Q: “We just had a staff meeting and our manager told us that ‘Results from a recent survey of the department stated we need to have more competency for the staff and the work they do.’ Do you know how many competencies a department should have?”
Great question! I think competencies go hand in hand with certification. I call them my “C²” (certification/competency). I will explain why in later articles.
Most medical facilities want Centers for Medicare & Medicaid Services (CMS) accreditation. To receive this, they will use various organizations to survey their facilities. If deemed “approved,” the facility will receive CMS certification.
When searching the various CMS standards, it is difficult to find our profession outlined; specifically (31-9093.00 - Medical Equipment Preparers). Yes, that is what we are called by the U.S. Federal Government.1,2,3,4 Remember, this is what your Human Resources Department will reference when conducting a wage analysis. If you have not visited the U.S. Bureau of Labor’s website (bls.gov), I advise you do.1
31-9093.00 - Medical Equipment Preparers states that staff: “Prepare, sterilize, install, or clean laboratory or healthcare equipment. May perform routine laboratory tasks and operate or inspect equipment.” Samples of reported job titles for this type of position are a) Central Processing Technician (CPT), b) Central Service Technician (CST), c) Central Sterile Supply Technician (CSS Technician), d) Certified Registered Central Service Technician (CRCST), e) Instrument Technician, f) Sterile Preparation Technician, g) Sterile Processing and Distribution Technician (SPD Technician), h) Sterile Processing Technician, i) Sterile Technician, and j) Sterilization Technician.2,3
Our critical thinking must take over for the next step, in defining competency. How is nursing competency defined by CMS, and then by some of the surveying organizations? “Why nursing?” you ask. In my investigation, we would fall under support staff for nursing in the various guidelines and nursing has some of the most published articles on this topic.
The U.S. Office of Personnel Management (OPM) states, “A competency is a measurable pattern of knowledge, skills, abilities, behaviors, and other characteristics that an individual needs to perform work roles or occupational functions successfully.”5 This is repeated throughout the CMS DEFINITIONS §483.35.6,7
One of the surveying organizations (The Joint Commission [TJC]) says the following on this subject. “While not formally defined, competency may be described as a combination of observable and measurable knowledge, skills, abilities, and personal attributes that constitute an employee's performance. The goal is that the employee can demonstrate the required attributes to deliver safe, quality care. Competency assessment timeframes may vary greatly based on the individual's entry skill level and the complexity of the task(s) the individual will be required to safely perform. … Competency assessment then focuses on specific knowledge, technical skills, and abilities required to deliver safe, quality care.”8
Documenting that staff attended in-service training, listened to a lecture, or watched a webinar may not be enough for demonstrating competency. It is best to collect metrics on how staff have integrated the knowledge and skills that were the subject of the activity. Staff already deemed competent in these skill areas must assess and evaluate fellow staff to see if they understand and can apply the knowledge gained to their work practice.
So, now the issues to address:
· How many competencies does a department need or should have?
· How does your department develop competency for staff?
· How does your department demonstrate the staff’s specific task or skill?
That is in next month’s article to help answer this question correctly.