What is the process for granting initial accreditation to new nurse anesthesia programs?

The COA’s process for the accreditation of a new nurse anesthesia program is focused on ensuring the program’s compliance with the accreditation Standards. The process, as identified in the COA’s Accreditation Policies and Procedures, is consistent with the recognition requirements of both the U.S. Department of Education (USDE) and the Council for Higher Education Accreditation (CHEA).  Please note the COA does not consider workforce (i.e. the supply and demand for CRNAs) in its accreditation review process.  This would be inconsistent with USDE and CHEA recognition requirements and have antitrust implications.

Prospective programs need to undergo a series of activities required by the COA prior to receiving their initial accreditation.

This begins with Council Policies: “Capability Review for Accreditation” (pp. C-1—C-3) and establishing “Eligibility for Accreditation” (pp. E-1—E-3).

Prospective programs seeking COA accreditation may not admit students to the nurse anesthesia program or enroll students in courses with anesthesia in the title or with anesthesia-related content before initial COA accreditation is granted.

The first step in the process for a new nurse anesthesia program is for the sponsoring institution to file a letter of intent with the COA. The letter of intent must be from the chief executive officer of the sponsoring institution and reflect the institution’s legal authority to grant the degree and its commitment to provide the necessary resources to establish a program that meets accreditation requirements.

Following the COA’s acceptance of the letter of intent, a new program starts an accreditation review process. The process includes the submission of evidence of eligibility (i.e., legal authority to grant the degree and meet all state regulatory requirements including requirements of the state boards of higher education and state boards of nursing), a self study (i.e., a program’s written explanation regarding how it meets each accreditation criterion with supporting documentation), payment of required fees, and hosting an onsite review. The onsite review is conducted by experienced nurse anesthesia educators and practitioners who are approved and trained by the COA to serve in their capacity as an extension of the COA (ref. policies “Onsite Review,” p. O-2—O-4  and “Onsite Reviewers and Fellowship Review Committee: Application and Appointment,” O-7—O-11).

An applicant program must demonstrate by appropriate documentation within the self study and verification by the onsite reviewers that the program is in compliance with the Standards, including the following requirements:

  1. Potential for professional and educational growth of students and faculty,
  2. A curriculum to enable graduates to attain certification as nurse anesthetists, including sequencing of courses for the entire program and a description of each course,
  3. Written agreements with sufficient accredited clinical sites to provide required cases and experiences for the total number of students to be enrolled when the program is fully implemented (e.g., first-, second-, and third-year classes),
  4. Appropriately qualified administrative personnel, faculty, and resources to comply with the Council’s Standards for Accreditation of Nurse Anesthesia Educational Programs and/or Standards for Accreditation of Nurse Anesthesia Programs: Practice Doctorate, and
  5. A three-year financial plan providing evidence of sufficient financial resources to implement and sustain an accredited program.

After the onsite review is completed, the reviewers’ prepare a written summary report to which the program must respond in writing, with supporting documentation, to all areas identified as partial- or non-compliance with the Standards.

Only after all of these activities have been successfully completed will the COA review the program. During its review, the COA analyzes all of the documentation associated with these steps in the accreditation process and makes an accreditation decision based on the program’s ability to demonstrate compliance with the Standards.

The Council then renders one of the following decisions: deferral, grant initial accreditation, or deny initial accreditation.  If initial accreditation is granted, the program may admit students.  The Council will determine the program’s initial class size based upon existing documentation of adequate resources, including but not limited to, the following:

  1. Financial,
  2. Program space, including classrooms, labs, etc.,
  3. Volume and variety of clinical experiences/number of sites,
  4. Number of qualified administrative, didactic and clinical faculty,
  5. Support personnel, and
  6. Student services that demonstrate they are sufficient to provide for the total number of students (ref. policy “Program Resources and Student Capacity,” pp. P-15—P-17).

After the program receives initial accreditation, it then must complete a self study and host an onsite review five years after the admission of its first class of students (ref. policy “Accreditation after Graduation of First Class of Students,” p A-1).

Please note that the COA does have a mechanism for third parties to submit comments and concerns regarding programs being considered for initial and continued accreditation.  Comments will be limited to the program’s compliance with the Standards.  Should anyone desire to submit official comments, please note that the program will be provided a copy of the comments and will have the opportunity to respond to them.  The COA will then have the opportunity to consider the comments of both parties (ref. policy “Third-Party Presentation,”pp. T-3—T-5).