LMT, Secretary*
Pamela Snider, ND, Treasurer*
Felicia Tomasko, RN
Kory Ward-Cook, PhD, MT (ASCP), CAE
John Weeks, ex officio*
David Wickes, MS, DC
Ron Zaidman, MTCM, MBA, DAOM Fellow
* Executive Committee
Councils of Colleges
Council of Colleges of Acupuncture and Oriental Medicine
Association of Chiropractic Colleges American Massage Therapy Association
Council of Schools Association of Accredited Naturopathic
Commission on Massage Therapy Accreditation
Council on Chiropractic Education
Council on Naturopathic Medical Education
Midwifery Education Accreditation Council
Testing and Certification
North American Board of Naturopathic Examiners
National Board of Chiropractic Examiners
National Certification Commission for Acupuncture and Oriental Medicine
Traditional World Medicines & Emerging Professions
Council on Homeopathic Education
International Association of Yoga Therapists
National Ayurvedic Medical Association Yoga Alliance
Sustaining Donors Group
Leo S Guthman Fund
Founding Philanthropic Partner