Tie competency process to performance appraisals
Start with regulatory, accreditation requirements
(Editor's note: This is the first of a two-part series that examines the components for a successful competency assessment program in outpatient surgery. This month, we look at the essential components of a program, and next month we'll look at some of the components that outpatient surgery programs routinely neglect to put in their competency assessments.)
A good competency assessment program for an outpatient surgery program should encompass skills that relate to each employee's job and specific patient populations served and should apply to all employees, according to experts interviewed by Same-Day Surgery.
The most effective competency programs are actively linked to job descriptions, orientation checklists, and performance appraisals, Dawn Q. McLane, RN, MSA, CASC, CNOR, chief development officer of the Nikitis Resource Group, a consulting firm based in Broomfield, CO. The documentation of the competency assessment should be incorporated into the performance appraisal process so that the competency assessment documents are submitted along with the employees' own self-appraisal, McLane recommends. "This is a successful motivator when each employee knows that they cannot complete the appraisal process and get their maximum pay increase without also completing the competency process," she explains.
There are different challenges for hospital-based programs and freestanding or office-based programs when developing competency assessment programs, admits McLane. "All of the employees within the hospital-based outpatient surgery program have similar jobs, mostly clinical," she says. "The difficulty for the freestanding center is that there are so many different types of jobs such as business office, admissions, and nursing." The challenge of creating appropriate competencies for a wide range of jobs is magnified by the limited resources, McLane adds. "A hospital-based program has access to the education, risk management, and infection control departments for help," she points out.
Another challenge for freestanding centers is the fact that accreditation organizations have not always required the same level of competency assessments from freestanding centers as in hospitals, says Marcy Grow-Dorman, RN, BSN, ambulatory surgery center director at Orthopedic Sports Medicine Center in Elkhart, IN. "Years ago, surveyors did not understand ambulatory surgery centers well and didn't require as much competency assessment," she says. Newer surgery centers are doing well meeting competency assessment requirements because surveyors have been requiring stricter adherence to standards recently, Grow-Dorman says. "Those centers that have been open for a while have had to change the way competency assessments were handled to meet the more rigorous requirements," she says. For example, making sure that a competency assessment addresses core competencies as well as competencies specific to the employee's job is important, Grow-Dorman adds.
The basic requirements for any competency program should include the following areas, according to McLane:
- Any area required for annual review by accrediting organizations or regulatory bodies such as federal requirements for bloodborne pathogens or exposure control plans.
- Organizationwide requirements that are specific to your institution such as policies, staffing, scheduling, and human resources.
- Role- or job description-specific competencies for each employee to include core competencies for all people in a certain category, such as nursing, and role-specific competencies that focus on the individual's job, such as equipment competencies for the surgical nurse.
Once you've developed your competencies, don't assume that they won't change, Grow-Dorman says. "You must re-evaluate the competencies on an annual basis," she advises. Biohazard handling requirements, basic and advanced cardiac life support certification, and other issues are constantly changed and updated by regulatory or research organizations, she points out.
"I find that the Association of periOperative Registered Nursing competencies are a good starting point," says Grow-Dorman. "Then you must look at your facility and your patient population to identify additional competencies for your staff."
Sources/Resource
For more information on developing competency programs, contact:
- Marcy Grow-Dorman, RN, BSN, Ambulatory Surgery Center Director, Orthopedic Sports Medicine Center, 2310 California Road, Suite B, Elkhart, IN 46514. Phone: (574) 970-4454. E-mail: [email protected].
- Dawn Q. McLane, RN, MSA, CASC, CNOR, Chief Development Officer, Nikitis Resource Group, 4962 Democrat Drive, Broomfield, CO 80020. Phone: (303) 828-4996. E-mail: [email protected].
To order a copy of the Association of periOperative Registered Nursing (AORN) competency assessments, go to www.aorn.org. Under "Products," choose "bookstore." Type "PNDS" in the keyword search box, then scroll down to "Kleinbeck: PNDS@Work: Clinical Competencies and Job Descriptions." The cost is $20 for non-AORN members and $15 for AORN members. The book can be ordered online or by calling customer service at (800) 755-2676.
A good competency assessment program for an outpatient surgery program should encompass skills that relate to each employee's job and specific patient populations served and should apply to all employees, according to experts interviewed by Same-Day Surgery.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content