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 Additional Considerations Patient satisfaction feedback Incident reports Physician feedback Preceptor/mentor teaching Performance Appraisal/Evaluation Continuing Education & Training Peer Review Skills Checks Orientation Job Description License, Certificate COMPETENCE Effectiveness assessed through performance improvement activities

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 report  Why 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