Assessing Competency in Clinical Care: Competing Demands and Realities Angela Egner, Chief Learning Officer Lisa Langdale, Director, Clinical Excellence Education

Begin with the End in Mind: Know

Begin with the End in Mind: Do

Begin with the End in Mind: Feel

Other Learning Demands: Accreditations and Designations

Other Learning Demands: Employer

Other Learning Demands: Professional

Most Important of All: Outcomes

Striving for Learning Effectiveness: Kirkpatrick Levels of Evaluation

Constant Demands Competing with This!

At MUSC Health: A Look at Nursing “Mandatories” Infection Control for HC Workers Diabetes Part 1 & 2 Pressure Ulcer Staging Pressure Ulcer Prevention at MUSC Braden Scale Scoring Pain Screening, Assessment & Management Organ Donation Universal Protocol Patient Restraints Blood Product Transfusion Safety Fall Prevention & Policy Review

At MUSC Health: A Look at Nursing Certifications Type of Nursing Certification Certifying Body General eligibility criteria – Visit association’s website for more details Longevity Professiona l Designatio n Adult Medical Surgical Medical-Surgical Nursing Certification Board (MSNCB) Current, active RN license Practice as an RN for 2 years Minimum of 2000 hours of clinical practice in the last 3 years No contact hour requirements 5 yearsCMSRN Adult Medical Surgical American Nurses’ Credentialing Center g/ g/ Current, active RN license Practice the equivalent of 2 years full time Minimum of 2000 hours of clinical practice in the specialty area within last 3 years 30 hours of continuing education in medical-surgical nursing within the last 3 years 5 yearsRN-BC Adult Critical Care American Association of Critical Care Nurses Current, active RN license Must meet one of the following: 1,750 hours in direct bedside care of acutely or critically ill pts during previous 2 yrs with 875 of those years in most recent year preceding application Or RN for at least 5 yrs with a minimum of 2000 hours of direct bedside care of acutely or critically ill pts with 144 of those hours accrued in most recent year preceding application 3 yearsCCRN

At MUSC Health: A Look at Enterprise Initiatives Specialized Medical Team Trauma Stroke Transplant Orthopedic/Joint Replacement CRRT Infant Security System Safe Patient Handling and Mobility Falls with Harm Reduction Blood Product Administration Mock Maydays/MET drills

At MUSC Health: Annual Competency Validation Organizational Annual Competencies: Moderate Sedation Foley (urinary catheter) insertion and removal Teach Back CLABSI prevention – port access and de-access Service Line Specific: Interpreting Tele rhythms Including TX Care of VAD patient Unit/Department Specific: POCT Care of the Heart/Lung Transplant patient Documentation of CPGs Pt handoff

MUSC Health Mission and Strategic Plan Effective competency assessment identifies the specific skills required in each job class to achieve organizational goals. How We Do It: The Donna Wright Model of Competency Assessment

Critical Thinking Technical Inter- personal

How We Do It: Methods of Competency Evaluation Return Demos Observation of daily work Discussion groups Case Studies Presentations Post-tests QI monitors Exemplars Mock Events Self Assessment Peer Reviews

How We Do It: The Clinical Education Workshop Opportunity for clinical staff (inpatient and ambulatory) to learn topics of high importance in a live, interactive environment (approximately 4500 employees)  High reliability principles and error prevention methods  Patient engagement, communication, and cultural sensitivity  A variety of clinical and strategic learning stations

How We Do It: Process: The MUSC Health Learning Council Purpose: Provide governance for employee learning policies and curriculum at MUSC Health. Key Responsibilities: MUSC Health Strategic Learning Plan Annual MUSC Health mandatory education and assignments* Emergent requests for MUSC Health mandatory education* Educational policies for approval. Certification guidelines Guidelines for mandatory instructional design and feedback on curricula, as requested Sourcing of third party vendors for mandatory learning content. Input on opportunities to enhance learning for MUSC Health employees. Input on learning management system modifications specific to MUSC Health. *Provider education must also be approved by the Medical Executive Committee (MEC).

How We Do It: Process: The MUSC Health Strategic Learning Plan Drivers: Strategic alignment of educational efforts with organizational strategy Forward planning with sensitivity to learner capacity, timing and resources Six month snapshot of “significant learning initiatives” – both planned and “on the radar” Aligns with a key organizational strategy Impacts multiple departments Significant learner population across the initiative (50+) Input from Learning Leaders across MUSC Health Reviewed Bi-Monthly by the MUSC Health Learning Council Reviewed Quarterly by MUSC Health Senior Leadership Council

How We Do It: Process: The MUSC Health Strategic Learning Plan

For You To Think About