The goal of the American College of Healthcare Architects (ACHA or "the College") is to transform health care through better built environments. To that end, ACHA provides board certification to architects in the United States and Canada who specialize in health care. The certification process is rigorous and overseen by an independent testing agency, in order to establish a professionally sound, legally defensible standard by which people can identify themselves as health care architects.
The tagline of the College is Experienced, Certified, Preferred, but what does that mean and how it that relevant to the C-Suite, the industry, and most importantly, the patients?
The College is comprised of certified healthcare architects with a deep knowledge of design and the impact on the healthcare community. According to a survey of its certificants in 2014, the College found:
- ACHA certified architects have 28.7 years of healthcare design experience.
- Nearly 90% of all ACHA certified architects focus primarily on healthcare design.
- ACHA certified architects have published an article or a book on a healthcare topic an average of 4.5 times.
- ACHA certified architects have presented a topic at a healthcare conference or similar event an average of 8.7 times.
The first step in certification is having that experience reviewed by an independent body of peers who carefully examine the portfolio submitted by a candidate. Once the level of required experience is confirmed, the candidate is approved to sit for the examination.
To preserve the integrity of the testing process, it continues to be overseen by an independent, third-party testing company. Questions are developed by the ACHA exam committee, which is chaired by an ACHA certified architect and appointed by the College's board of regents. These questions are reviewed for clarity and properly framed with input from the testing firm. This process ensures questions cover the needed material, are not ambiguously worded and conform to scientifically appropriate models for examining candidates. Because test takers must be licensed architects, the exam is geared towards topics related specifically to health care projects, as opposed to architectural domains already covered by architectural licensure organizations. Unlike many other certifications, the ACHA examination is based on experience and much of the content cannot be studied.
The certification exam is divided into four major sections with questions falling into the categories of analysis, application and recall. The first section covers the forces that drive the business of health care, including economics, regulation and reimbursement, health care models and technology. The second section is about pre-design, with questions regarding programming and master planning. The third section, on design, has questions about facility design, departmental design and detailed design, like coordinating equipment layouts, requirements and manufacturer specifications or developing room data to align with patient and staff safety, experience and privacy needs. The final section covers delivery and implementation, with questions about contracts; construction documents; reviewing owner-provided fixed medical equipment and technologies for coordination with contract documents; assisting the owner with approval, licensing and certificate of occupancy processes; and post-occupancy evaluation and research. Each item on the test is linked to a specific health care setting: general, acute care, post-acute care, outpatient care or behavioral and mental health care.
The entire certification process is designed to recognize the expertise of architects who have substantial experience in all aspects of health care architecture projects. Architects who earn the ACHA credential have had their health care experience and knowledge independently evaluated and approved through the application, portfolio and testing process. It's a stamp of approval that differentiates architects with specialized health care skills for their clients, employers and colleagues.
While there are many highly qualified and experienced healthcare architects in the industry, some discerning industry leaders are more comfortable going with an ACHA architect who has been through the rigorous certification process. The College encourages professionals with this specialty to do the same, whether emerging professionals or icons in the field.
Message from the President
In a characteristic display of honesty and candor, the Board of Regents recently discussed the importance of the various ways our firms reflect to the market our commitment to the priority of board certification in healthcare architecture. The Board discovered that, unfortunately, our firms do not consistently telegraph a clear message of the value of being a board certified healthcare architect. Bear in mind that all members of the Board of Regents are board certified, and work in the healthcare specialty within their firms.
The revelation came to light after the Board tried to answer some of the following questions with a “yes” or “no” response. Do you, or does your firm:
- Assign a board certified architect to every healthcare project you undertake?
- Attempt to hire only board certified architects for your healthcare team?
- Promote differentially within the firm the architects with ACHA board certification versus the non-certified?
- Give non-certified individuals practicing in healthcare architecture a window of time to become board certified, after which they experience consequences, including loss of employment, withholding of bonuses, or something else?
- Reward employees who have satisfied the rigorous certification requirements and achieved board certification, such as with higher compensation, opportunities for advancement, or greater project responsibilities?
- Use board certified architects as mentors to younger health architects in your firm who are not certified and have expressed a desire to learn about and specialize in healthcare architecture?
- Advocate that employees become board certified, including possibly providing support in the preparation of their portfolio for the certification review, training and coaching in preparation for the certification exam, and covering the costs of the examination process?
- Market the board certification of your architects so that clients and joint venture candidates will know that some of your employees have this important credential?
- Provide support to board certified employees for the maintenance of their credential, including the extra continuing education requirements relative to non-certified AIA members?
- Insist that a board certified architect handle project inquiries/reviews with the authority having jurisdiction for a project?
Failure to answer “yes” to any of the above does not necessarily indicate that you (or your firm) do not support board certification in healthcare architecture because, in some limited instances, there may be good answers to a “no” response to the questions. However, in the minds of clients and others to whom we market our expertise, failure to act consistently on board certification could raise doubts about the depth of our convictions on the value of certification. If we are not supporting the credential consistently in our practices, then we invite questions about its value and about our willingness to make it a centerpiece of our credentialing.
For our clients, does consistency matter on whether we include a board certified architect when we assemble our teams for them? For firms considering a joint venture with our firms and looking for marketability in credentials, does consistently having board certified specialists on our project teams matter? For our employees either pursuing or sustaining board certification, do employee policies on material support for certification impact employee loyalty? For employment candidates to be hired into the healthcare practice, does a firm’s support of this important credential matter to the recruiting process? In each of these scenarios, the answer arguably is, or should be, “yes.”
How, for instance, do you tell a client that a board certified healthcare architect is not required for their job? Is it not important enough to justify including one? Is the complex healthcare organization and marketplace, into which even the simplest of projects must fit and function, not sufficient cause to include a credentialed professional on every project? How do you explain not having enough credentialed individuals to go around for every healthcare job in the firm? How do you persuade the client not to think their project was assigned the “B” team because their project team does not have a board certified architect?
Consider the recent action of HDR Architects, which established an internal goal for the firm of having all of its healthcare project leadership become board certified. This is clearly intended to send a strong message that board certification for their healthcare portfolio is a matter of high priority.
As the Board of Regents contemplated the healthcare architecture landscape, and looked at the inconsistencies in their individual practices, it was sobering to realize that in many circumstances the inconsistencies of certificants had become some of the biggest impediments to the more widespread acceptance of and advocacy for the credential.
Some individuals reading this are no doubt thinking that this is advocacy in the extreme, and that no client, joint venture partner, or employee candidate has ever analyzed the board certification employee, situation this thoroughly. Perhaps. But can we say with absolute certainty that our inconsistent behaviors as certificants haven’t raised some hint of doubt among those we are most eager to convince that board certification matters?
A. Ray Pentecost III, DrPH, FAIA, FACHA
President, American College of Healthcare Architects, 2017
Become a Certified Healthcare Architect
We appreciate your interest in the American College of Healthcare Architects. If you, or someone you know is qualified, the Regents invite submission of an application. Learn about the ACHA application process.