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CODA: Resolution urges changes

San Antonio—In accepting the final report of the Task Force on the Commission on Dental Accreditation in June, the ADA Board of Trustees noted the impact of the task force's benchmarking study that explored best practices in more than 20 accrediting agencies and placed CODA in perspective within the arena in which it operates.

"Whereas CODA seems to be conforming to accreditation processes which are considered best practices, the study did elicit some areas in which significant variation exists," said Board Report 15 to the 2008 House of Delegates. "These include the size of the commission, the breadth of the scope of accreditation, communications and the definition and understanding of the ADA/CODA relationship."

The House agreed, and at its October meeting approved Resolution 37H-2008, which states that the ADA should encourage CODA to accept and implement the changes in "Implementation of Recommendations in the CODA Task Force Report." The report sets forth 34 recommendations that range from slight alterations to more substantial changes in existing structure, governance, policy, operating procedure and functionality.

Complete text of House-approved Res. 37H-2008

Resolution 37H-2008, Implementation of Recommendations in the CODA Task Force Report, states that the ADA "out of its deep concern about aspects of the accreditation process strongly urges the ADA Commission on Dental Accreditation to accept and implement the Report of the Task Force on CODA, and be it further

"Resolved that the ADA urges CODA to work with all interested parties to implement the recommendations as they are reflected in the body of the Report, and be it further,

"Resolved that the President of the ADA appoint a committee for the express purpose of monitoring and assisting CODA in implementing the recommendations of the Task Force Report, and be it further

"Resolved, that this committee consist of a chair, three members of the Board of Trustees and three members of the House of Delegates, and be it further

"Resolved that the ADA urges CODA to provide a comprehensive report to the 2009 House detailing progress on the implementation of the recommendations of the Task Force Report."

The Board appointed the 14-member task force in April 2007 in response to concerns from several communities of interest. The task force included representatives of CODA, the Council on Dental Education and Licensure, American Dental Education Association, American Association of Dental Examiners, a public member of CODA with accreditation expertise, and members of the ADA Board and House of Delegates with no affiliation with ADEA or AADE.

"The task force was very pleased that the House validated its efforts by passing Res. 37," said Dr. David Whiston, task force chair. "Every member of the task force worked extraordinarily hard to deliver a far-reaching consensus document to the House of Delegates.

"The ADA is certainly committed to reaching out to all areas of our profession for the ultimate benefit of patients," he continued. "Obviously the task force feels that a significant part of that public benefit comes from strong professional leadership, and the accreditation process contributes directly to the professional integrity necessary for that leadership."

"We are taking this report and these recommendations very seriously and we will thoroughly, objectively and honestly communicate our results, however long it takes," said Dr. James Koelbl, chair of the Commission on Dental Accreditation.

Some of the task force's recommendations were being developed by CODA before the report was issued, he added.

For example, the report calls for enhanced communications between CODA and its communities of interest and an extended meeting format. The commission has already distributed the first issue of its new electronic newsletter, Accreditation News, and a recent information session was held at ADA Headquarters for members of the communities of interest. Both of these changes were the result of an ad-hoc CODA Committee on Communication, which has been working over this past year under the leadership of Dr. Larry Nissen.

In addition, the format of the January 2009 meeting has been revised in order to allow more time for the review and discussion of accreditation decisions.

"For the recommendations that have not been addressed yet, we can deal with some of them now through our existing standing committees, but some will obviously take more time," said Dr. Koelbl.

One recommendation in the report is that CODA continue its affiliation with the U.S. Department of Education. "The relationship should continue to be monitored and if additional or different accreditation affiliations present benefits they should be investigated," said Board Report 15. "However, the relationship of 'arm's length relationship' needs to be better defined to determine exactly how long the arm is and how much coordination can occur between CODA and the ADA."

In issuing its final report, Dr. Whiston said the task force specifically focused on structural and cultural changes in CODA as identifiable targets for improvement.

The task force offered several reasons for restructuring CODA in its report, including the fact that the commission accredits a broader scope of educational programs within a single commission compared to most other accreditation agencies; CODA has a larger number of commissioners compared to most other accreditation agencies; research indicates expected increases in the number of dental related and advanced practice programs; and potential changes in practice scope and an increase in the number of international programs applying for international accreditation could add to CODA's workload.

The task force recommended that CODA establish an oversight body with two accrediting agencies that would conduct accreditation activities for: (1) predoctoral, allied dental and international predoctoral programs, and (2) specialty, advanced general dental and international advanced dental programs.

In addition to the House-authorized ad-hoc committee—to be appointed by ADA President John S. Findley—to monitor and advise the commission on implementation of the task force recommendations, Dr. Koelbl will appoint a special CODA ad-hoc committee to oversee the process and deal with more substantive items, such as restructuring. It is anticipated that the committee will meet via telephone conference call prior to the January commission meeting to begin developing a process for reviewing the ADA recommendations.

Plans are also in the works for the full commission to address the report's 34 recommendations during a mega issue discussion at CODA's January 2009 meeting.

Ongoing communication with the ADA Board of Trustees and other communities of interest will be a priority for CODA as it analyzes and implements the task force report, said Dr. Koelbl.

"No matter how good a process CODA has, and we have objective evidence that CODA's process of accreditation is one of the best in the world, we recognize it can always be improved," he said. "We're open to looking honestly at ourselves and doing what we can to make it better."