The Employer’s Role in Determining Employee Competence

When was the last time you questioned whether the individual who provided you or a loved one with a health care service was qualified or competent?  I don’t know about you, but the last time I had blood drawn, I didn’t think twice about extending my arm for the nice lady with the long needle.  Why? Because as patients, we generally don’t question our healthcare workers.  We assume that the provider – physician, hospital, home health agency, pharmacy – has vetted its employees, ensured that they are licensed/certified (if needed), competent, trained and supervised to provide the care we receive.    Healthcare providers are in a unique position.  We enjoy the public’s trust, and once that trust is broken, it’s hard to recover.

Good providers question whether they’re doing enough to assure competence.  The first thing most do is to check training and references.  We do this usually by requiring a copy of someone’s diploma, license or certification.  Do you check the certification at its source?  For licenses, that’s probably the case when you check the appropriate issuing state agency.  But what about other certifications? Are you ensuring the documents you receive are legitimate – as much as practical – or just taking things at face value and hoping for the best?

When it comes to references, many of our clients are a little lax.  Often, the HR manager or administrator sends out a reference request and no one tracks to make sure the request is returned, completed by the former employer.  Keep in mind that references can be checked orally as well.  While many employers won’t give you ‘the dirt’ on a former worker, they will at least verify the individual worked there, the dates of tenure and the position held.  This is enough to verify what the individual noted on the application or resume.  So when references aren’t returned in a timely manner, pick up the phone. The statement signed by your applicant, authorizing a reference check, will cover a phone call as well.  Some organizations have state and/or accreditation requirements to check references.  Understand that sending out a reference request two years ago and failing to follow up won’t meet the standard; we suggest a simple tickler system and regular personnel file reviews to make sure you have all your ducks in a row.

Does licensure ensure someone is competent?  I know a few people who wouldn’t agree with that assumption.  What responsibility does an employer have to assure its staff is competent?  The role of testing is seen as a challenge and its suggestion elicits four-letter words from many employers.  But a short 10- or 15- question quiz can give you a sense of someone’s skills and thought processes.  Commercially available tests may fit the bill or you could create a short list of areas in your organization for which you want to ensure an understanding and competence.  Demonstrations are helpful, as are verbal explanations.  The vogue in hiring practices these days is not, ‘Are you a team player?’ since only the dimmest bulb will tell you he isn’t (and you probably won’t want to hire him anyway).  Today’s HR manager asks the applicant to, “Tell me about a situation where you had to work as part of a team and the challenges you encountered.”  Open-ended questions give the manager the most information, not only about the subject matter but in observing the applicant’s choice of words and demeanor.

If this sounds like a huge burden for you, consider your organization’s turnover and pattern of hiring decisions.  Are you easily swayed by a good line, only to find out months later that the person doesn’t have the proper skills?  Or is otherwise not a good fit for your company or department?  A little extra time on front-end will minimize the likelihood that you’ll get a bad apple or someone who exaggerated his/her skill-set.

The last part of the loop on competence has to do with ongoing training.  For licensed or certified individuals, ongoing training in certain topics is a requirement.  Those employees may obtain the needed CEUs or training elsewhere and bring you a certificate for the personnel file.  However two items for consideration:  are employees being trained on a task the way you expect it to be performed?  What about regular training and review of your organization’s policies and standards?  This should be part of any good organization’s human resource plan. A regular review of your service standards as well as patient confidentiality, compliance, how to handle patient complaints, etc. will convey that you take these topics seriously and demand excellence from your staff.

After all, your patients expect it and more important, they trust you to ensure it.

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