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Competency is Your Center's Currency
Your staff is qualified, but is it excelling?
James Stobinski
Publish Date: May 22, 2014
OR Excellence
James X. Stobinski, PhD, RN, CNOR James X. Stobinski, PhD, RN, CNOR

Speaker Profile

  • Director of credentialing and education at the Competency and Credentialing Institute.
  • Formerly director of surgical services at St. Luke's Regional Medical Center in Boise, Idaho.
  • Worked his way up from janitor, orderly and staff nurse.

You hire your facility's nurses, surgical techs and instrument reprocessors based on their competence — that is, their potential ability, their capability to function in a given situation. Competence can be measured through knowledge-based tests. But once your staff members are on the job, are you routinely monitoring their competency? That is, how well do you know how well they're actually performing? "Competency is much more difficult to measure," says James X. Stobinski, PhD, RN, CNOR. As the director of credentialing and education at the Competency and Credentialing Institute in Denver, Colo., Dr. Stobinski knows what it takes to ensure that your staff remains at the top of its game, and in his presentation "Let's Talk About the Big C — Competency," he'll show you why that's critically important to your center's continued success.

  • Beyond training and testing. Assessing competency in the surgical setting is not just a testing drill, where it's possible for everything to look great on paper. It's a lot more than that. It has to be a framework for measuring knowledge, skills and attitude. Teaching mechanisms can measure knowledge. If you really want to know how someone performs their job though, you'll have to observe skills and attitude, since classwork won't be able to tell you how they'll do when they're handling patients. But many of us don't observe regularly, and if you're going to assess your staff's competency, you'll have to cover all these bases. We have to acknowledge that testing is only a part of assessing competency, and we have to do more.
  • Effort to excellence. I'm not going to sugarcoat it, it's going to take some time and energy to accomplish this. Health care is always evolving, and there's too much going on for you to rely on the assumption that an occasional refresher course will ensure that your staff knows their stuff. For staff, staying current in their positions and maintaining their skill sets through participation in continual professional development programs should be a personal responsibility. If you want to make sure your staff is competent, you must provide resources and encouragement, too. Certifying authorities can do some of the work for you as well, since maintaining certification will force staff members to stay current.
  • Hire higher. It's becoming more prevalent in perioperative nursing for administrators to look for candidates with BSNs, or to require their existing staff to earn them. To stay competitive, you have to hire the best nurses, but there's another advantage to asking more of them. Research increasingly shows that staying current with the latest standards and practices results in better patient outcomes. That seems like a win-win: If we send more nurses back to school, there are fewer complications, wound infections, decubitus ulcers; there is a direct positive effect on the bottom line; and, in a tough job market, they're more attractive as candidates.
  • James X. Stobinski, PhD, RN, CNOR
  • What's at stake. Your facility's clinical reputation depends on competency assessment. Your patients want to know that they'll be getting good, safe care, of course, and getting patient satisfaction and quality of care right carries a whole host of incentives. But it goes deeper than that. Your accreditation speaks to the need for proper education and training, and accreditation agencies will be driving your competency assessment. Your surveyors will want to ensure that your staff's qualifications aren't just dates on paper, but that they can effectively do the job. Individual performance is important, and they're going to check that more and more frequently. I'd expect to see them shadowing patients through a facility, watching all the people who come in contact with them. Competency assessment gives us the confidence to welcome surveyors into our facilities.