Competency standards: Where to find them
Competency standards: Where to find them
Compliance with Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards for competency is found in the management of human resources chapter of the accreditation manual.
To comply, Maryanne Popovich, RN, MPH, executive director of the home care program for JCAHO in Oakbrook Terrace, IL, suggests that agencies first determine, by category of staff and type of patient, which competencies they need to assess. Once those are identified, agencies can best evaluate the competency of staff.
"Organizations often try to do this backward," Popovich says. "Managers should create a list of the kinds of patients they treat. If an employee will never give an infant a bath, why would they need to show competency for this? This is the area where we see wasteful resource allocations." Popovich says that agencies might think JCAHO expects private duty staff to be competent in all areas, but that is not the case. "We don't give agencies a list of competencies because we want to maintain flexibility in the meeting of the standards," she says.
Popovich references the following standards for private duty organizations to keep in mind when it comes to evaluating competency of staff:
HR.3.1.
This standard calls for the agency to have an appropriate number of staff qualified and healthy to perform the services provided by the organization and to meet the needs of patients. The agency must provide evidence that all staff have current licensure, certification, or registration; proper education and training; compliance with health requirements; and the competence to perform assigned responsibilities. Proper documentation must be kept.
HR.3.2.
This standard addresses the number and qualifications of supervisory staff. Each supervisor must have current licensure, certification, or registration; proper education and training; understanding of care or services being supervised and staff responsibilities associated with the level of care provided; competency for assigned supervisory responsibilities; and clinical and supervisory experience.
HR.4.1.
This standard is directed at personal care and support staff. It requires staff to have proper training before providing patient care. Staff should also demonstrate skills and show proficiency in the following areas: communication with patients; observation, reporting, and documentation of patient status; identification of patient needs; maintenance of a safe and healthy environment; infection control procedures; and nutrition and food preparation techniques. In addition, staff should have knowledge of the following: body functioning; appropriate bathing and personal hygiene techniques; safe transfer and ambulation of patients; taking vital signs; exercises or treatments; and safe use of equipment.
HR.6.
This is the main competency standard. It stipulates that agencies assess, maintain, and improve the competency of staff. It states that agencies should have a consistent annual competency process in place to measure and assess staff competence. Agencies need to identify skills that will be observed and when these skills need further education or training.
JCAHO places emphasis on demonstration of knowledge and competency of skills, communication with patients and caregivers, anticipation of care needs, and response to patient needs. This standard states that competency may be evaluated through written or oral examination or through observation.
During a JCAHO survey, the nurse surveyor will review competency by accessing information from personnel files, observing care being provided in the home through home visits, and interviewing staff. Important documentation includes competency assessment evaluations, orientation materials, inservice and continuing education records, supervisory policies, and evidence of the credentialing verification process.
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