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CQIA - Certified Quality Improvement Associate - BrainDump Information

Vendor Name : Quality-Assurance
Exam Code : CQIA
Exam Name : Certified Quality Improvement Associate
Questions and Answers : 41 Q & A
Updated On : November 16, 2018
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CQIA exam Dumps Source : Certified Quality Improvement Associate

Test Code : CQIA
Test Name : Certified Quality Improvement Associate
Vendor Name : Quality-Assurance
Q&A : 41 Real Questions

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Quality-Assurance Quality-Assurance Certified Quality Improvement

hashish sensible Launches Canada’s First country wide cannabis Certification program | killexams.com Real Questions and Pass4sure dumps

November 13, 2018 03:05 ET | supply: Victory square technologies Inc.

...Victory rectangular portfolio company to promote best assurance and pressure continual development in the hashish trade

VANCOUVER, British Columbia, Nov. 13, 2018 (GLOBE NEWSWIRE) -- In a movement aimed toward accelerating innovation, promotion excellent assurance, and using continual development in the Canadian cannabis trade, hashish shrewd, Inc., a portfolio business of Victory rectangular applied sciences Inc. ("Victory square" or the "enterprise") (CSE:VST) (OTC:VSQTF) (FWB:6F6) is launching Canada’s first national certification program.

The newly-dependent country wide hashish Certification software is driven by means of a product assessment panel and buyer guidance group responsible for assigning the '’cannabis smart” seal of approval for products grown throughout Canada. The seal lets Canadian buyers recognize with sure bet that items are produced to the highest grade of best and meet the strictest fitness Canada security standards.

“We’re proud of the leadership function being played by using cannabis intelligent and are very comfortable to see the introduction of this country wide hashish Certification application,” spoke of Shafin Diamond Tejani, CEO of Victory square applied sciences. “Product exceptional is without doubt one of the market’s suitable priorities, and the excellent assurance focus of the hashish shrewd application will aid Canada remain a global leader within the cannabis sector. As incubators and accelerators, we are extremely joyful to work with entrepreneurs who're making daring alterations in the cannabis business; changes that no longer only advantage Canadian buyers but have the abilities to tremendously have an impact on the world market.”

Designed to enrich the existing regulatory gadget, cannabis smart certification is a voluntary program that promotes nice assurance and drives continual development in the hashish industry. it is going to help producers set themselves and their items aside on the electricity of the greater standards upheld via the countrywide cannabis Certification software.

“patrons demand quality when it comes to the products they eat,” said Barinder Rasode, Co-founding father of hashish wise and CEO of the country wide Institute for cannabis health and schooling (niche). “It’s now not satisfactory to simply produce a superb nice product. individuals need to consider that satisfactory exists.”

application standards encompass defining ‘craft’ or ‘high great’ hashish with specific scientifically decided markers, setting up clear excellent parameters and providing the general public with non-biased satisfactory assessment stories.

“agencies have to be lively in contributing to perceptions of satisfactory, because it is these perceptions that encourage individuals to opt for one product over an additional,” defined Rasode. “That connection creates a reason to purchase and a rationale to dwell loyal.”

Rasode believes that valued clientele are willing to pay extra for products they consider most fulfilling meet their wants, however it takes effort and resources to create that plenty sought-after customer loyalty.

“in this initiative around fine handle, improvement and innovation, we’re proud to be a part of the Victory rectangular household, especially given VST’s world recognition for using affect and fostering increase,” talked about Rasode. “This partnership will help us create a relied on manufacturer, unencumber new alternatives and set the global commonplace for cannabis quality.”

candidates to the countrywide hashish Certification software will supply batch particular terpene, cannabinoid and moisture content material analysis from a health Canada licensed laboratory. All items are reviewed by way of a panel of experts who continue to be nameless.

as soon as a sample has handed analytical trying out and fundamental visible/olfactory analysis, it might be blind style validated with the aid of as a minimum one member of the hashish shrewd tasting panel. products that flow eligibility necessities and tastings should be given certainly one of three cannabis smart certifications.

For further counsel concerning the business, please contact:

Investor members of the family Contact - Prit SinghEmail: prit@victorysquare.comTelephone: 905-510-7636

Media members of the family Contact – Shafin Diamond DirectorEmail: media@victorysquare.comTelephone: 604-283-9166

ABOUT VICTORY rectangular applied sciences INC.

Victory rectangular applied sciences (VST) is an accelerator with 20+ portfolio businesses concentrated on emerging technologies equivalent to: Blockchain, computer getting to know, synthetic Intelligence and VR/AR. we have a proven process for making a choice on and investing in spectacular delivery-united stateswho are working on resourceful and disruptive tasks in every sector of the world economic system, including Finance, fitness, precise estate, insurance, entertainment and training. We use our event, expertise and substances to assist grow and scale these portfolio agencies, which outcomes in explosive returns for VST and its shareholders. For more tips, please discuss with www.victorysquare.com.

ABOUT cannabis intelligent

hashish smart has developed a product satisfactory certification application. we have formed a product overview panel and customer guidance neighborhood answerable for assigning the 'cannabis smart' seal of approval. Designed to enrich the latest regulatory federal gadget, cannabis intelligent product certification shows to the general public which certain plant life have been grown, processed and cured to fulfill the average exceptional requisites expected by way of the experienced customer.

in regards to the CANADIAN SECURITIES trade (CSE)

The Canadian Securities trade, or CSE, is operated by using CNSX Markets Inc. diagnosed as a stock exchange in 2004, the CSE started operations in 2003 to supply a contemporary and efficient alternative for groups seeking to access the Canadian public capital markets.

forward-looking counsel

This information unlock incorporates “ahead-looking counsel” within the which means of relevant securities laws regarding the outlook of the enterprise of Victory rectangular, together with, with out quandary, statements concerning the completion of the acquisition of an interest in Limitless Blockchain and the timing, can charge and terms thereof, the have an impact on of the acquisition on the company, the strategic path of the business, and its goal of broadening its portfolio of pursuits in resourceful companies. Such ahead-searching statements may, with out quandary, be preceded via, followed with the aid of, or include phrases reminiscent of “believes”, “expects”, “anticipates”, “estimates”, “intends”, “plans”, “continues”, “assignment”, “expertise”, “feasible”, “consider”, “seek”, “intention”, or equivalent expressions, or may additionally employ such future or conditional verbs as “may additionally”, “may”, “will”, “may”, “should still” or “would”, or might also in any other case be indicated as forward-searching statements by way of grammatical construction, phrasing or context. All statements other than statements of ancient fact contained during this information liberate are forward-looking statements. forward-looking assistance is based on certain key expectations and assumptions made with the aid of the management of Victory rectangular. besides the fact that children Victory rectangular believes that the expectations and assumptions on which such ahead searching guidance is based mostly are cost-effective, undue reliance should now not be placed on them because Victory square can give no assurance that they will prove to be correct. actual results and traits might also fluctuate materially from those contemplated by these statements. The statements contained during this information liberate are made as of the date of this information free up. Victory rectangular disclaims any intent or obligation to replace publicly any ahead-looking assistance, whether as a result of new information, future movements or consequences or otherwise, other than as required by way of relevant securities laws. The Canadian Securities trade has neither authorized nor disapproved the contents of this information free up and accepts no responsibility for the adequacy or accuracy hereof.

To gain knowledge of extra concerning the hashish smart application and the software technique, talk over with www.cannabiswise.com.


Fox Run domestic health Care crew Named precise company | killexams.com Real Questions and Pass4sure dumps

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Fox Run, an Erickson residing retirement community, nowadays introduced that it has been named a exact agency of the 2018 HomeCare Elite, a consciousness of the precise-performing home fitness corporations within the united states. For 13 years, HomeCare Elite has yearly recognized the exact 25 % of Medicare-certified businesses and highlighted the desirable a hundred and excellent 500 businesses universal.

The ranking is developed through ability® network, a number one tips expertise enterprise helping providers and payers simplify the executive and medical complexities of healthcare. it's subsidized by means of DecisionHealth, writer of home fitness Line and the complete home fitness ICD-10-CM diagnosis Coding manual.

"i want to congratulate the group at Fox Run and thank them for his or her dedication to offering invariably incredible care," said Christine Lang, senior director for capacity network. "right through a time of increasing calls for on domestic fitness experts' time and attention, these caregivers and leaders have validated that they have prioritized their patients and created an exceptional groundwork for serving their communities and partnering with other healthcare suppliers."

Kathleen Mullen, domestic Care Administrator at Fox Run, oversees a team of 25 fitness care professionals who make about 600 monthly visits to residents and neighboring communities. Fox Run has been named to the checklist six instances.

"Being diagnosed as some of the appropriate domestic health organizations by way of HomeCare Elite is a massive honor through which we take superb satisfaction," referred to Kathleen Mullen. "Our whole crew strives for a collaborative strategy in offering pleasant results for seniors. consistent team of workers training, coordination with native physicians, our medical partners at Fox Run and extensive excellent assurance and improvement courses are cornerstones of this application. most importantly, we are privileged to have a committed group of professionals who basically trust in our values and providing the personal contact to ensure that seniors are living superior lives."

"Congratulations to Fox Run from the entire body of workers at DecisionHealth," referred to Marci Geipe, product supervisor for decision fitness. "Your management and staff have placed a top class on the affected person care your company provides as showcased via your best result rankings. The complete community merits from the compassion that your body of workers indicates toward your sufferers, leading to cost savings for the entire healthcare gadget."

HomeCare Elite corporations are decided by an evaluation of performance measures in best results, top-quality practices implementation, affected person adventure (HHCAHPS), first-rate improvement and consistency, and economic fitness. with the intention to be considered, an company need to be Medicare-certified and have statistics for at the least three results in home health examine. Out of eight,898 organizations considered, 2,223 are diagnosed on the 2018 HomeCare Elite winners list universal.

The complete record of 2018 HomeCare Elite organizations can also be downloaded with the aid of visiting the ability community site at abilitynetwork.com/hce.

About Fox Run: Fox Run, considered one of 19 continuing care retirement communities managed through Erickson dwelling®, is based on a scenic 108-acre campus in Novi, Michigan. The group is discovered in Oakland County and is domestic to essentially 1,300 residents who are supported by way of a crew of greater than 750 employees. additional info about Fox Run can be discovered at FoxRunNovi.com.

About Erickson living: Erickson living® is a nation-main developer and manager of continuing care retirement communities. The Erickson living community currently includes 19 communities in 11 states, which together are domestic to greater than 24,000 residents who're supported with the aid of a crew of more than 14,000 personnel. further information regarding Erickson living is attainable at EricksonLiving.com.

About ability network: ability network, an Inovalon business (NASDAQ:INOV), is a leading cloud-based mostly, SaaS counsel know-how enterprise assisting suppliers and payers simplify the executive and medical complexities of healthcare through imaginative applications and facts analytics. The aggregate of myABILITY and the Inovalon ONE™ Platform creates a vertically integrated cloud-based platform empowering the fulfillment of true-time value-based mostly care from payers, manufacturers and diagnostics, all the strategy to the affected person's point of care. For extra guidance, seek advice from www.abilitynetwork.com or write to elements@abilitynetwork.com. For extra guidance about HomeCare Elite, name 888.572.4009, write to homecareelite@abilitynetwork.com or discuss with www.abilitynetwork.com/hce.

About H3.community: In March 2017, Simplify Compliance LLC introduced the merger of DecisionHealth, LLC with present manufacturers HCPro and HealthLeaders Media, to form the H3.community! H3.community, with its three pillars of thought management, expertise, and utility, offers essential perception, analysis, equipment and practising to healthcare groups nationwide empowering modern-day healthcare professionals with solution-focused counsel and intelligence to ebook their corporations' efforts in attaining compliance, financial performance, management, and organizational excellence. The introduction of the H3.community comes as healthcare faces an exceptional length of transition that brings uncertainty and opportunity. As guidelines and rules are revisited and payment models changed, the need for readability, actionable information and professional practising for all issuer settings and functional areas will raise dramatically.

About DecisionHealth: For over 30 years, DecisionHealth, an H3.group manufacturer, has served because the business's leading supply for news, evaluation and educational assistance with company names reminiscent of domestic health Line and half B information. Our unique blend of award-winning on-team of workers journalists and unmatched access to fitness care executives, suppliers and their administrative staffs outcomes in enterprise administration assistance and operationally concentrated editorial that has captured the attention of virtually a hundred,000 domestic fitness care authorities and specialty health care professional practices.

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Diameter fitness Continues Pennsylvania expansion with New… | killexams.com Real Questions and Pass4sure dumps

Diameter fitness Continues Pennsylvania expansion with New ClinicalConnect HIE Partnership

FARMINGTON, Conn. (PRWEB) November 06, 2018

Diameter fitness, a number one enabler of medical insight through the cleaning, de-duplication and enrichment of clinical facts throughout the care continuum, has introduced that ClinicalConnect HIE, western Pennsylvania’s fitness tips alternate (HIE), has selected the Fusion, Analyze, and great purposes to automate methods and standardize statistics interchange between payers, suppliers, and different materials. ClinicalConnect HIE joins the ranks of Diameter fitness’s different Pennsylvania-based HIE consumer, HealthShare alternate of Southeastern Pennsylvania (HSX).

ClinicalConnect HIE become established to join clinicians with digital medical data to aid increase patient care delivery. Now masking greater than three.7 million sufferers throughout the area, ClinicalConnect HIE became seeking an answer that could optimize data pleasant and facts trade throughout its community of issuer businesses. using the Diameter fitness platform, ClinicalConnect HIE will assist enable faster affected person care, in the reduction of needless testing and increase care administration for its consumers, just like the tuition of Pittsburgh medical middle (UPMC) fitness device.

“It turned into totally crucial for us to discover a know-how accomplice that could combine into our existing infrastructure at scale,” referred to Phyllis Szymanski, Director of ClinicalConnect HIE. “With Diameter health, we will deliver clean, meaningful insights on the clinical facts flowing through our system. This provides big cost for our contributors working on key programs like great reporting.”

“ClinicalConnect HIE is among the many most a success fitness tips exchanges within the u.s.,” noted Eric Rosow, Chief executive Officer of Diameter fitness. “through our partnership, ClinicalConnect HIE continues to display its dedication to proposing instant entry to actionable fitness information for its contributors so as to advantage patients and those liable for their care. We’re excited so as to add ClinicalConnect HIE to our client roster of the precise HIEs in the nation.”

Diameter health’s Fusion application allows ClinicalConnect HIE to standardize and enrich scientific records, creating a single, longitudinal patient view to support cost-primarily based care models, accountable care initiatives, and increase results along the continuum of care. The Analyze software measures clinical facts completeness and accuracy to create immediate scores and inform ClinicalConnect HIE’s ongoing satisfactory growth initiatives. The great software, certified with the aid of the country wide Committee for high-quality Assurance (NCQA) and the ONC, automates medical best reporting, and creates typical supplemental statistics for HEDIS and superstar reporting. together, the functions will convey ClinicalConnect closer to attaining the Institute for Healthcare growth’s Triple purpose: improve affected person experience, enhance the fitness of populations, and cut back the charge of healthcare.

About Diameter HealthDiameter health empowers groups that depend upon multi-supply data streams, reminiscent of fitness suggestions Exchanges (HIEs), responsible Care organizations (ACOs), health techniques and fitness plans, to release the full expertise and value of their facts. The Diameter health platform and functions permit medical perception during the normalization, cleaning, deduplication and enrichment of medical records from across the care continuum. This creates a single, unified source of longitudinal structured affected person information for more desirable care and actionable analytics for scientific integration, population health, and great reporting initiatives. For extra suggestions, consult with http://www.diameterhealth.com or e-mail data@diameterhealth.com.

About clinical join HIEClinicalConnect HIE is western Pennsylvania’s fitness information alternate (HIE). It was shaped to aid deliver more advantageous affected person care throughout the region and past by growing a different community of electronic medical information that securely connects clinicians with sufferers’ vital scientific assistance on every occasion it’s vital.

ClinicalConnect HIE assists in providing quicker patient care, reduces pointless checking out, and improves the management and operations of healthcare.

Contact author

Antonia Rutter Diameter health(617) 332-9999 x 209Email > seek advice from web site

Marin Tracking US




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CQIA exam Dumps Source : Certified Quality Improvement Associate

Test Code : CQIA
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Certified Quality Improvement Associate

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Joint Commission International to hold accreditation and quality improvement practicum in Tokyo | killexams.com real questions and Pass4sure dumps

Program promotes improving health care quality and achieving up-to-date accreditation

OAK BROOK, Illinois, Nov. 1, 2018 /PRNewswire/ -- Joint Commission International (JCI) announces it will hold its Tokyo International Practicum on Accreditation and Quality Improvement 3-7 December 2018. This comprehensive educational program aids the preparation processes for health care organizations seeking JCI accreditation by thoroughly explaining JCI's methods and standards and highlighting best practices and processes needed to achieve accreditation and patient-centric success.

Joint Commission International Logo.

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During the five-day educational event, participants will learn tangible benefits of JCI accreditation and necessary practices of the highest-quality health care organizations in the world. Additionally, the program will offer half-day tracer demonstrations at two JCI-accredited, Tokyo-based health care organizations: Mitsui Memorial Hospital and St. Luke's International Hospital.

"This course is ideal for organizations considering JCI accreditation or preparing for an upcoming initial JCI survey. The program content provides essential information for quality managers or anyone else involved in JCI survey preparation," says Paul Reis, associate director International Education, Joint Commission International.

The JCI practicum also features interactive, small-group work sessions with JCI faculty and attendees, during which participants will learn and practice essential elements of the JCI accreditation process methodologies. The program not only helps organizations understand how JCI measures standards compliance, but also provides a framework for evaluating an organization's standards readiness using existing management and staff.

The cost of JCI accreditation and quality improvement practicum is $3,400 USD per attendee. To register or find out about other upcoming JCI events and more, please visit JCI's website at www.jointcommissioninternational.org.

About Joint Commission InternationalJoint Commission International (JCI) was established in 1994 as a division of Joint Commission Resources, Inc. (JCR), a wholly controlled, nonprofit affiliate of The Joint Commission. Through international accreditation and certification, advisory services, publications and education programs, JCI extends The Joint Commission's mission worldwide by helping improve the quality of patient care. JCI works with international health care organizations, public health agencies, health ministries and others in more than 100 countries. Visit www.jointcommissioninternational.org for more information.

Media Contact:       Maureen LyonsCorporate Communications(630) 792-5171mlyons@jointcommission.org

Logo - http://globalfinance.zenfs.com/en_us/Finance/US_AFTP_PRNEWSWIRE_LIVE/Joint_Commission_International_to_hold-56ce77d976b5e9dfb56374d1362b7398


Addiction Psychiatry Fellowship: Meeting a Critical Need | killexams.com real questions and Pass4sure dumps

The consequences of people being addicted to alcohol, illicit drugs, and tobacco is costly to our nation, exacting more than $740 billion annually in costs related to crime, lost work productivity, and health care.1 We are amid an opioid epidemic, yet there is a significant dearth of addiction psychiatrists who can provide the medication-assisted treatments that have been shown to decrease opioid morbidity and mortality.2 Addiction psychiatry fellowships offer specialized training in the evaluation and management of patients with addictions and co-occurring mental health disorders. Recruiting more specialists to the field of addiction psychiatry is a critical health care need.

Addiction is a global phenomenon.3 It affects rich and poor nations, developed and developing countries. In the United States, opioid overdose deaths continue to rise. Although the startling number of opioid-related deaths has received much attention, it is critical to remember the effect of other substance use disorders. An estimated 16 million Americans meet criteria for alcohol use disorders and an additional 40 million demonstrate unhealthy or high-risk drinking.4 The current prevalence of smoking is 15.1%, which means that 40 million people in the country are addicted to nicotine. The emergence of newer tobacco delivery products (primarily “e-cigarettes” but also other electronic nicotine delivery systems) has increased the rates of nicotine use among adolescents5 and threatens the 2020 Healthy People Tobacco Use Objectives.6 Of the roughly 23 million Americans who suffer from alcohol and drug use disorders, only 11% receive treatment at a specialty facility.7 Thus, millions of Americans have substance use disorders, and the vast majority of patients with addictions do not receive specialized care from an addiction psychiatrist.

Addiction psychiatry, a recognized subspecialty of psychiatry, is an exciting area of practice that involves working with a challenging and complex illness. The field focuses on the evaluation, diagnosis, and management of patients struggling with addictive disorders, including those involving illicit drugs, prescription medications, gambling, sex, food, shopping, and the Internet. As a further layer of complexity, patients with addictions often have other co-occurring mental health disorders that also require psychiatric care. Addiction psychiatry fellowship training provides physicians with the knowledge and skill to care for these patients who have complicated addictions. Fellowship-trained physicians serve the public by providing subspecialty care, acting as a community resource for expertise in their field, creating and integrating new knowledge into practice, and educating future generations of physicians.

Given the permeability of addictive disorders in most aspects of mental health treatment, additional training in addictions expands the knowledge base of the physician so that he or she can provide high-quality, evidence-based care, making the physician more confident and effective. Most residents choose to pursue this training due to their inherent interest in this field, often spurred by patient interactions during training or personal (family, friend) experiences with addictions. There is a tremendous potential for research in all aspects of addictions, ranging from molecular and gene therapy to pharmacotherapy and public health studies.

History

Although the field of addiction psychiatry has existed for many years, the designation of addiction psychiatry as a subspecialty of psychiatry occurred relatively recently. The American Board of Psychiatry and Neurology (ABPN) is one of 24-member boards of the American Board of Medical Specialties (ABMS). In October 1991, ABPN and the ABMS, with support from the American Psychiatric Association, established a “Committee on Certification of Added Qualifications in Addiction Psychiatry,” and “Addiction Psychiatry” was granted subspecialization status in 1993. In 1997 the committee was renamed the “Committee on Certification in the Subspecialty of Addiction Psychiatry” and became more geared toward developing the subspecialty of addiction psychiatry. Since 1998, completion of an Accreditation Council for Graduate Medical Education (ACGME) recognized addiction psychiatry fellowship has been required for completion of the ABPN board certification examination in addiction psychiatry. Presently there are 49 addiction psychiatry programs that have ACGME recognition with a total of 129 positions.8

Fellowship Application Process

Addiction psychiatry fellowships are generally 1-year of clinical training; however, some programs offer a 2-year fellowship in which the second year is research focused. Residents interested in pursuing training in addiction psychiatry are encouraged to begin learning about programs 18 months in advance of the anticipated fellowship start date, typically midway through the third year of general psychiatry residency training. Like general psychiatry residency programs, addiction fellowship programs have a similar core training structure; however, some offer specialty experiences like exposure to adolescent addictions or perinatal addictions, and others may offer training specifically in addiction therapy or research. Interested applicants can learn more about programs by talking to peers and mentors informally at conferences or other venues. A full listing of addiction psychiatry residency programs is available on the website of the American Academy of Addiction Psychiatry (AAAP; https://www.aaap.org/jobs-fellowships/), and the AAAP staff and members of the AAAP Education Committee ( https://www.aaap.org/about/committees/) are an additional resource for learning about fellowship programs.8

Programs generally start accepting applications in late spring (14 to 15 months before anticipated fellowship start date), with typical applicants submitting applications at the end of post-graduate year 3 or the beginning of post-graduate year 4. The application is similar in content to what is used for the residency application (eg, personal statement, CV, letters of recommendation, including one from the applicant's general psychiatry training director, and other documents listed on the program websites). Strong applications will demonstrate interest in and experience with addiction beyond the 1 month of addiction training required for all general psychiatry residents. This level of interest may be demonstrated by additional clinical rotations, holding positions on committees related to addictions, involvement in teaching or advocacy activities, writing journal commentaries or textbook chapters, involvement in research projects, or involvement at an addiction psychiatry conference. The application is submitted directly to the fellowship program, as there is no common application service or match for addiction psychiatry fellowships. Applicants typically apply to 2 to 5 programs, as it is typically not difficult to secure a fellowship position. However, reputable programs and/or programs in attractive geographical locations can be more competitive. After review of the completed application by the fellowship training director, appropriate candidates are then invited to interview. On the interview day, the applicant typically receives an overview of the program by the training director and will meet with several faculty members and ideally with at least one current fellow. Although some fellowship programs offer rolling admissions in which a candidate may be offered a fellowship position shortly after the interview, other programs do not make any offers until all applicants have been interviewed. Applicants must successfully complete their general psychiatry residency training before starting addiction psychiatry fellowship. Some programs prefer that applicants have completed the 8-hour Drug Addiction Treatment Act 2000 waiver training to prescribe buprenorphine prior to beginning fellowship; some programs also prefer that fellows are fully licensed to practice medicine by the state medical board at the beginning of fellowship.9

The Fellowship Year

Fellowship training includes developing knowledge in the biological basis for addictions, pharmacology of abused substances, medically assisted withdrawal treatment (“detox”), pharmacotherapy for addiction and comorbid psychiatric disorders, including medically assisted treatment with methadone and buprenorphine for opioid use disorders, and psychotherapeutic techniques. Fellows also gain knowledge in important ethical and legal regulations specific to addictions, including regulation of opioid treatment programs (OTP; ie, “methadone clinics”), relevant state/federal regulations, documentation requirements and insurance complexities, and the Code of Federal Regulations 42 rules regarding privacy and protected health information for substance abuse treatment. In addition, fellows gain experience in working with interdisciplinary teams composed of chemical dependency counselors, social workers, nurses, and psychologists. Programs vary in their available resources and settings but typically include inpatient units, detoxification centers, residential units, outpatient substance abuse clinics, outpatient buprenorphine clinics, OTPs with methadone and/or buprenorphine, inpatient or outpatient women's or adolescent addiction units, exposure to pain management, HIV/hepatitis C treatment, addictions consultation, research, and psychotherapy.9 All fellowships will include formal didactic experience. ACGME requires fellows to complete two scholarly projects during their year of training. These scholarly projects include participation in grand rounds, posters, workshops, articles, publications, or book chapters.10

Fellowship graduates typically pursue certification in addiction psychiatry through the ABPN. Graduates from an ACGME-accredited addiction psychiatry fellowship training program are eligible to sit for the subspecialty examination in addiction psychiatry after they have passed their general psychiatry boards.9 The addiction psychiatry examination is offered every other year.

Developing an Addiction Psychiatry Fellowship Program

Most of the requirements for an addiction psychiatry fellowship are similar to those for other ACGME-recognized training programs and are detailed in the ACGME Common Program Requirements (Fellowship);11 a brief overview of the requirements is provided here. Notably, the fellowship program must have appropriate faculty for training fellows, including at least two faculty members with subspecialty certification in addiction psychiatry, one of whom must be the program director. The addiction psychiatry fellowship program must be sponsored by an ACGME-accredited sponsoring institution. The sponsoring institution is the organization or entity that assumes the ultimate financial and academic responsibility for the fellowship program consistent with the ACGME institutional requirements. Together, the program and the institution must ensure an appropriate and safe environment for training: access to food while on duty; safe, quiet, clean, and private sleep/rest facilities available and accessible for fellows with proximity appropriate for safe patient care; clean and private facilities for lactation that have refrigeration capabilities, with proximity appropriate for safe patient care; security and safety measures appropriate to the participating site; and accommodations for fellows with disabilities consistent with the sponsoring institution's policy. The sponsoring institution and program must also provide ready access to subspecialty-specific and other appropriate reference material in print or electronic format. This must include access to electronic medical literature databases with full-text capabilities. The fellowship program, in partnership with its sponsoring institution, must engage in practices that focus on mission-driven, ongoing, systematic recruitment and retention of a diverse and inclusive workforce of residents (if present), fellows, faculty members, senior administrative staff members, and other relevant members of its academic community.

The fellowship program is responsible for identifying and establishing relationships with appropriate training sites. The program, with approval of its sponsoring institution, must designate a primary clinical site. When the sponsoring institution is not a rotation site for the program, the most commonly used site of clinical activity for the program is the primary clinical site. A participating site is an organization providing educational experiences or educational assignments/rotations for fellows. Participating sites should reflect the health care needs of the community and the educational needs of the fellows. A wide variety of organizations may provide a robust educational experience and, thus, sponsoring institutions and participating sites may encompass inpatient and outpatient settings including a university, a medical school, a teaching hospital, a nursing home, a school of public health, a health department, a public health agency, an organized health care delivery system, a medical examiner's office, an educational consortium, a teaching health center, a physician group practice, a federally qualified health center, or an educational foundation. There must be a program letter of agreement (PLA) between the addiction psychiatry fellowship program and each participating site that governs their relationship. The PLA must be renewed at least every 10 years and be approved by the designated institutional official (DIO). The program must monitor the clinical learning and working environment at all participating sites. At each participating site there must be one faculty member, designated by the program director, who is accountable for fellow education for that site, in collaboration with the fellowship program director. The program director must submit any additions or deletions of participating sites routinely providing an educational experience, required for all fellows, of 1-month full-time equivalent or more through the ACGME's Accreditation Data System. The program's educational and clinical resources must be adequate to support the number of fellows appointed to the program. The clinical learning environment has become increasingly complex and often includes care providers, students, and post-graduate residents and fellows from multiple disciplines. Ideally, the presence of these practitioners and their learners enriches the learning environment. Programs have a responsibility to monitor the learning environment to ensure that fellows' education is not compromised by the presence of other providers and learners, and that fellows' education does not compromise core residents' education.

The program director (PD) is a critical component of any addiction fellowship. In recognition of this critical role, the ACGME mandates that a single individual is designated as the PD and that the PD must have subspecialty designation in addiction psychiatry. The PD is appointed by the institution after approval by the institutional graduate medical education committee (GMEC), and final approval of PD resides with the ACGME Residency Review Committee. The fellowship PD is responsible for the design and conduct of the program in a fashion consistent with the needs of the community, the mission of the sponsoring institution, and the mission of the program, with the ultimate goal of training physicians to provide high-quality care to patients with addictions. The PD must have dedicated time for the leadership of the fellowship, and the PD is responsible for communicating with the fellows, faculty members, DIO, GMEC, and the ACGME. The PD, as the leader of the program, must administer and maintain a learning environment conducive to educating the fellows in each of the ACGME competency domains and the ABPN milestones for addiction psychiatry. The PD must also serve as a role model to fellows. The PD should display the traits that are expected of fellows including compassion, integrity, respect for others, outstanding professionalism, high quality patient care, educational excellence, and a scholarly approach to work. The PD is responsible for creating an environment where respectful discussion is welcome, with the goal of continued improvement of the educational experience for fellows and faculty.

The ACGME recently revised the fellowship eligibility requirements that will take effect July 1, 2019. All required clinical education for entry into ACGME-accredited fellowship programs must be completed in an ACGME-accredited residency program, an American Osteopathic Association-approved residency program, a program with ACGME International (ACGME-I) Advanced Specialty Accreditation, a Royal College of Physicians and Surgeons of Canada accredited program, or a College of Family Physicians of Canada accredited residency program. The ACGME Review Committee has also expanded the definition of “scholarly activity” by including nontraditional forms of scholarly work. Under this revision, faculty participation in grand rounds, posters, workshops, quality improvement presentations, podium presentations, grant leadership, nonpeer-reviewed print/electronic resources, articles or publications, book chapters, textbooks, webinars, service on professional committees, or serving as a journal reviewer, journal editorial board member, or an editor for a peer-reviewed publication. In addition, in the new Common Program Requirements, the scholarly activity of programs will be judged as a whole rather than simply counting scholarly activity among core faculty.10

Challenges

Addiction psychiatry is an expanding field, and currently there is a high demand for this specialty in both the private and public sector. As of Fall 2017, there are 1,098 active certified addiction psychiatrists in the US,8 a small number compared to the estimated 23 million Americans in need of treatment for drug and alcohol addictions. Two recent federal laws have expanded treatment access for addictive disorders. The Affordable Care Act, for the first time in US history, requires all insurers, including Medicaid, to cover the treatment of drug and alcohol addiction.12 For anyone with insurance coverage, the Mental Health Parity and Addiction Equity Act ensures that the duration and dollar amount of coverage for substance use disorders is comparable to coverage for medical and surgical care.13 Together, the two federal laws are expected to make billions of dollars available to the behavioral health care market. The shortage of addiction psychiatrists threatens to stall a national movement to bring the prevention and treatment of substance use disorders into the mainstream of American medicine at a time when millions of people with addictions have a greater ability to pay for treatment thanks to expanded coverage14 and increases the risk of patients receiving substandard, non–evidence-based treatment for addictions.

References
  • National Institute of Drug Abuse. Trends & statistics. https://www.drugabuse.gov/related-topics/trends-statistics. Accessed October 8, 2018.
  • Cousins G, Boland F, Courtney B, Barry J, Lyons S, Fahey T. Risk of mortality on and off methadone substitution treatment in primary care: a national cohort study. Addiction. 2016;111:73–82. doi:. doi:10.1111/add.13087 [CrossRef]
  • United Nations Office on Drugs and Crime. World drug report 2016. https://www.unodc.org/wdr2016/. Accessed October 8, 2018.
  • National Institute of Alcohol Abuse and Alcoholism. Alcohol facts and statistics. https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics. Accessed October 22, 2018.
  • Leventhal AM, Strong DR, Kirkpatrick MG, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700–707. doi:. doi:10.1001/jama.2015.8950 [CrossRef]
  • Centers for Disease Control and Prevention. Healthy People 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use. Accessed October 22, 2018.
  • Substance Abuse and Mental Health Services Administration. Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf. Accessed October 22, 2018.
  • American Academy of Addiction Psychiatry. Fellowship positions. https://www.aaap.org/clinicians/trainee-resources/fellowships/. Accessed October 22, 2018.
  • Kumar N. Addiction psychiatry fellowship: how and why to apply. https://www.aadprt.org/application/files/1315/3624/6506/ADDICTION_PSYCHIATRY_FELLOWSHIP_HOW_AND_WHY_TO_APPLY.pdf. Accessed October 22, 2018.
  • Accreditation Council for Graduate Medical Education. Common program requirements for one-year fellowships. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/One-Year_CPRs_2017-07-01.pdf. Accessed October 22, 2018.
  • Accreditation Council for Graduate Medical Education. ACGME program requirements (fellowship). https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRFellowship2019.pdf. Accessed October 8, 2018.
  • Buck JA. The looming expansion and transformation of public substance abuse treatment under The Affordable Care Act. Health Aff (Millwood). 2011;30(8):1402–1410. doi:. doi:10.1377/hlthaff.2011.0480 [CrossRef]
  • Centers for Medicare & Medicaid Services. The Mental Health Parity and Addiction Equity Act (MHPAEA). https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/mhpaea_factsheet.html#Key%20changes%20made%20by%20MHPAEA. Accessed October 22, 2018.
  • Vestal C. How severe is the shortage of substance abuse specialists. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/4/01/how-severe-is-the-shortage-of-substance-abuse-specialists. October 8, 2018.

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