What is Competence in Healthcare? (Part II)

Competency is a tool for developing staff – and much more

While competency evaluation is obviously a tool for developing clinical and non-clinical staff, secondary – and equally important – goals of competency evaluation are to create business alignment amongst nursing, ancillary, and facility support staff. Doing so will promote strong working relationships between managers and their staff and improve employees’ engagement and satisfaction with their work environment.

Evaluating competency in a routine, organized manner promotes awareness of organizational goals and assures the evaluation of competencies against the goals monitored. When monitoring shows that existing competencies do not support the goals of the organization, a tactical response can be initiated to address these gaps. Evaluating competency across the organization in this way also allows the organization to pinpoint areas that need specific strategies required for the entire organization.

Focus on an Employee's Potential to Improve

The importance of relationship building between managers and their staff is based on an assumption that employees have the potential to improve – or at least be valuable to the organization based on their current competencies (if not in the area where they currently work). The manager’s professional responsibility is to identify and develop the employee’s potential by determining gaps in competency and providing learning opportunities to fill those gaps. For employees whose competencies cannot be improved, the manager’s responsibility then lies in finding the right place in the organization to capitalize on existing competencies or to determine the employee is not suited for the organization at all.

A competency evaluation process can actually improve employee engagement and job satisfaction. Research shows that engaged employees perform more consistently, effectively, and efficiently than equally-qualified, non-engaged employees. If employees are inadequately prepared to achieve required competency expectations, they can easily become disengaged. They may become indifferent, lacking the will, skill, desire, or basic motivation to promote their own professional career ladder objectives. If they do not see themselves as a critical influence on strategic business objectives of the organization, they may lose interest in their specific role. This disengagement will be reflected in not only the nurse’s satisfaction and engagement scores but in physician and patient satisfaction as well.

Competency supports personal and organizational accountability.

Managers who do not hold employees accountable for less-than-acceptable performance lower and “reset” the acceptable benchmark. The competency assessment can be utilized as the mechanism to hold nurses accountable to meet minimal organization expectations. Managers can institutionalize and articulate their expectations from pre-hire assessment through the peak of the career ladder. If an employee knowingly and defiantly fails to meet clearly articulated expectations, the manager should not hesitate to terminate the nurse’s employment.

On the flip side, managers can identify high performers and promote accountability for continued growth and career planning activities.

Competency evolves as employees develop their abilities and progress through their careers.

Competency assessment is not a motionless or stagnant process. Competency assessment is actually a fluid and ongoing process. It is dynamic and responsive to the changing needs and environment within the organization. Competency assessment should reflect the current direction and demands of the organization every changing clinical environment. As the needs of the patients, staff, and organization evolve, the appropriate competencies can and should be modified and adjusted. Organizations can be flexible in using competency evaluation for employees from pre-hire to orientation to annual assessments.

A successful competency assessment process evolves throughout the professional life cycle of the employee. In developing a competency assessment program, it is important to understand the initial assessment of job competencies at the time of hire differ from ongoing competency assessment. Ongoing competency assessment evaluates the knowledge, skills, attitudes, and behaviors that reflect the new, high-risk, problematic, and time-sensitive nursing functions of nursing practice. Considering these requirements and the inextricable relationship between competencies and quality of care, developing and implementing an effective competency program is crucially important.

Consulted Sources

Cohen, Michael, What You Accept is What You Teach: Setting Standards of  Employee Accountability. Creative Health Care Management: Minneapolis, MN 2006

Delbueno, Dorothy; Buyer Beware The Cost of Competence. Nursing Economic: November 2001

Wright, Donna, The Ultimate Guide to Competency Assessments in Health Care. 3^rd edition. Creative Health Care Management: Minneapolis MN 2005