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
The subject of exam preparation materials is regularly discussed at meetings of the ACHA Board of Regents, routinely lamented by frustrated exam-takers, and rigorously debated by certificants who, armed with the best of intentions want desperately to believe that if the right two or three people just work at it hard enough something wonderful and helpful could emerge. In December last year I traveled as the ACHA President- Elect to Kansas City, in part for a general orientation to the ACHA management company, and in part to meet with representatives of the professionals who develop and administer the exam for the ACHA.
I was prepared to lend my voice of support to those who for years have vigorously complained about the lack of a definitive text with which a candidate for certification could prepare for the ACHA test. As a university professor, both now and at various times during my career, I was struggling to understand this “gap” in preparatory materials for individuals who wanted to study for a challenging exam.
I was not prepared for what happened next. Experts in testing methods, steeped in the traditions of statistical and probabilistic academic notions, met with me and then-President Mark Nichols to explain in layman’s terms the particulars of a very sophisticated examination rubric. The experience was profoundly educational, and the takeaways from the visit were transformative.
My first takeaway was that syllabus testing was different from certification testing. Syllabus testing is commonly found in a school setting, where the content for the class is declared, made available, massaged interactively with students in a variety of learning experiences, and ultimately reviewed on some kind of test or paper. Certification testing, in contrast, is an attempt to evaluate an individual’s experience and understanding, broadly, over an entire industry. It represents mastery not of the narrowly defined content for a class, but of the integrated, multi-disciplinary, and far-reaching dimensions of a career domain. Wide-ranging personal experiences, though difficult to prescriptively cite for test preparation purposes, can be as important as material that might be found in a book.
My second takeaway was that the grading system for the ACHA certification exam is, in itself, complex and rigorous. Some have wondered why it is impossible to declare the passing grade for the exam before it is taken. The answer is that the exam itself is evaluated after it is administered to make sure that the questions are fair. A question that nobody gets right may be evaluated as a good question that everyone happened to miss, or maybe that it overreached the testing bounds, or perhaps it was poorly worded and unclear. The number of correct answers for a passing score will vary based on the post-examination evaluation of the exam itself by the testing experts.
My third takeaway was that the Regents may not fully appreciate the robust nature of the ACHA testing mechanism. Accordingly, the ACHA Board of Regents is considering changing the By-Laws from a Regent “may sit on the exam committee for the first year” to a Regent “must sit on the exam committee for the year prior to joining the Board.”
While I was very impressed with the expertise and professionalism of our testing advisors in Kansas City, I was deeply struck with a new appreciation for the level of commitment and personal investment that the exam committee makes in the ACHA exam process. Staffed by hard-working certificants who care about the College and the high standard of excellence it represents to healthcare and to architecture, the exam committee does a tremendous job maintaining and improving one of the most important elements of board certification. We all owe them a major “thank you” for a demanding job exceedingly well done.
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.