The role of accreditation in the future is many fold. It defines standards of quality in nursing education programs. To refer only to clinical practice standards and then deduce what is needed for nursing education is backward. Colleagues in nursing practice must be a part of the discussions along with faculty who represent the variety of nursing programs today. Potential standards must be debated in a wide arena of nursing educators and then build to consensus. A fine example of this process is the development of two Essentials Documents, one for undergraduate education and one for graduate education which were created by task forces of American Association of Colleges of Nursing. Although not defined as standards of quality, these documents serve as guidelines for curriculum development.

There also needs to be a variety of methods to build documents, standards and/or guidelines for quality nursing programs. Criteria for evaluation would follow from these documents. Today many nursing programs focus on the criteria for evaluation and plan accreditation activities around them. That seems to me to be also backward. Ongoing communication through meetings, conferences, workshops, town meetings, and a variety of Internet communication technologies will serve to produce, by the accrediting agency, the widest understanding of a definition of program quality. Along with extensive communication with nursing educators, an infrastructure needs to be put in place that supports this type of activity. Beginning, developing, and expanding programs of nursing in this changing health care environment is a dynamic process.

Finally with the expansion in the number of graduate programs, particularly nurse practitioner programs, it is important to cooperate with specialty and role-related organizations when developing and evaluating programs. Cooperation among organizations which can build to an alliance of interest groups can help nursing programs build and develop programs without redundancy, loss of resources, or confusion of disparate standards. Indeed efficiency, efficacy, and clarity of purpose will flow from consistent quality indices.

Summary

In the past when I have thought about accreditation activities, I was reminded of the Alan Arkin film "The Russians Are Coming, The Russians Are Coming." Anxiety and concern over the production of a document called the self study only led to a visit by real people. As they approached the school, anxiety led to panic and the most unusual activities from cleaning, straightening, and power dressing to concern, self-doubt, and feelings of inadequacies emerged. It was the fear of the unknown that led to a sense of confusion and conflicting messages.

Accreditation is needed. However, accreditation must become an integral part of the daily functioning of the program or school, not an episodic event. It is justifiable use of resources when it leads to overall continuous program improvement. By incorporating quality standards of nursing education into ongoing activities, a seamless, continuous development of the program and/or school exists. I believe this is attainable and will contribute to quality nursing education. I support nursing education accreditation and applaud recent efforts to establish a relevant, contemporary and accountable organization to support college and university nursing programs.