Accreditation, Certification, Licensure, Registration
If you’re confused about all the credentials available to you and what they mean to your career or profession, you’re not alone. The “alphabet soup” of letters after healthcare and design professionals’ names has grown in recent years and the distinctions between one credential and another are often blurred and can be confusing.
To help you better understand the purpose of, differences between, and requirements for each of the credentials, The Center for Health Design (CHD) and the American Academy of Healthcare Interior Designers (AAHID) convened representatives from several credentialing organizations to discuss and agree upon definitions and organize information about the various programs.
Those represented included the American College of Healthcare Architects (ACHA), Evidence-based Design Accreditation and Certification (EDAC) from CHD, Green Building Certification Institute (GBCI), International Facility Management Association (IFMA), National Council of Architectural Registration Boards (NCARB), and the National Council for Interior Design Qualification (NCIDQ).
The group agreed that obtaining a professional credential is a credible way to demonstrate proficiency in a field. A credential identifies an individual who is committed to his/her profession and provides a tangible recognition of his/her knowledge and/or experience. Common terms and definitions are listed below.
Credential: An umbrella term used for many types of programs such as licensure, certification, accreditation, and certificates. A credential is an attestation of qualification, competence, or authority issued to an individual by a third party with a relevant or de facto authority or assumed competence to do so.
Credentialing: The process used to establish the qualifications of professionals, organizational members, or organizations and to assess their background and legitimacy to meet predetermined and standardized criteria. Individuals, organizations, processes, services, or products may be credentialed.
Licensure: A process by which a governmental agency grants time-limited permission to an individual to engage in a given occupation after verifying that he or she has met predetermined and standardized criteria (usually education, experience, and examination).
- The goal of licensure is to ensure that the licensees have the minimal degree of competency necessary to ensure that public health, safety, and/or welfare are protected.
- To become licensed, one usually has to meet eligibility requirements and pass an assessment that covers a broad range of knowledge and skills, usually at the entry level.
- There are usually ongoing requirements that need to be met to maintain the license (CEUs, retests, physical exams, etc.).
- Typically, they are granted at the state level; if the individual works in multiple jurisdictions, then they must be licensed in each jurisdiction. Licensing requirements vary from jurisdiction to jurisdiction.
- Professional associations do not grant licensure but can play a role in licensure activities, such as advocating for the license and collaborating with agencies responsible for the development and administration of licensing.
In most cases, the terms “licensure” and “registration” are used interchangeably. An example of this credential would be a registered architect or licensed interior designer.
Certification: A voluntary process by which a nongovernmental agency grants a time-limited recognition to an individual after verifying that he or she has met predetermined and standardized criteria.
- To become certified, an individual must meet eligibility requirements and pass an assessment.
- Certification is voluntary and the individual does not need to be certified in order to engage in a given occupation. Certification has traditionally been an association activity in which a group of professionals determines the need to publicly state its standards through assessment of competence, quality, or specialized knowledge.
- The certification assessment may cover a broad area of knowledge and skills at entry, specialty, or advanced levels.
- Certificants usually have ongoing requirements, such as continuing education or retesting, to maintain the certification.
- A certificate program should not be confused with certification.
Examples of certification programs are those offered by AAHID, ACHA, American College of Healthcare Executives (ACHE), EDAC, and GBCI (LEED). While it offers credentials for individuals, GBCI actually uses the term “certification” for its building credential program, which does not fit the traditional definitions described above.
Certificate: A voluntary process by which a person or organization acquires a document serving as evidence, or as written testimony, of status, qualifications, privileges, or the truth of something.
- Generally issued by an institution not authorized to grant diplomas, or to a student not qualifying for a diploma.
- A one-time recognition that does not expire or have ongoing requirements.
- Unlike certification or accreditation a certificate belongs to the individual and not the organization.
Accreditation: A voluntary process by which a nongovernmental entity grants a time-limited recognition or credentials to an organization after verifying that predetermined and standardized criteria are met.
- Accreditation is voluntary; however, sometimes it becomes so important that it can be considered quasi-mandatory.
- The focus of an accreditation’s assessment is on safe and effective processes and outcomes.
- Accreditation usually has ongoing requirements (such as applications or site visits) that need to be met to maintain the accreditation.
Example of this are Joint Commission, Council for Interior Design Accreditation (CIDA), National Architectural Accrediting Board (NAAB), Council on Education for Public Health (CEPH), Planetree, etc.
Many organizations in the healthcare and design industry offer different types of credentials. The following provides summary information about several programs that are relevant to those who are involved in planning, designing, building, renovating, or maintaining healthcare facilities.
The American Academy of Healthcare Interior Designers
AAHID certifies the knowledge, skills, and abilities of healthcare interior designers. Board-certified healthcare interior designers are distinguished and qualified by demonstrated experience in the specialty of healthcare interior design and successful completion of a comprehensive exam. The AAHID appellation recognizes knowledge, skill, commitment, and excellence to the healthcare industry. Designers must first meet the prerequisite qualifications of the successful completion of the NCIDQ exam and of five years of demonstrated experience in healthcare interior design. For more information, visit www.aahid.org.
The American College of Healthcare Architects
The American College of Healthcare Architects provides board certificatio
n for architects who practice as healthcare specialists. Certificate holders include healthcare architects throughout the United States and Canada with specialized skills and proven expertise. Before earning the ACHA board certificate, healthcare architects must document their experience and demonstrate their skills through a computer-based examination. ACHA requires its certificate holders to work towards the improvement of healthcare architecture on behalf of the public, to practice in an ethical manner, to maintain high standards of specialized continuing education, and to add to the body of knowledge. In addition, ACHA certificate holders must successfully complete 18 learning unit hours each year, with 12 being specific to healthcare. Qualified individuals are invited by the ACHA regents to submit an application. For more information, visit www.healtharchitects.org.
Evidence-based Design Accreditation and Certification
The EDAC program, managed by The Center for Health Design, educates and assesses individuals on their understanding of an evidence-based design (EBD) process. The goal of the program is not to test people about their knowledge of current evidence, but instead teaches a process to identify and use available and credible research to inform design, and how to develop goals and hypotheses, gather data, and measure results to share with the industry. There are no prerequisites to sit for the EDAC exam, but the following are recommended:
- A bachelor’s degree in a field related to the healthcare or design industry (i.e. healthcare administration, healthcare services, architecture, interior design, environmental psychology, etc.) and at least one year of experience in the healthcare or design industry;
- More than two years of work experience in the healthcare or design industry;
- Professional level status of any industry-related professional association or accrediting body (i.e., AIA, ASID, IIDA, IFMA, ASHE, AONE, AAHID, ACHA, NCIDQ, JACHO, AMA, etc.); and
- A graduate-level degree in a field related to the healthcare or design industry (master’s degree, equivalent, or higher level degree).
For more information, visit www.healthdesign.org/edac.
Planetree Visionary Design Network (VDN)
Planetree’s VDN provides design firms the opportunity to differentiate themselves through the formal accreditation of their commitment to the design of healing environments. The credential establishes the firm as a specialist in evidence-based healthcare design following the Planetree philosophy and its core components of healing design. Firms complete a self-assessment and an application. Once the application is accepted, firm leaders are interviewed to discuss their organization’s commitment to healing environments, EBD, and principles of design excellence and innovation. This is followed by an on-site assessment of one project that reviews the physical environment as it relates to the Planetree model of care and key aspects of a healing environment. For more information, visit www.planetree.org.
Green Building Certification Institute
GBCI is an independent, third-party organization committed to ensuring precision in the design, development, and implementation of the processes used to increase and measure green building performance (certification) and green building practice (credentialing). Established in 2008 to administer project certifications and professional credentials and certificates within the framework of the U.S. Green Building Council’s Leadership in Energy and Environmental Design (LEED) Green Building Rating Systems, GBCI offers the marketplace the highest-level validation that LEED building certifications and LEED professional credentials have met specific, rigorous criteria.
The LEED Green Associate credential is suited for individuals who seek to showcase their general green building knowledge. To become a LEED Green Associate, candidates must demonstrate the following: involvement in supporting a LEED-registered project, current work or previous employment in a sustainable field of work, or completion of an education program in green building principles.
The LEED AP with specialty credential is for individuals who plan to work directly in the LEED certification process. To become a LEED AP with specialty, candidates must show documented professional experience on a LEED-registered project within the last three years, with verification through LEED online or employer attestation. For more information, visit www.gbci.org.
International Facility Management Association (IFMA)
IFMA offers several credentials, including a Facility Management Professional (FMP) designation, which is a knowledge-based credential that will help to accelerate a facility manager’s transition into the profession. By earning the FMP credential, professionals can improve their knowledge, enhance their skills, and gain immediate credibility with employers, clients, and peers.
The Sustainability Facility Professional (SFP) is an assessment-based certificate program delivering a specialty credential in sustainability. By earning the SFP credential, facility management professionals can develop and gain recognition for their expertise in sustainable facility management practices while impacting their organization’s triple bottom line.
The Certified Facility Manager (CFM) credential sets the industry standard for ensuring the knowledge and abilities of practicing facility managers. The CFM exam is competency-based, testing what a person can do compared to standards that define the practice of facility management. For more information, visit www.ifma.org.
American Society of Healthcare Engineers
In an effort to develop leaders who work in unison to optimize the physical healthcare environment, ASHE offers two professional certifications: Certified Healthcare Constructor (CHC) and Certified Healthcare Facility Manager (CHFM). The CHC and CHFM designations provide a number of benefits to those who achieve them as well as to the entire healthcare industry. Eligibility requirements for each are a blend of education and experience. For more information, visit www.ashe.org/about/certifications.
National Council of Architectural Registration Board
NCARB represents the architectural registration boards of the 50 U.S. states, the District of Columbia, and three U.S. territories (Guam, Puerto Rico, and the U.S. Virgin Islands). NCARB certification facilitates reciprocal registration for architects among all 54 NCARB member boards and 11 Canadian jurisdictions, and can be used to support an application for registration in other countries. Although certification does not qualify a person to practice architecture in a jurisdiction, it does signify that he or she has met the highest professional standards established by the registration boards responsible for protecting the health, safety, and welfare of the public. All registered architects are eligible to apply for the NCARB certificate and must meet education, experience, and examination standards. Any changes to these standards must be approved by an absolute majority of the council’s member boards. For more information, visit www.ncarb.org.
National Council for Interior Design Qualification (NCIDQ)
NCIDQ protects public health, safety, and welfare by identifying interior designers who have the knowledge and experience to create interior spaces that are not just aesthetically pleasing, but also functional and safe. An independent, nonprofit organization of state and provincial credentialing bodies, NCIDQ has i
ssued professional certificates to competent interior design professionals since 1974. Interior designers who meet NCIDQ’s eligibility requirements for education and experience, and pass the rigorous NCIDQ examination are assigned a unique NCIDQ certificate number that attests to their qualifications for employers, state regulators, and the general public. In addition to developing and administering the examination, NCIDQ provides research and expertise that informs state and provincial licensing laws and regulations for the interior design profession. NCIDQ maintains minimum education and work experience requirements for eligibility to take the NCIDQ examination. For more information, visit www.ncidq.org.
Comments & Conclusions
“To legally practice, an architect is required to be licensed in the jurisdiction where the project is located,” notes Stephen Nutt, AIA, NCARB, CAE, vice president of programs at the National Council of Architectural Registration Boards in Washington, D.C. “The NCARB certificate enables the architect to become easily and quickly licensed in all 54 U.S. jurisdictions so they are ready to serve the needs of their clients. Simply put, the NCARB certificate ensures their professional mobility.”
The others are credentials that qualify an individual’s knowledge and experience in a specialty area, such as healthcare interior design, healthcare architecture, evidence-based design, green design, and facility management. They complement and support one another, ensuring the highest level of competency in the healthcare design profession. Some, like AAHID, ACHA, ASHE, and IFMA’s credentials are specifically for facility and design professionals. Others, like EDAC and GBCI’s LEED credentials, provide qualification of additional knowledge, as they can be obtained by anyone in the healthcare and design industry.
“Having more than one credential shows the breadth of knowledge and experience that an individual has,” says Carlos Amato, AIA, ACHA, LEED AP, EDAC, chairman of the ACHA Certificate Holders Committee. “Because many of the credentials relate to one another, it doesn’t necessarily mean that you have to acquire a whole different skill set either.”
Most of the credentialing programs mentioned above have continuing education requirements and all have application and testing fees. As new credentialing programs have been introduced, some healthcare and design managers have had difficulty justifying the costs for their employees to achieve and maintain another credential.
“However, if they think about it as employee education, a credentialing program becomes a relatively low-cost way to support future growth and development,” says Jocelyn Stroupe, AAHID, IIDA, ASID, EDAC, president of AAHID. “That’s actually a good thing.” HCD
Thanks to other contributors to this article, including: Jocelyn Stroupe, AAHID, IIDA, ASID, EDAC and Linda M. Gabel, AAHID, IIDA, for AAHID; Carlos Amato, AIA, ACHA, LEED AP, EDAC, for ACHA; Katy Harmon, LEED AP BD+C, for GBCI; William Gregory, IFMA Fellow, PE, CFM, and Jeffrey J. Tafel, CAE, for IFMA; Stephen Nutt, AIA, NCARB, CAE, for NCARB; and Jeff Kenney and Kim Ciesynski, ASID, for NCIDQ.