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 ConsiderationsPatient satisfaction feedbackIncident reportsPhysician feedbackPreceptor/mentor teaching

Performance Appraisal/Evaluation

Continuing Education & Training

Peer ReviewSkills Checks

Orientation

Job DescriptionLicense, 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 ActivitiesRemediate if necessary, then reassessAssign accountability for follow-up

REPORTING RESULTS/LINK TO EDUCATION

PEERING INTO THE CRYSTAL BALL

Reporting Results/Link to Education

Annual reportWhy report findings?What you will reportTo whom you will reportHow 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