Accreditation Criteria

 

Download the PHCC Center Criteria (pdf)

Pulmonary Hypertension Care Centers (PHCCs) will be designated as either a PHA-accredited Center of Comprehensive Care (CCC) or a PHA-accredited Regional Clinical Program (RCP) based on a number of factors, including quality and depth of resources available for the expert care of their PH patients, as well as the array of therapies offered by the Center. This two-level system stems from an acknowledgement that some PH care providers are qualified to correctly diagnose and initiate first line treatment in less sick PH patients with subsequent referral to a CCC for a more advanced therapies, when necessary.

It should be stressed that both CCCs and RCPs will be accredited by PHA after undergoing a thorough evaluation and satisfactorily meeting the respective criteria set forth in the table below. In turn, all PHA-accredited Centers will be expected to uphold the principles of delivering appropriate and effective care to PH patients outlined in the PHCC Charter Document.

If you have any feedback, comments or concerns that you would like to provide to the PHCC initiative leadership, please email Medical@PHAssociation.org.

Last Revised: June 4, 2014

  CCC PHCC Center of Comprehensive Care RCP PHCC Regional Clinical Program

Center Director

Must have completed Fellowship in pulmonary medicine, critical care medicine, and/or cardiology

Must be fellowship trained in pulmonary medicine, critical care medicine, and/or cardiology

Should be board certified in pulmonary medicine, critical care medicine, and/or cardiology

Should be board certified in pulmonary medicine, critical care medicine, and/or cardiology

Must have a minimum of two (2) years experience treating PAH after fellowship

Must have a minimum of two (2) years experience treating PAH after fellowship

Must be an active participant (Organizing/Steering Committee, Presenting/Speaking, Poster Presenter, etc.) in at least one of the following in the last three (3) years:

  • Regional Meetings;
  • National Meetings;
  • International Meetings; or
  • PH Task Force

Must be actively participating in regional PH congresses (attended at least 1 in the prior year)

Must be involved in PH-related education exemplified by some of the following endeavors:

  • Educating Center and Hospital Staff
  • Mentoring Trainees
  • Involved in Community Outreach
  • PH-related Committee Work

Must provide ongoing education/mentoring of staff

Should be a member of Pulmonary Hypertension Clinicians and Researchers (PHCR)

Should be a member of Pulmonary Hypertension Clinicians and Researchers (PHCR)

Should have completed thirty (30) hours of CME related to PH over the past 3 years (attending and/or presenting)

Should have completed twenty (20) hours of CME related to PH over the past 3 years (attending and/or presenting)

See "Facilities" section below

When appropriate, Director collaborates and co-manages patients with a regional CCC

  • Advanced medical therapies
  • Advanced surgical interventions
  • Investigational protocols
   

Center Coordinator

Must be an allied health professional employed by the CCC, practice or institution

  • ≥ 1.0 FTE (can be satisfied by more than one person)

Must be an allied health professional employed by the RCP, practice, or institution

  • ≥ 0.25 FTE

Must be a RN, APRN, PA, RRT or Pharmacist

Must be a RN, APRN, PA, RRT or Pharmacist

Must be proficient in disease state and with all PAH therapies (oral, inhaled, IV/SQ) and delivery devices

Must also be knowledgeable about the approval, initiation and maintenance of all PAH therapies

Must be proficient in disease state and with all oral PAH therapies

Must also be knowledgeable about the approval, initiation and maintenance of oral PAH therapies

Must be an active participant in regional / national / international PH congresses (one or more of the following occurred within the preceding three [3] years):

  • Task Force Membership
  • Organizing/Steering Committee
  • Presenting/Speaking (oral, poster, meet-the-expert, CME, etc.)

Must be an active participant in regional PH congresses

Should be involved in PH-related education exemplified by some of the following endeavors:

  • Educating Institution's Staff
  • Educating Allied Healthcare Practitioners
  • Promotion of Medical and General Community Disease Awareness
  • Involvement in PH Support Group Activities

Should provide ongoing education/mentoring of staff

Should be a member of the Pulmonary Hypertension Professional Network (PHPN)

Should be a member of the Pulmonary Hypertension Professional Network (PHPN)

Should have completed 12 hours of CME/CE related to PH over the past 3 years (attending and/or presenting)

Should have completed 12 hours of CME/CE related to PH over the past 3 years (attending and/or presenting)

   

Program Staff and Support Services

Physicians' effort towards PH program, including clinical care, clinical research, and administrative duties, should total at least 0.75 FTE

 

 

Should actively be managing a substantial cohort of patients

  • ≥ 75 PAH patients
  • Mitigating factors will be taken into consideration (e.g., regional population, Center catchment area, proximity to other Centers, duration of Center's existence, tenure of Center director etc.)

Should actively be managing a minimum of 25 patients

 

Must follow available diagnosis and treatment consensus guidelines when possible1

Must follow available diagnosis and treatment consensus guidelines when possible1

Must have proficiency and experience with all PAH therapies (oral, inhaled, parenteral)

Must have proficiency and experience with all non-parenteral PAH therapies

Must have adequate experience prescribing and managing parenteral prostanoid infusions.

  • Managing ≥ 20 infusion patients over preceding 3 years
 

Program support staff FTE must be commensurate with the program's volume of patients and adequate to manage the program's patients on parenteral therapies

Program support staff FTE must be commensurate with the program's volume of patients and adequate to manage the program's patients on PAH-specific therapies

Pulmonary and/or Cardiology service on-call 24/7

Pulmonary and/or Cardiology service on-call 24/7

Rheumatology consultation

Rheumatology consultation

Social work

Social Work

Dietary / Nutritional service

Dietary / Nutritional services

Cardiac Anesthesia

 

Pulmonary transplant service or referral process

 

Congenital heart disease consultant or referral process

 

PTE service or referral process

 

Coagulation service

 

Palliative care service

 

Pulmonary and/or cardiac rehabilitation on site

 

Program must have published in peer-reviewed journals in the field of pulmonary vascular disease. It is desirable that at least one publication will have been published within the prior 5 years

 
 

Facility

Members of the PH Center must be directly involved with care of the CCC's inpatients

Members of the PH Center must be directly involved with care of the RCP's inpatients

Must have inpatient wards with specially-trained staff and specific protocols for managing PAH, including chronic prostacyclin infusion

 

Must have ICU facilities (within affiliated hospital) with specially trained staff and specific protocols for managing PAH, including chronic prostacyclin infusion

Must have ICU facilities (within affiliated hospital)

Must have cardiac catheterization laboratory

  • Must have experience with acute vasodilator testing using inhaled nitric oxide, prostacyclin or adenosine

Must have cardiac catheterization laboratory

  • Must have experience with acute vasodilator testing using inhaled nitric oxide, prostacyclin or adenosine

Either the PH program director or a designated physician must perform or preside over right heart catheterization and must personally review tracings

Either the PH program director or a designated physician must perform or preside over right heart catheterization and must personally review tracings

Must have an echocardiography laboratory with experience in PH

  • The echocardiography laboratory should have accreditation by the Intersocietal Accreditation Commission

Must have an echocardiography laboratory with experience in PH

  • The echocardiography laboratory should have accreditation by the Intersocietal Accreditation Commission

Must have a pulmonary function laboratory

Must have a pulmonary function laboratory

Must be able to perform Exercise Testing (e.g., 6-Minute Walk, CPET, treadmill test, or other)

  • Must display manual of procedures and provide report document

Must be able to perform Exercise Testing (e.g., 6-Minute Walk, CPET, treadmill test, or other)

  • Must display manual of procedures and provide report document

Must have a pharmacy with access to and proficiency with parenteral prostacyclin agents.

  • Pharmacy staff must be proficient with preparation of prostacyclin infusions
 

Must have an active Radiology department with experience in PH:

  • Vascular access for placing and helping manage chronic indwelling catheters, if parenteral therapy prescribed (unless performed by institution's Surgery Department)
  • Thoracic Radiology
  • Nuclear Medicine (for performance and interpretation of V/Q scans)

Must have an active Radiology department with experience in PH:

  • Vascular access for placing and helping manage chronic indwelling catheters, if parenteral therapy prescribed (unless performed by institution's Surgery Department)
  • Thoracic Radiology
  • Nuclear Medicine (for performance and interpretation of V/Q scans)

Must have system in place to assure patient confidentiality

Must have system in place to assure patient confidentiality

Should accept patients insured by Medicare & Medicaid

Should accept patients insured by Medicare & Medicaid

Must have institutional support for the PH Program

Must have institutional support for the PH Program

Should have the ability to accept transfer of referred patients via an expedited route

  • Assistance to nearby RCPs, including the acceptance of patients in need of advanced PAH therapies, should be provided when requested
 
 

Research

 

 

 

 

 

*CCC demonstrates a strong commitment to clinical research, as a part of the larger PH community's efforts to improve outcomes and find a cure.*

 

Center staff (physicians and/or coordinators) must have actively participated in at least three (3) separate IRB-approved patient-oriented PH investigations within the previous three (3) years.

  • Enrollment in therapeutic (e.g. pharmacologic or non-pharmacologic) or non-therapeutic investigations (e.g. genetic, epidemiologic, or mechanistic studies that are not clinical trials)
  • Inclusive of locally-initiated, single-center projects
  • Requirements cannot be satisfied by observational registries.
Not applicable

Must have research staff actively participating in PH research

  • At least one phase 2 or 3 PH clinical investigation and/or non-industry investigation in the past three (3) years.

Should have access to an Investigational Drug Service

Must have institutional IRB or the ability to use outside (central) IRB

Center staff must have published at least one PH-related publication within the last 5 years in a peer-reviewed journal in the field of pulmonary vascular disease

1 - a) V/Q scans to exclude CTEPH; b) right heart catheterization to confirm PAH diagnosis; c) Acute Vasodilator Testing in IPAH patients (or document valid reason for not performing); and d) Parenteral prostacyclins for WHO FC IV patients (or document valid reason for not using)
† - Must have resources or established referral pattern
‡ - Should have resources or established referral pattern

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The National Organization for Rare Disorders (NORD) awarded PHA the Abbey S. Meyers Leadership Award in 2012 for outstanding service to PHA members in advocacy, education and other key areas.