Agency finds new way to measure competency

As administrator and CEO of Kokua Nurses in Honolulu, Judy Walden, BSN, MHA, knew there must be a more efficient way to screen applicants than the agency's 10-year-old form.

"I also thought we needed a new way to measure competency to meet Joint Commission requirements," she says. When Walden's director of patient care came up with the idea for a form that would do both, she was thrilled.

The result is a four-page document that won praise from a surveyor for the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, last year. The comprehensive form also allows Walden to keep track of which nurses have the necessary skills to see particular patients. (See form, pp. 122-125.)

Kokua Nurses developed the forms with input from the nursing staff. The forms provide a space on the left side of the page for an applicant to self-assess skills in a broad range of areas, including:

· leadership;

· patient education;

· equipment proficiency;

· clinical.

The other side of the form provides places for recording when and how the competency in those areas was checked.

The forms have been used for the past year, says Walden. She has noticed these five positive results of using the new form:

1. The form is a good screening tool for potential employees. It provides Walden or her supervisors with a way to direct the job interview more effectively and screen out candidates who don't have the required experience. "It's also a great way to make sure staff don't overstate their abilities," she says. "They self-assess, then you assess."

2. The form shows the Joint Commission how and when Kokua Nurses checks for competency. At the top of each form is a legend describing the various ways to check for competency, such as a test, an inservice, a home visit, or a lab.

3. The form monitors training needs, which makes it a good process improvement project, too, notes Walden.

4. The form provides another tool in annual performance reviews for employees. "If they weren't competent in something last year, you can check them during their review," she says. "It offers a great point of reference."

5. The form gives Walden a tool to profile her nursing staff in her computer. She keeps a list of which nurses can perform which tasks.

Along with her nurses, Walden has similar forms for home health aides and for hospital nurses who do the private duty work at the agency.

Employees have reacted positively to the forms, says Walden. "They see the flow from what they can't do to what's completed," says Walden, suggesting that a hard copy be given to nurses to keep as a record of what needs to be completed and what competencies are already done.

Walden says one of the great things about the form is how simple it is to adapt to specific needs of different agencies, or to changes that come about in what services her own agency provides. "I can see this evolving over time," she says.