Using an employee who is not competent can lead to a multitude of issues, ranging from incomplete or improperly completed essential paperwork to potential harm to patients because the patients were not properly instructed on the safe use of their equipment/product.
Accreditation Commission for Health Care (ACHC) addresses the importance of competency assessments in the Sleep Accreditation Standards.
Standard SLC4-2J: Written policies and procedures are established and implemented requiring all personnel to receive training and/or education and to competently perform the required client/patient service activities prior to being assigned to work independently. Direct care personnel are observed and evaluated to verify ongoing competency of job duties performed.
The standard requires that written policies and procedures define the minimum education and training, licensure, certification, experience, and competencies required for each service offered, as well as the method for documenting that personnel have received the required training (e.g., certificates and diplomas).
Qualified personnel observe and evaluate all direct care/service personnel performing their job duties at frequencies required by state or federal regulations. If no regulation exists, the evaluations are performed at least once annually to assess that quality care/service is being provided.
Written policies and procedures must define the evaluation criteria. This activity may be performed as part of a supervisory visit and is included as part of the personnel record.
Competency is the ability of a personnel to demonstrate the knowledge and skills needed to perform job duties related to the care, services, and products being provided to patients, including management of equipment. The competency assessment is more than a checklist; it is an acknowledgment of proficiency in completing tasks. All direct care personnel, employees, or contractors who have the responsibility of providing care to or educating patients must have completed competency assessments.
Competency assessments are to be specific to the personnel job responsibilities and are to be completed:
- Initially during orientation, before duties are performed independently.
- Before performance of a new task.
- Annually.
During completion of competency assessments, the following should be documented:
- The job duties being assessed.
- How personnel performed (i.e., proficient or competent, competent in some areas but not others and needs additional training, should be supervised while doing these tasks, etc.)
- Validation of skills or identification of any skill or knowledge gaps.
- Education or additional training provided for all required competencies not met.
Competency assessments must be documented and can be completed in a variety of manners such as but not limited to:
- Observation of personnel performing their job duties.
- A combination of knowledge-based testing and observation.
- A combination of self-assessment and observation.
Self-assessment tools alone are not acceptable. Peer review of clinical personnel by like personnel can be used as long as review is within the definition in policies and procedures. The person completing the competency assessment must see evidence of competency to complete the skills or tasks being assessed.
Competency assessments are vital for all organizations to identify areas of staff strengths and areas that need improvement. Without assessments, organizations would have no ability to mitigate skill gaps effectively, and patient quality of care/service could be compromised. Providing personnel with the appropriate training and skills is essential to ensuring patients receive the best care/service possible.
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If you have questions or need more information, contact your Account Advisor, email customerservice@achc.org, or call (855) 937-2242, ext. 458.
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