February 2001

National Clinical Competency Program Implements Assessment System for Caregivers

A part of the National Clinical Competency Program, Catholic Health Initiatives has begun the rollout of an assessment system, called the Performance Based Development System (PBDS), that gauges the clinical competence of nurses and other direct caregivers and makes individualized recommendations for their training and professional development. The rollout process will include all market-based organizations within the next three years. Catholic Health Initiatives will purchase PBDS for system-wide implementation at a total cost of about $1.7 million, in contrast to the $4.6 million total cost if each market-based organization purchased the system separately. "Having Catholic Health Initiatives purchase the system and administer it centrally is far more cost effective," said Debbi Honey, RN, vice president of clinical operations and project leader for the National Clinical Competency Program. More than 15 facilities within Catholic Health Initiatives already have experience using PBDS, which includes a video tool that simulates clinical situations to assess caregivers’ technical, interpersonal and critical thinking skills. Several more market-based organizations were in the process of evaluating the system when Catholic Health Initiatives made the decision to purchase PBDS. Centralized administration will deliver benefits Two market-based organizations – St. John’s Regional Medical Center in Joplin, Mo., and Memorial Health Care System in Chattanooga, Tenn. – are the initial implementation sites for the national program. Centralized administration will enable a small staff of Catholic Health Initiatives national employees to provide operational support, clinical competence assessments, ratings, analysis and results trending to all market-based organizations. "Centralized administration will also allow us to create one large database related to clinical competence, which will show patterns of need for education and performance improvement," said Honey. "The tool saves money because it pinpoints areas in which nurses and other caregivers need training." The National Clinical Competency Program is a partnership among market-based organizations and several Catholic Health Initiatives resource groups, including human resources, clinical leadership and risk management. "This is an exciting program that will help Catholic Health Initiatives to be identified as a leader in providing quality and safe medical care to the patients we serve," said Hal Ray, MD, chief medical officer for Catholic Health Initiatives. "I hope that the future will provide a similar program for our physicians." The program addresses several system-wide issues and needs, including the satisfaction of state and federal regulatory requirements for evaluation of clinical competence; the reduction of risk exposure; improved performance and outcomes; and the recruitment and retention of nurses. "The current nursing shortage is different from any other that we have seen," said Honey. "Past shortages were cyclic and were corrected by recruiting more women, who make up the vast majority of the nursing workforce, into the profession. However, today there are so many career options for women who might once have become nurses that we may never have ‘enough’ nurses again. So, in addition to finding new ways to recruit male and female nurses, we have to find new ways to take care of those we have. By using this tool we can better help our nurses with their professional development." System will contribute to risk reduction "This program helps to assure a high level of clinical competence within our nursing workforce," said Michael Fordyce, senior vice president, human resources. "We know from national research that skilled professional nurses attract other skilled professionals to employers who respect and value their talents. We want nurses to see Catholic Health Initiatives as that employer." In addition to identifying skill development opportunities for individual nurses, the PBDS assessment tool identifies areas in which caregivers are not competent, which could potentially pose a risk to patients. "The program is being funded by a loss prevention incentive grant provided by First Initiatives Insurance, Ltd., Catholic Health Initiatives’ wholly owned captive insurance company," said Mitch Melfi, chief risk officer for Catholic Health Initiatives. "We recognize that the most effective way to prevent loss is by providing the highest possible quality of care. Support of a program such as this, which focuses on developing the competency of our caregivers, will certainly help in reducing Catholic Health Initiatives’ cost of risk." The National Clinical Competency Program has direct and positive implications for the quality of patient care throughout Catholic Health Initiatives. "Caregivers who are clinically competent are essential to our continued ability to provide safe and efficient care to patients," said Honey. "The bottom line is that this program is the right thing to do for our patients, our nurses and our system."