Demystifying the Competency Conundrum

Facilitated by:

Sylvia McKee, MN, RN, BC

Coordinator, Clinical Staff Development & Education VA Salt Lake City Health Care System Developing a highly visible, tightly linked competency assessment program is key to organizational success.

Topics to Cover

Why Competency Assessment? Establishing a Competency Program Initial and On-going Competency Assessment Process Validating Competency Results of Competency Assessment

COMPETENCY FACTS

SECRET INGREDIENTS YIELD MAGIC POTIONS

Why Competency Assessment?

Competent Staff = Quality Care

JCAHO Requirement

NEW Competence Assessment HR.3.10 Competence to perform job responsibilities is assessed, demonstrated and maintained.

Competence vs. Competency

Competence: An individuals capacity to perform his or her job functions.

Competency: An individuals actual performance in a particular situation.

Professional Competence
The

ability to function effectively in the tasks considered essential within a given profession.

The ability to integrate knowledge and skill to perform a task under the varied circumstances of the real world.

Competency Actual performance is the gold standard for demonstration of competency.

Competency vs. Training

Train to instruct so as to make proficient or qualified Training the process or experience of being trained Competency an individuals actual performance in a particular situation The ability to integrate knowledge and skill to perform a task under the varied circumstances of the real world.

Components of Competence
COMPETENCE
Performance Appraisal/Evaluation

Continuing Education & Training

Orientation Job Description
License, Certificate

Effectiveness assessed through performance improvement activities

Additional Considerations Patient satisfaction feedback Incident reports Physician feedback Preceptor/mentor teaching

Peer Review Skills Checks

Program Components

Backbone to a high-quality assessment program

Policy Process Reporting Mechanism

How Will I Know It When I See It?

Initial Competency Assessment Ongoing Competency Assessment

Initial Competency Assessment

Education Certification Experience Knowledge Testing Self-assessment Interviews (PBI) In-service or CE attendance

References Previous competence assessments and performance evals Direct observation Preceptor evaluation Formal peer review Narrative/anecdotal comments

Ongoing Competency Assessment

JCAHO requirement - AGAIN!!

New HR.2.30 Ongoing education, including in-services, training, and other activities, maintains and improves competence.

Limited (job specific)

PROCESS/TOOLS

EXPANDING YOUR REPERTOIRE OF TRICKS

Competency Assessment Process

Performance tests consists of evaluation entries embedded within a checklist

A performance standard is used to compare actual performance against in order to determine competency.

Competency Assessment Tools

A performance checklist is used to determine presence of performance

Demonstration of knowledge does not equal demonstration of competence.

Competency Assessment Tools

Learner centered: performance criteria stated in terms of what the learner has to demonstrate for the behavior to be considered competent.

Writing Competency Statements

Essential

Characteristics of A Competency Statement

Describes

a general category of behavior or performance Describes staff behavior Describes behavior that is observable and measurable Includes no conditions imposed on performance Is validated by practitioners in the designated role and setting

Writing Competency Statements Initial Assessment Examples

Handouts Orientation Competency Skills Checklists

Dialysis Physical Science Technician Research Research Nurse BSN and/or Coordinator

Writing Competency Statements Annual Assessment Examples Operating Room Research Nurse

Writing Performance Criteria

Essential

Characteristics of Performance Criteria

Describe

employee behavior Describe behavior that is observable and measurable Limited to a single behavior Include sufficient description of the behavior Include desired conditions imposed on performance Include a performance standard Include only essential aspects of performance

Writing Performance Criteria Initial Assessment Examples

Handouts Orientation Competency Skills Checklists

Dialysis Physical Science Technician Research Research Nurse BSN and/or Coordinator.

Writing Performance Criteria Annual Assessment Examples Operating Room Research Nurse

VALIDATING COMPETENCY

READING THE STARS

Validating Initial Competency

Requirements
Develop

of position

skills checklist Develop measurable performance criteria

Performance standard to compare actual performance against

Determine

method of assessment to be used Provide training if required Assess

Validating On-going Competency

Select

competencies (high-risk, low volume, problem prone)

Develop

measurable performance criteria

Performance

checklist Performance standard to compare actual performance against

Determine

method of assessment to be used Assign appropriate person to perform assessment Provide training if required Assess

Validating Competency
Key

Activities

Remediate

if necessary, then reassess Assign accountability for follow-up

REPORTING RESULTS/LINK TO EDUCATION

PEERING INTO THE CRYSTAL BALL

Reporting Results/ Link to Education

Annual
Why

report

report findings? What you will report To whom you will report How will the report be used?

Competency assessment = snapshot

Performance appraisal = videotape

Competency Assessment

Is this staff member able to do his/her assigned job? Answer: found in comparing employees performance against a set of criteria Completed during orientation Ongoing to determine if competency maintained

Performance Evaluation

Is this staff member doing his/her assigned job? Answer: found in comparing daily performance against set of expectations Compiled and summarized annual basis Used to monitor the quality of care/service

QUESTIONS ?

THANK YOU