A Leadership Project Focused on Competence, Clinical Outcomes, and Culture Change

Abstract

To demonstrate how an ongoing competency validation program can enhance proficiency among health care workers, improve clinical outcomes, and influence culture change in an inpatient unit. In 2012, an academic medical center adopted an annual competence program with the goal of identifying competent nurses and to develop learning plans for those who demonstrated knowledge deficits. The overall goal of the program was to improve clinical outcomes and to influence positive culture change in a busy, metropolitan birthing unit. A rigorous annual competency program was developed whereby health care providers were required to demonstrate a wide range of competencies based on six themes: (a) patient-centered care, (b) teamwork and collaboration, (c) evidence-based practice, (d) quality improvement, (e) safety, and (f) informatics. After 4 years, the unit has seen 100% attendance to competencies, an improvement in staff satisfaction related to competencies, an improvement in clinical outcomes, the identification of nurse champions, and the requirement for nurses to participate in ongoing staff development. Investing time in creating the curriculum for a competency program, facilitating the program, evaluating results, and completing remediation is a huge investment. The payoff is worth the time. The results of competency assessments are useful in determining a nurse’s overall proficiency and can be helpful in identifying nurse champions. Using subjective evaluations with predetermined expectations is an effective way to determine competence. A competency program can positively affect clinical outcomes and unit culture.