The following changes to Standards 2, 3, and 4 of the AASM Standards for Accreditation were approved by the AASM Board of Directors during the April 2007 meeting. These changes are now in effect:
Standard 2 was modified to allow for logistical considerations which dictate that many sleep fellows will have to wait 6 – 18 months before they can apply to take the board certification examination in sleep medicine. Such candidates who have completed a sleep fellowship are now be able to serve as directors of sleep disorders centers while they are awaiting the first opportunity to apply to sit for the examination.
Standard 2. Each center must have on staff at least one of the following:
1. An individual who is board-certified in sleep medicine by the American Board of Sleep Medicine (ABSM, i.e., Diplomate of the American Board of Sleep Medicine, DABSM) or by an American Board of Medical Specialties (ABMS) approved board,
2. An individual who has been accepted by an ABMS approved board to sit for the examination in sleep medicine. To retain the accreditation, the ABMS examination in sleep medicine must be passed within 2 examination cycles.
3. An individual who has completed a 12 month fellowship in sleep medicine and is awaiting the first available opportunity to apply to an ABMS board to sit for the sleep medicine examination. To retain accreditation, the ABMS examination in sleep medicine must be passed within 2 examination cycles.
The person fulfilling Standard 2 must perform duties on site. REQUIRED
Intent 2. An individual with demonstrated training and expertise in sleep medicine is an essential participant in the sleep disorders center. This individual has specific duties as defined in these standards, including oversight of sleep study scoring and interpretation, and the quality assurance program of the center. These duties require the presence of the individual in the sleep disorders center on a regular basis.
Standard 3 was revised because of the need to recognize the vital importance of establishing educational standards for sleep techs. Standard 3.a. now requires that by July 1, 2009, each AASM accredited sleep center and laboratory have on staff a sleep technologist either certified by the Board of Registered Polysomnographic Technologists (BRPT) or accepted to take the BRPT examination. Standard 3.b. requires that technicians not certified by the BRPT will need to have completed a CoA PSG accredited training program or be enrolled in an A-STEP program. Standards 3.c. through 3.f. have not been modified from prior Standards.
Standard 3. The center must maintain a staff of appropriately trained and supervised technicians.
3.a. Commencing July 1, 2009, at least one full time employee of the center must be certified by the Board of Registered Polysomnographic Technologists (BRPT) or accepted by the BRPT to sit for its certification examination. The individual fulfilling this standard must be present at the center at minimum 30 hours a week. An accredited center that loses its sole BRPT certified technologist will have 120 days to fulfill this standard.
3.b. Commencing July 1, 2009, technicians not certified by the BRPT will need to be enrolled in A-STEP or have completed a CoA PSG training program.
3.c. Each technician must have valid certification in cardiopulmonary resuscitation. Valid certification in cardiopulmonary resuscitation includes skills training.
3.d. Each technician must be able to perform the duties indicated in the appropriate Polysomnographic Technician Job Description.
3.e. Technician staffing must be adequate to address the workload of the center and assure the safety of patients. This includes a maximum patient to technician ratio of 2:1 under usual circumstances for attended polysomnography.
3.f. Technicians work under the supervision of the medical director.
Intent 3. Diagnostic testing is a critical function of the sleep disorders center. Technicians must be able to respond in an emergency, have adequate training, and be present in sufficient numbers to provide the highest quality of patient care. The medical director provides supervision of the technicians. In order to maintain a high standard of technical competence within the center, at least one technician is required to be certified by the BRPT, and other technicians should have completed or be engaged in education in sleep technology.
Standard 4.b. was changed to allow Diplomates of the American Board of Sleep Medicine to review information provided for patients directly referred for sleep studies.
Standard 4. Patient acceptance policies and procedures sufficient to support safe and effective patient evaluation must be in place.
4.a. Written criteria for patient acceptance must be present, including age, a mechanism for acceptance, criteria for exclusion of patients, and information required from a physician prior to polysomnography.
4.b. For “directly referred” patients, the medical director or a designated center staff physician or a designated DABSM must review the information provided for each patient and determine if the proposed evaluation conforms to the AASM Practice Parameters for the Indications for Polysomnography and Related Procedures, or, if not, whether the evaluation is indicated for other reasons.
Intent 4. The center may decide to exclude certain patients based on clinical judgment, physical limitations of the center, or financial considerations. The criteria for such exclusions must be included in the Policy and Procedures Manual and applied uniformly. The center may accept patients for testing without prior clinical evaluation within the center only if these patients are documented to meet minimum indications for polysomnography established in the Academy Practice Parameters.