Show Me the Money… · Robyn Woidtke, MSN-Ed, RN, RPSGT, CCP, CCSH RWV Clinical Consulting,...

Show Me the Money…

Benefits of the CCSH Credential Ned Barnes, RPSGT, RST, CCSH

Show Me the Money…

Objectives…

CCSH Credential…

--History and Overview

--Pathways to Obtaining CCSH

--CCSH Board (content and costs)

Sleep Medicine Industry Changes…

--Changes that will change all of us in Sleep Medicine

CCSH – the payoff?...

--What it’s worth (all the possibilities)

--CCSH’s Today… Case Scenarios

Disclosures…

None that I know of

I’m just a small town Sleep Tech that mostly does night Sleep Studies…

CSE…Clinical Sleep Educator

Role of a Clinical Sleep Educator (as outlined on the CSE Certificate):

“…to aid in the care and management of patients with sleep disorders, primarily sleep apnea; to collaborate and communicate with health care providers, patients, and families; and to promote education and community support for sleep disorders and good sleep habits…”

The History of the CCSH Credential…

--In 2012 BRPT launched its Clinical Sleep Educator (CSE) certificate program. The purpose of the CSE was to give an identity to healthcare workers focusing on patient care and outcomes in sleep health. The CSE certificate helps distinguish these specific duties in sleep health from more traditional roles

--The CSE program quickly gained popularity – (now more than 1,500 CSEs) and high demand from the field was identified to establish a sleep health credential.

www.brpt.org

CCSH…Certification in Clinical Sleep Health

CCSH (as defined on the CCSH Credential Certificate):

A Credential certifying competence in the practice of clinical sleep health, with related patient care and safety.


--In August 2014, the CCSH credential was introduced as a credential to enhance patient care and standardize the knowledge and skills required for this emerging specialty of clinical sleep health professionals.

www.brpt.org


-- The CCSH is an advanced credential examination for healthcare providers who work directly with sleep medicine patients, families and practitioners to coordinate and manage patient care, improve outcomes, educate patients and the community, and advocate for the importance of good sleep.

www.brpt.org

Robyn Woidtke, MSN-Ed, RN, RPSGT, CCP, CCSH RWV Clinical Consulting, Principal, Castro Valley CA Assisted in the creation of the CSE Curriculum and CCSH

--2006, the ACCP hosted…

Sleep Apnea Aftercare Consensus Conference, from this conference it was determined that there was a need for a role as the CSE (although the proceedings were never published)

--2009…Sleep Educator Conference in Pheonix, AZ…

hosted by ACCP (CHEST); Sponsored by ResMed & Respironics

--After 2009…A second Sleep Educator Conference

in Chicago, IL. Hosted by ACCP (CHEST).

--ACCP (CHEST)… chose to not continue the Sleep Educator Conferences, after the above three events.

”I really believed the program needed to continue. I contacted some of the faculty members from the second offering to see if they wanted to continue to work on keeping it going, all agreed.”


Core Group “Band of Gypsys” (CSE Faculty):

Dr. Naresh Dewan, MD Creighton University, Omaha, NE

Dr. Charles Atwood, MD, FCCP, FAASM University of Pittsburg

Dr. Rochelle Goldberg, MD, FCCP, FAASM, DABSM Philadelphia, PA

Dr. Barb Phillips

Ed Grandi

Shari Rogers, CRNP

Wayne Hull, RPSGT

Robyn Woidtke, MSN-Ed, RN, RPSGT, CCP


--2010… Sleep Educator Conference…

Held in conjunction with FOCUS Conference in San Diego, CA

“At that meeting, I met with Janice East and Cindra Altman (current and incoming BRPT president) to see if the BRPT would consider taking over the program etc... they agreed that it would be a worthwhile endeavor. So, then BRPT took over the administration of the program, but continued to work with Bob Miglino to have the course the day prior to the Focus meeting.”

“Through the CSE program [each year], we also asked about creating the credential. It was clear that people wanted to have it, so working with the BRPT , a group of us began the process of creating the new credential.”


“Cindy Altman and Janice East were very much a part of the credential creation as were Bonnie Robertson, Pam Minkley, Marietta Bellamy, (current BRPT board members at the time)”.

“It really took a lot of dedication and work from some wonderful people to keep it going early on… Also, the leadership of the BRPT really were forward looking.”


“Cindy Altman and Janice East were very much a part of the credential creation as were Bonnie Robertson, Pam Minkley, Marietta Bellamy, (current BRPT board members at the time)”.

“It really took a lot of dedication and work from some wonderful people to keep it going early on… Also, the leadership of the BRPT really were forward looking.”

Reading between the lines…

The Clinical Sleep Educator Idea, Curriculum, Certificate Program, and eventually CCSH Credential…began and was developed and sustained by an ad hoc group of Sleep Professionals united by a passion to better serve Sleep Patients everywhere!

Pathways to acquiring the CCSH…

CCSH: Eligibility … There are currently two eligibility pathways for the CCSH exam:

Pathway 1: Clinical Experience. For candidates with at least 1000 hours of experience in clinical sleep health AND a bachelor’s degree or above.

Pathway 2: Healthcare Credential. For candidates with an approved healthcare credential or license AND an associate’s degree or above.


CCSH: Eligibility … There are currently two eligibility pathways for the CCSH exam:

Pathway 1: Clinical Experience. For candidates with at least 1000 hours of experience in clinical sleep health AND a bachelor’s degree or above.

Pathway 2: Healthcare Credential. For candidates with an approved healthcare credential or license AND an associate’s degree or above.


List of Approved Credentials for CCSH Pathway 2

--Polysomnographic Technologist (RPSGT)

--Respiratory Therapist (RRT, CRT)

--Neurodiagnostic Technologist (REEGT, CLTM)

--Health Educator (CHES)

--Nurse (RN, LPN, MSN)

--Nurse Practitioner (NP)

--Physician (MD, DO)

--Physician Assistant (PA)

--Dentist (DDS)

--Doctor of Philosophy (PhD) in health, counseling, science


CCSH: Eligibility … Former (very recently retired) temporary eligibility pathway

Pathway ‘T’: CSE Certificate. For candidates with a BRPT-issued Clinical Sleep Educator Certificate AND a current healthcare credential or license.

CCSH Exam Blueprint…

The Certification in Clinical Sleep Health examination consists of 100 multiple choice items. Of these, 75 items count toward the candidates’ scores and 25 are pretest items that are not scored.

www.brpt.org


The Successful Candidate Will Have Knowledge Of: Sleep physiology, respiratory/cardiac/neurophysiology, sleep disorders and diagnostic criteria, sleep related comorbidities, intervention/treatment/therapy modalities, clinical guidelines, adherence/compliance techniques, testing options, sleep and related test results, human growth and development, cultural competency, behavioral health models, health literacy, written care plans, learning theories, outcomes data and measures, verbal and written communication skills, medical terminology, patient assessment techniques, chart review and documentation, medications and over-the-counter products, patient confidentiality, ethics, emergency procedures, safety, basic knowledge of computers, math skills/calculations.

www.brpt.org


DOMAIN 1: SLEEP OVER THE LIFESPAN 20%

DOMAIN 2: CLINICAL EVALUATION AND MANAGEMENT 40%

DOMAIN 3: PATIENT AND FAMILY COMMUNICATION AND

EDUCATION 30%

DOMAIN 4: PROGRAM MAINTENANCE AND

ADMINISTRATION 10% www.brpt.org


DOMAIN 1: SLEEP OVER THE LIFESPAN

TASK A: Describe normal sleep architecture, quantity, and quality

TASK B: Identify factors contributing to variations in normal sleep

TASK C: Identify and recognize the pathophysiology, epidemiology, and clinical presentation of abnormal sleep

www.brpt.org


DOMAIN 2: CLINICAL EVALUATION AND MANAGEMENT

TASK A: Correlate and document sleep and medical history

TASK B: Identify co-morbid conditions and impact on patient

TASK C: Assess and explain evaluation and measurement tools

TASK D: Evaluate treatment/therapy

www.brpt.org


DOMAIN 3: PATIENT AND FAMILY COMMUNICATION AND EDUCATION

TASK A: Provide education to patient and family

TASK B: Understand and explain the importance of sleep hygiene

TASK C: Encourage and promote patient self-assessment and self-management

www.brpt.org


DOMAIN 4: PROGRAM MAINTENANCE AND ADMINISTRATION

TASK A: Develop multidisciplinary programs

TASK B: Manage performance improvement and quality

TASK C: Promote sleep disorders as a public health Issue

www.brpt.org

CCSH Exam Costs…

CCSH Practice Exam… $ 55.00

CCSH Exam… $450.00

www.brpt.org

Change is in the Wind…

Changes that will Change all of us in Sleep…

Remember when we first heard about the Bidding system for DME’s

and how dramatically that changed the DME world?


Overall Cost for diagnostics, treatment and follow up of OSA Patients (over a 5 year period)……$ 7000 - $10000

Insurance Industry Goal for Overall Costs for diagnostics, treatment and follow-up of OSA Patients (over a 5 year period)……$1700

Dr. Daniel Sak D.O., FCCP


Overall Cost for diagnostics and treatment of OSA Patients (over a 5 year period)…

…$ 7000 - $10000

Insurance Industry Goal for Overall Costs for diagnostics and treatment of OSA Patients (5 yr period)…

…$1700

Some Likely Changes:

--Tele-Medicine (developing at a different pace in each state)

--HST’s (likely the future standard in OSA Diagnostics)

--Auto-Titrations (likely the new ‘norm’)

--New Technology (apps) that will cut costs and bring Sleep Medicine to many on low budgets

--’Drug Store’ level (‘Amazon.com’ level) access to Sleep Medicine for millions

--New innovations in OSA treatment

Dr. Daniel Sak D.O., FCCP


How will you - (how will I)…

prepare for the new Sleep Medicine Paradigm that is coming???




--Some of us may stay in the Sleep Lab

--Some of us may go back to Respiratory, or some other field

--Some of us may pursue new avenues in Sleep




--Some of us may stay in the Sleep Lab

--Some of us may go back to Respiratory, or some other field

--Some of us may pursue new avenues in Sleep

The CCSH can help with pursuing new avenues!


--I believe the credential is important in the trajectory of the field to provide a non technical certification for non techs, to help build the field. Similar to Diabetic Educator, I believe that this role can be useful on many different levels, that is to educate, communicate, case manage and provide the patient with a resource within/out the sleep laboratory.

--I see this role not only applicable in the sleep clinic setting, but public health, population health management programs, occupational health etc....

--In the hospital I could see the role to increase the promotion of sleep in patients particuarily in CCare areas, in addition to DC planning

Ranbir Kang, BHSc, CCSH, RPSGT, RCT Kelowna Sleep Clinic/Good Sleep Health Kelowna, BC. Canada

“I earned the CCSH credential because l believe there is a need for a better understanding of all sleep disorders in the community setting…”

“Unfortunately, sleep therapy has turned into sleep apnea therapy and I feel we need more clinical sleep health specialists who are capable of educating the public on all sleep disorders that may affect them…”

“Through the knowledge I gained in completing my CCSH credential I feel much more confident in helping patients manage other sleep disorders -- beyond sleep apnea…”

“I am better able to help my patients manage primary insomnia as well as provide them with information to get the care they need if they suffer from other sleep disorders.”

“I'm most excited about the evolution of a "sleep disorder therapist." In many communities a "sleep disorder therapist" primarily consists of someone who is able to identify and treat sleep apnea.”

Anna Cash, RPSGT, RRT, CCSH Manager of the Sleep Diagnostic Institute at the Medical Center of Lewisville Lewisville, TX

"I want to be instrumental in improving the health of our patients as well as the community we serve by providing the highest quality of education available. I see the CCSH credential as a way to achieve this…”

“My daughter, Julie Pitman and I challenged each other to take the first exam and we passed!”

“I use my skills to educate the community through health fairs and community outreach programs. I also educate our patients, and the nursing, respiratory, and sleep staff on the importance of recognizing and reporting OSA in their patients.”

“It's very exciting to be recognized and respected as a professional and expert in this growing field."

Julie Pitman, RPSGT, RST, CCSH Chief Sleep Technologist and Supervisor of the Stanford Center for Sleep Sciences and Medicine Redwood City, CA

"I feel as though the RPSGT position has been very 'behind the scenes' as far as continuity of care is concerned. We are on the frontlines when it comes to diagnostic testing, defining treatment parameters and scoring the studies, however, most techs tend to not think about what happens to the patient after they leave the sleep lab…”

“The CCSH role allows us to be re-inserted into the patient's continuity of care, allowing us to further utilize our knowledgebase and the skillsets that have been underutilized for so many years…”

“The CCSH role will not only help to improve how we diagnose and treat our patients, but will also help the field to better identify the undiagnosed population and have better methods of following up with patients after treatment has been prescribed…”

“In my lab, we've already begun to use the skillsets of the CCSH position to improve our patient care. We've created PAP compliance and follow-up care plans for our patients to help them in their journey toward bettering their sleep…”

“We have a PAP-Nap and mask-fitting program to help patients who are struggling with their PAP therapy, and we're employing many alternative treatment devices to better the patient experience with treatments for respiratory disturbances in sleep. In addition, we have plans to start up perioperative programs with several different departments within Stanford Health Care and we are excited to be a part of helping to define these new processes for the future of sleep.”

Pat McBride, CCSH, BA, RDA, Sleep Clinician Dental Sleep Medicine Office Michael J. Selleck, DDS, AAPMD, Lafayette, CA, and Kimberly Hubenette, DDS, Sonoma, CA Consultant at various Sleep Laboratories and sleep medicine practices in the San Francisco Bay area. Frequent lecturer on inter-disciplinary care models…

"Adding educational models and skillsets to my armamentarium is essential to delivering a very high level of credibility to the physicians, dentists and educational communities with which I work. I am also pursuing an RPSGT credential…”

“My mission has been to educate practitioners to embrace a patient focused pedagogy, and make it work in the real world medical system…”

“That's where it begins. First we care, then we work hard towards change. It's pretty exciting stuff I'd say."

Grace Denault, BA, RPSGT, RST, (CCSH Pending) Academy of Sleep and Wellness Newark, Delaware

The Academy of Sleep and Wellness is a newly formed company, branching out from Delaware Sleep Disorder Centers.

--We have administered an A-STEP course in conjunction with Delaware Technical and Community College for about 10 years.

--More recently we developed a Clinical Sleep Educator (CSE) Course with the University of Delaware.

--Other upcoming projects include on-line CEU programs, board prep courses and outreach to public and corporate groups.


I will be taking the CCSH exam shortly.

--The focus of sleep medicine is turning towards patient education and chronic disease management (OSA, Narcolepsy, Insomnia).

--The CCSH credential establishes that one has studied and developed skills necessary for the longitudinal care our patients require.


Advice to those considering the CCSH…

--First step is to carefully read over the outline for the test.

--Determine what your weakest areas are. Then study everything, but set a ratio of 2 hours on your weak spots, 1 hour on the rest and keep repeating.

Julie (Carlson) Schumacher, R. EEG T., RPSGT, RST, CCSH Sleep Center Services Oregon Health and Science University Chesapeake, Virginia

“I currently work as a remote scoring technologist and therefore have not had career involvement with the credential.”

“I hope that by obtaining the CCSH, I will be a commodity… in the group involvement of effective patient care.”

“With technology, environmental and cultural changes, it becomes increasingly necessary for all involved in patient care to have good communication - this training and credential helps…“

“I would advise anyone eligible for [this] credential to strive for achieving credentialed status as it helps to standardize and keep the profession accountable and knowledgeable…”

Chris Grant RPSGT, RST, Clinical Sleep Educator Salinas Valley Memorial Healthcare System Salinas, CA

--My CSE has helped me tremendously with knowledge and for my patients. Different styles/approaches vary depending on the situations; age, culture, gender and beliefs. It's amazing when you are able to take a little bit of extra time in sharing your knowledge to educate our patients...

--I’m still studying for the CCSH exam this will be my 2nd try.

Daniel D. Lane, BS, RPSGT, CCSH Interim PSG Program Director President Orange Coast College BRPT Irvine, CA McLean, VA

--What do you hope to accomplish in the future with your CCSH?

“More and more attention is given to "Patient Centered Care". The need for qualified and experienced patient advocates is increasing, and CCSH credential holders will become liaisons between physicians and patients.”


“I Think the CCSH has a broad reach…”

“Because I have the credential, it provides added confirmation of the role that this individual plays in sleep health…”

“I have several educational programs I am involved in, so the credential helps with this.”

Cristy Plain RPSGT, CCSH Marketing Coordinator, Director of Patient Care Vivos Panama City Beach, Emerald Coast Dental Spa

“I never in a million years dreamed I would move from Guthrie, Oklahoma to Destin, Florida.

I also never imagined I would be changing lives from a Dental office instead of from a sleep lab.

However that is exactly what my CCSH has allowed me to do!”


“Before reaching for the CCSH credential I was RPSGT and loving it.

I love the sleep world. I love helping patients feel better, and live a more functioning life.

When I first heard about the CSE program I started saving up to attend the next seminar with this on the agenda. “


“So my journey began….”

“I went to Nashville and took the CSE seminar and test…”

“By the time my certificate was received in the mail, I had already set up a CPAP compliance program at our hospital…”

“. I built the program into one that made enough revenue for our lab that I no longer had to answer for the RVU’s being in the red with daytime staff, all while being told this will never work…”

“Then we began making enough money the other labs in our network took notice and asked for help…”


“My issue with all of this was CPAP being the only real option we spoke of…”

“I began looking at Oral Appliance therapy and how it was being used and the testing results. I found when a patient was screened properly it was working…”

“Then I discovered the DNA [an epigenetic orthodontic appliance that enhances craniofacial development and opens the airway]…it was actually correcting people’s underdeveloped mandible and maxilla bones. This was opening the airway for patients…”

“Then we joined VIVOS life and began working with children. How many labs are giving children an alternative to tonsillectomy or CPAP…”


“So in summation I no longer work 12 hour nights. I am a day girl out educating, marketing, and directing patient care at a Dental Sleep Medical facility…”

“Even better is I didn’t have to worry about losing that night time shift differential to become a daytime worker. My CCSH paved the way for me to be paid what I am worth, and to work the shifts I wanted to work…”

“Who could have imagined that just 2 years ago!”

So as the World of Sleep Changes…

--Are you interested in the short and long-term success of your Sleep Patients?

--Are you interested in taking your Sleep Career to a new level?

--Are you good at studying and preparing for major exams?

--Are you willing to extend yourself into a new role in Sleep Medicine?

Then the CCSH may be for you

Thank You

Benefits of the CCSH Credential Ned Barnes, RPSGT, RST, CCSH [email protected]

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Show Me the Money… · Robyn Woidtke, MSN-Ed, RN, RPSGT, CCP, CCSH RWV Clinical Consulting,...

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