Competency testing crucial to preventing hospitalizations, mitigating risk, LTC expert says

Employees' specific areas of weakness can be identified during pre-employment screenings and strengthened during orientation, Shubert said.
Employees' specific areas of weakness can be identified during pre-employment screenings and strengthened during orientation, Shubert said.

Improving employee competency testing in long-term care facilities can help reduce rehospitalizations, cut down on workplace injuries and boost overall resident care, an expert told a national gathering of nursing directors on Monday.

Linda Shubert, MSN, RN, CHSE,  director of clinical education at River Garden Hebrew Home Senior Services, also urged facilities to review their competency testing methods to improve their hiring efforts and increase scores on resident satisfaction surveys. Shubert spoke at the National Association of Directors of Nursing Administration in Long Term Care 2016 National Conference.

“Why would you competency test? The biggest question would be why would you not competency test, especially since all the stakeholders are asking for it,” Shubert said. “Research shows competency and care quality go hand in hand.”

Competency testing also can help address workplace issues unique to long-term care, such as a limited prospective employee pool, budget constraints and a staff with diverse levels of experience and skill. Shubert shared several suggestions for beefing up employee competency training, including holding simulations of incidents (or “whodunnit” scenarios), pre-employee competency screenings and online modules.

Employers also can experience the benefits of testing through increased employee retention since developing additional competencies, education and experience can help increase employees' perceived value.

“We need to let the employees know that we want them to succeed,” Shubert said. “Intervene early on, before they're not successful.”

The importance of staff competency was also stressed in a later session on risk management given by Robin Bleier, RN, LHRM, CLC, of RB Health Partners, Inc. Staff, along with residents, visitors, and the community as a whole, are key assets in successful risk management, Bleier said.

“People can either be your asset or they can be your risk,” Bleier said. “It is up to us to make them our asset.”

Staff reporting and an overall team effort are necessary when investigating potentially harmful incidents and conducting root cause analyses, Bleier told the audience. Staff should be encouraged to report any incidents immediately — without thinking they're “tattling.”

Vigorous root cause analysis can help identify factors that impact an incident's magnitude, location and timing, helping facilities prevent problems from recurring when possible.

“It's really important that when you think you found the root to test it,” Bleier said. “The beauty of root cause analysis is to really examine the circumstances, peel back the onion and focus.”

Close to 300 directors of nursing are in Austin, TX, this week to celebrate NADONA's 30th anniversary. The conference continues through Wednesday.