Recertification - Clinical Activity | ABCP - American Board of Cardiovascular Perfusion

Introduction

All certified perfusionists must recertify annually. Recertification is designed to ensure that Certified Clinical Perfusionists, through continuing education and clinical activity, continue to meet standards and possess current and adequate knowledge in the field. Recertification consists of two (2) components:

clinical activity [40 activities reported every year]- described on this page
professional activity [45 CEUs reported every third year].

Clinical Activity Requirements ⤴

A Certified Clinical Perfusionist (CCP) is required to perform a minimum of 40 clinical activities annually.

Of the 40 clinical activities, a minimum of 25 must be documented as Primary Clinical Perfusion Activities (PCPA). Clinical case credit is only given to the perfusionist who is considered the primary perfusionist in a Primary Clinical Perfusion Activity. A primary perfusionist is defined as the perfusionist who is responsible for the conduct of perfusion for 60% of the case and whom the hospital/institution recognizes as the primary perfusionist. Only one (1) perfusionist may submit for primary perfusionist per clinical case.

If a CCP is unable to attain 40 Primary Clinical Perfusion Activities, a maximum of 15 activities may be documented as Secondary Clinical Perfusion Activities (SCPA) and will count towards the 40 case requirement. Only one (1) SCPA case credit is allowed for a given perfusion procedure.

CCPs who become newly certified in the fall (in the middle of the reporting cycle) will be required to document 20 cases on the Clinical Activity Report (CAR) for their first reporting cycle only. If a CCP that becomes certified in the fall is unable to attain 20 primary clinical perfusion activities, a maximum of eight activities may be documented as Table B – Secondary Clinical Perfusion Activities (SCPA) and will count towards the 20-case requirement. The reporting period will be from the date of the certification examination through June 30 of the following year to assume regular reporting requirements of 40 cases (July 1 through June 30) in subsequent years.

All clinical cases must be performed on human patients and documentable in an audit. Clinical activities (PCPA and SCPA) along with their core elements are defined in Tables A and B, respectively.

Table A- PCPA

Primary Clinical Perfusion Activities (PCPA)	Clinical Definition	Core Elements
1P Cardiopulmonary Bypass (CPB), Primary	A Certified Clinical Perfusionist (CCP) who is the primary operator of the heart-lung machine used during cardiac surgery and other surgeries that require extracorporeal circulation, used to manage the patient's physiological status.	Blood pump, reservoir, heat exchanger, oxygenator, extracorporeal circuit used accordingly with hemodynamic/lab value monitoring.
2P Instructor CPB Bypass, Primary	A Certified Clinical Perfusionist (CCP) who serves as a clinical instructor to a student enrolled in an accredited perfusion program during primary clinical perfusion activities that require extracorporeal circulation, used to manage the patient's physiological status.	Blood pump, reservoir, heat exchanger, oxygenator, extracorporeal circuit used accordingly with hemodynamic/ lab value monitoring. Primary Clinical Perfusion Activities (PCPA) performed as clinical instructor in an accredited program are considered a primary perfusion activity and will receive full case credit. During clinical instruction in which the student is operating extracorporeal circulation equipment, there must be direct one-to-one supervision by the clinical instructor. Students may also receive credit toward certification eligibility for the same case.
3P Extra-Corporeal Membrane Oxygenation (ECMO), Primary	A Certified Clinical Perfusionist (CCP) who is the primary operator of Extra-Corporeal Membrane Oxygenation (ECMO) circuit that provides life support for respiratory and/or cardiac failure. The CCP must be documented at the institution as a member of the patient care team for that period and a physician name must accompany the case in the Clinical Activity Report.	Extracorporeal circuit, oxygenator, heat exchanger used accordingly with hemodynamic/lab value monitoring. For each ECMO case, one case credit per 24 hours will be awarded for initiating and bedside managing ECMO (4-hour minimum) or bedside managing (6-hour minimum). No simultaneous credit will be awarded for managing multiple ECMO patients in this time period.
4P Isolated Limb, Ex Vivo Organ Perfusion, Primary	A Certified Clinical Perfusionist (CCP), who is (1) the primary operator of an extracorporeal device used to deliver anticancer drugs directly to an arm, leg, or organ and manages the patient's physiological status or (2) the primary operator of an extracorporeal device, including an oxygenator/de-oxygenator and pump, used to manage the physiologic state of isolated and separated human organs from the body, for potential transplant opportunities.	Reservoir, blood pump, heat exchanger, oxygenator, extracorporeal circuit used accordingly with hemodynamic, temperature, and lab value monitoring. No simultaneous credit will be awarded for managing multiple organs.
5P Veno-Venous or Left Heart Bypass, Primary	A Certified Clinical Perfusionist (CCP) who is the primary operator of an extracorporeal device, used to perfuse specific vascular regions within the circulatory system or recirculate venous blood for purposes such as clot/tissue removal.	Blood pump, extracorporeal circuit used accordingly with hemodynamic/lab value monitoring.
6P Ventricular Assist Device (VAD), Primary	A Certified Clinical Perfusionist (CCP) who is the primary operator of the Ventricular Assist Device (VAD) that provides cardiac support for the failing heart.	For each VAD case, one case credit per 24 hours will be awarded for initiating and managing VAD or bedside managing (6-hour minimum). No simultaneous credit will be awarded for managing multiple VAD patients in this time period.

Table B- SCPA

[A maximum of 15 SCPAs are allowed per reporting period.]

Secondary Clinical Perfusion Activities (SCPA)	Clinical Definition	Core Elements
1S CPB, First Assistant, Secondary	The "CPB First Assistant" is the Certified Clinical Perfusionist (CCP) whom the hospital/institution recognizes as the assistant to the primary perfusionist during the conduction of perfusion.	The "CPB First Assistant" must be documented within the operating suite and actively assisting during the operative case. Multiple First Assistant credits will not be allowed during concurrent operative procedures.
2S Ex Vivo, First Assistant, Secondary	A Certified Clinical Perfusionist (CCP) who is the secondary operator of an extracorporeal device, used to manage the physiologic state of isolated and separated human organs from the body, for potential transplant opportunities.	Reservoir, blood pump, heat exchanger, oxygenator, extracorporeal circuit used accordingly with hemodynamic, temperature, and lab value monitoring. No simultaneous credit will be awarded for managing multiple organs.
3S Intraperitoneal Hyperthermic Chemoperfusion or Intrapleural Hyperthermic Chemoperfusion (HIPEC), Secondary	Certified Clinical Perfusionist (CCP) who is the primary operator of an intraperitoneal or intrapleural device.	A device with pump flow, circulation, temperature, monitoring and regulation of chemotherapeutic fluids within abdominal or thoracic cavity for periods exceeding thirty (30) minutes. Syringe infusion devices will not be counted as a SCPA.
4S Cardiopulmonary Bypass (CPB) Standby Procedures, and Extracorporeal Membrane Oxygenation (ECMO) Standby Procedures, Secondary	A Certified Clinical Perfusionist (CCP) who is the primary standby operator of the heart-lung machine which is used during cardiac surgeries that may require extracorporeal circulation to manage the patient's physiological status, or is the primary standby operator of the Extracorporeal Membrane Oxygenator (ECMO) that provides life support for respiratory and/or cardiac failure.	Any procedure that may require immediate and onsite extracorporeal circulatory support. Standby procedures must be documented, requested by the attending physician and verifiable in an audit.
5S High-Fidelity Perfusion Simulation (HFPS), Secondary	A Certified Clinical Perfusionist (CCP) who is the primary operator of the heart-lung machine or ECMO circuit, used to manage physical and physiological variables during simulated perfusion scenarios taking place at an ABCP-recognized HFPS center. HFPS is the use of simulation modalities or mechanisms to create a realistic patient model or perfusion situation.	HFPS must be an interactive process facilitated by a CCP using standardized medical simulation devices that integrate realistic perfusion events experienced during CPB procedures in a realistic surgical setting using a conventional heart-lung machine or ECMO circuit. Each HFPS or series of HFPS must have an education/briefing, simulation, and debriefing. The simulation/simulation series length must be no less than 50 minutes of active simulation activity. One case credit is awarded for each HFPS activity that meets or exceeds these guidelnes. Each HFPS must include and retain a participant evaluation form.

Online Filing System ⤴

Beginning with the 2013-2014 recertification period, all regular recertification reports must be submitted through the Online Filing System (OFS). The CCP may access his/her OFS account in order to record cases (Clinical Activity Report) and CEUs (Professional Activity Report) throughout the reporting period.

OFS Details are available on our FAQs page (items 10-13). The ABCP National Office staff is also available to assist CCPs who have questions or issues regarding the system.

Documentation

The CCP must sign all hospital perfusion records in order for the designated authority to verify cases on the Clinical Activity Report during audits.

Audits

The American Board of Cardiovascular Perfusion conducts an audit to ensure the accuracy of the Clinical Activity Report in order to maintain high standards and quality assurance. A percentage of Clinical Activity Reports are chosen randomly each year for audit.

The audit process is conducted by the Chief Perfusionist, Operating Room Director or other designated hospital authority. The Clinical Activity Report and the signed Authorization for Release of Information form are sent to the designated authority for verification.

It is necessary for each CCP to list a designated hospital authority for each hospital in which cases are reported. The designated hospital authorities and the addresses for the authorities must be listed on the Adding a Hospital screen on the Online Filing System. Designated Authorities should be updated annually.

If the cases cannot be verified by the designated authority, the perfusionist is contacted to provide verification of the cases and explain discrepancies. The perfusionist is ultimately responsible for providing verification of the cases and explaining discrepancies. Should fraudulent cases be discovered, the issue is submitted to the ABCP Ethics Committee for appropriate actions.

Clinical Activity Report

Clinical Activity Reports cover the period of July 1^st of the previous year through June 30^th. For new CCPs that become certified in the fall, the reporting period begins on the date of the certification examination through June 30^th of the following year.

Each CCP must submit an annual Clinical Activity Report through the Online Filing System in order to document 40 clinical activities; 20 clinical activites are required for new CCPs (certified in the fall) for their first reporting cycle only. The report includes:

a clinical case summary;
an Authorization for Release of Information form;
hospital address and designated authority information.

A complete Clinical Activity Report is required for annual recertification.

Recertification Filing Deadline ⤴

All reporting periods end on June 30^th. Clinical Activity Reports must be completed and filed through the Online Filing System with the appropriate fee no later than midnight August 1^st.

The first Clinical Activity Report for a newly certified perfusionist is due August 1^st in the year following the year in which he/she successfully completes the examination process.

Late Fees

Certified perfusionists submitting recertification reports after August 1^st through August 31^st are assessed an $81.00 Late Filing fee.

Extension of Certification Period

CCPs who are unable to fulfill recertification requirements by the end of a reporting period may request an extension of the filing deadline as follows:

Requests must be made in writing by the August 1^st filing deadline.
The Extension Clinical Activity Report* must be submitted, complete with all activity up to June 30^th along with the appropriate Filing fee.
If approved, the deadline will be extended to December 31^st at which time the application must be completed and an $81.00 Late Filing fee paid.

An extension will not be granted to an individual more than once during a three-year period or to an individual on conditional certification.

Form 7d Access the *Extension Clinical Activity Report

Recertification Notification

Upon receipt of complete recertification reports and appropriate fee(s), a new time-limited certificate will be issued to each CCP every third year.

For the ensuing years, dated stickers will be issued and must be attached to the CCP's current certificate to extend the certificate's validity.

Certificates and date stickers issued by the ABCP are the sole property of the ABCP and may be canceled at its discretion. By acceptance of the certificate, the holder agrees to return the certificate to the ABCP upon demand. Presentation and display of the certificate is permitted only when it is current and valid. Presentation, display or any other use of an outdated, invalid certificate is expressly prohibited.

Inactive Status

At times, a CCP will be unable to maintain certification because of a deficiency in either clinical and/or professional activity. For this reason, and because many individuals wish to maintain an acknowledgment of having been certified, an inactive status may be requested. Individuals on Inactive Status receive all ABCP publications, and their names are published on the ABCP website.

The process for obtaining Inactive Status follows:

After notification of loss of certification, submit a request to the ABCP National Office for Inactive Status.
Sign an agreement to discontinue the use of the title, "CCP."
Remit the Annual fee to the ABCP National Office prior to August 1^st.

Inactive CCPs are listed on the ABCP website.

CCP Emeritus

CCP Emeritus information and a current CCP Emeritus listing is available on the ABCP website.

Change of Address

Certified Clinical Perfusionists are responsible for informing the National Office of the American Board of Cardiovascular Perfusion of their current address. The CCP should update the Online Filing System with the address change and notifying the National Office.

Conditional Certification and Extended Leave ⤴

Conditional Certification

A CCP who fails to submit the completed recertification report with the appropriate fee by the August 1^st deadline and does not formally request an extension will be placed on conditional certification.

A perfusionist on conditional certification must apply to the ABCP for reinstatement before the next August 1^st filing deadline. The petition statement must include:

an explanation in writing of the reasons for not completing the recertification requirements (clinical activity) for the previous year;
a completed recertification report* for the current reporting year comprised of 40 cases with the first 25 consisting of cardiopulmonary bypasses (CPBs) that are supervised and verified by a current CCP; and
payment of all normal Filing fees, an $81.00 Late Filing fee and an $81.00 Reinstatement fee.

Form 10d, Form 11d Access the *Conditional Certification Report

Extended Leave

If unable to successfully complete the reinstatement requirements for conditional certification, the perfusionist must request "extended leave" status in writing prior to the August 1^st deadline of the conditional certification year.

Extended leave gives the perfusionist (placed on conditional certification for clinical inactivity) an additional year after the conditional certification year to complete the following clinical requirements:

a recertification report* for the current reporting year comprised of 40 cases with the first 25 consisting of cardiopulmonary bypasses (CPBs) which are supervised and verified by a current CCP;
payment of all normal Filing fees, an $81.00 Late Filing fee and an $81.00 Reinstatement fee.

Form 10d, Form 11d Access the *Report for Extended Leave

If unable to satisfy the above requirements, reinstatement will be granted upon successful completion of the CAPE prior to the December 31^st deadline of the "extended leave" year.

If none of the above requirements are completed by December 31^st of the extended leave year, all steps listed below in the "Re-entry into the Certification Process" section must be completed.

Professional Activity

Individuals on clinical activity conditional certification and extended leave are required to complete the Professional Activity Report* during the conditional certification period.

Form 8d Access the *Professional Activity Report

Loss of Certification ⤴

A CCP will lose certification if he/she:

is on conditional certification or extended leave and does not successfully meet the requirements for reinstatement; or
is found guilty of unethical conduct as described in the Ethical Standards of the American Board of Cardiovascular Perfusion; or
falsifies any portion of a recertification report.

The American Board of Cardiovascular Perfusion shall be the sole judge of whether or not the information before it is sufficient to require or permit revocation of any certificate issued by the ABCP, and the decision of the ABCP thereon shall be final. CCPs who lose or who are in danger of losing certification may make a formal written appeal to the ABCP.

Re-entry into the Certification Process

A perfusionist may petition the ABCP for re-entry into the certification process and then complete the following steps:

apply for, take and pass the appropriate examination(s)-
- If uncertified for less than three (3) years, the applicant must take the Clinical Applications in Perfusion Examination only. No perfusionist may utilize this option in two (2) consecutive recertification cycles.
- If uncertified for three (3) years or more, the applicant must:
  - take both the Perfusion Basic Science Examination and the Clinical Applications in Perfusion Examination;
  - submit a list of 40 clinical activities documented as Primary Clinical Perfusion Activities (PCPA) performed since the date of his/her request; and
  - submit a letter of clinical competency from his/her supervisor.
remit the appropriate Examination fee(s); and
remit a $250.00 Reinstatement fee.

The ABCP must approve perfusionists who have lost certification because of unethical conduct for re-entry.