Demystifying the Competency Conundrum Facilitated by: Sylvia

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 individual’s capacity to perform his or her job functions. Professional Competence The ability to function effectively in the tasks considered essential within a given profession. Competency: An individual’s 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.

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 individual’s 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 Peer Review Skills Checks Effectiveness assessed through performance improvement activities Additional Considerations Patient satisfaction feedback Incident reports Physician feedback Preceptor/mentor teaching

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 of position Develop 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 employee’s 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