Selecting Appropriate Competencies

1. Selecting Appropriate Competencies A new era in competency assessment Lynn Howe, RN, MS

2. What is Competency Assessment? • Advances in patient care necessitate and compel nurses to continuously address evolving competency needs • The skills and abilities nurses mastered and excelled in just a few years ago may no longer be as valuable or necessary today

3. The Evolution In the past, the focus has been clinical knowledge and mastery of technical skills. Today foundational competencies include: • Teamwork and interpersonal skills • Commitment to professionalism • Implementing evidence-based practice • Assessing communication abilities • Fostering safety improvements

4. Competency Defined Competency is the application of knowledge. It is measured at the bedside, in the job role. It is not assessed by: • Passing a test • Taking a course • Using a checklist

5. The Strategic Importance • Patient Safety • Quality Outcomes • Employee satisfaction • Patient Satisfaction • Physician Satisfaction • Verification of clinical expertise • Reflective Practice • Accountability

6. Competency Goals • Drives standards of practice • Standardization • Accountability • Establishes and determines your baseline

7. Quality Measures • Interpretation of quality indicators serve as the baseline for competency assessment • If quality indicators fall short or you have no evidence of any baseline data, this is the starting point

8. Empowered Assessments • Don’t give out or choose the competency to be evaluated • Establish a process to identify competencies selection • Reinforce the process for competency selection • Provide process to identify what competency needs to be assessed and they are not given the competency itself

9. Standardization • Standardized the competency process rather than individual competency itself • Competency will differ across units

10. Static vs. Dynamic • Competency is an ongoing dynamic process • Competency is ever changing • Don’t repeat the same competencies year after year • Your organization needs to focus it’s energy on the ongoing competency selection process • Initial Orientation competency drives safety • Annual competency drives organizational changes

11. Brainstorm First, Prioritize Second • What is new? • What is changing? • What is problematic? • What is high risk? • What is important to the employee? • What is time sensitive?

12. Data help drive process • Collect quality data in a central location • Review data to see if a gap can be identified • No problem = no competency needed • Gap identified? Show and discuss how you arrived at this conclusion and assign competency accordingly • You may demonstrate something was considered, but a competency was not ultimately needed

14. What are the Competencies?

17. Medication Error • A medication error occurred • Situation investigated • Asked an RN to demonstrate how he/she would calculate a pediatric drug dose • RN did not routinely work with pediatric patients • The RN could not do the calculation • Corrective action…all RNs must take a medication exam annually • True or False: Medication test proves competency?

18. The Truth • Medication tests prove very little • Nurses who are required to calculate medication doses for an unfamiliar patient population may: • Demonstrate ability to utilize internal resources to calculate medication dose • Use drug dose applications on mobile devices • Call pharmacy • Call pediatric units for staff support • Ask for another RN to double check calculation

19. Educators or Shared Governance • They should not select all competencies • They should reinforce the model to clarify infrastructure • In the past, leaders select competencies and educators do the “doing” • It’s a new era! • Educator s demonstrate critical thinking • Leaders should hold their team accountable

20. Education vs. Accountability • How much money is spent on inappropriate education? • Accountability issue or competency issue? • When baseline or advanced competency level is achieved, but outcomes are not met, it is an accountability issue • It is an educational issue, when skill is lacking • It is an accountability issue, when will is lacking

21. Evidence of Achievement • Place the employee in the center of the process • Ask the employee to provide evidence of verification • If employee refuses to provide verification, then an accountability issue is present

22. A New Approach • Application of Knowledge • Professional Practice Standards • Evidence of Achievement • Outcomes • Not simply a check list any longer

24. Common Mistakes • Don’t fall into the common competency traps • Don’t repeat the same competencies year after year • Don’t validate • Don’t perpetuate • Lets identify some common mistakes

35. Does someone follow in another car?

36. In Summation • Competency enables healthcare organizations to create business alignment, promote a culture of accountability, develop people, strengthen relationships between managers and employees and improve overall satisfaction of employees , physicians and patients.

37. Recommended Reading

38. Thank you!