Writing a Healthcare Competency: How Detailed Should You Get?

By Donna Wright, MS, RN, Consultant at Creative Healthcare Management 

I get many questions from people about how detailed to get when writing a healthcare competency statement. Should you write a competency statement and then add a sub-set of details that reflect all the skill aspects of that competency or details that describe the steps of a given procedure? The answer to this is, “Not necessarily.”

When measuring a healthcare competency, it is important to be specific about the objective measurement that will be used to assess the competency. However, the articulation of the objective measure that will be assessed in the competency does not necessarily have to appear in the competency documentation. Here are some examples of how to indicate the details without adding them to the competency statement:

Competency statement:

Assess the individual’s ability to start an IV, using procedure number 33.14.2 of the policy manual. 

• You see the detail of the procedure is indicated in a reference to the policy manual without writing all of the details into the statement itself.
• This approach also decreases the challenge of having to update both procedure and competency lists when practice changes. 

Competency statement:

Demonstrate the ability to safely mix the XYZ medication for IV administration, using the preparation poster in the medication room. 

• Again, you have specified the details of the competency through the reference tool you want people to use when doing this action.
• This approach is also better because you are teaching people to use the reference tool you want them to use every day. If you put the details in the competency documentation, you bypass the reference tool, and therefore do not teach and reinforce the reference tool. 

Competency statement:

Demonstrate the ability to manage a difficult customer service encounter where a family member or visitor is aggressively demanding or their behavior is escalating.

Use either the “difficult customer service encounter exemplar form” or the case study packet on “difficult customer service encounters.” 

• This competency has two possible verification methods. Each of the verification methods is a specific tool that has the expectations, details, and policy indicated in it. You do not just write “case study” in the verification method list, but instead you indicate the specific case study on “difficult customer service encounters.” 

In summary, a healthcare competency statement does not have to indicate specifically all of the details themselves as long as it indicates where the details to complete the competency can be found. If the competency statement refers to details that can be found elsewhere, you can avoid the mess of plugging up your documentation on the competency record with all the steps or details of a particular competency. And, as in two of the examples above, pointing out the details in another location actually helps to make people aware of reference tools and information systems in your organization and reinforce their use. 

A staff development specialist known for her irreverent wit, Donna brings a global perspective to her work. In this country and in the over two dozen others, Donna’s best known for the work she does based on two of her books, The Ultimate Guide to Competency Assessment and Relationship-Based Care (co-authored with several CHCM colleagues). The Ultimate Guidehas become the industry standard for HR departments in establishing and assessing competency, and Donna specializes in setting up systems for organizations to ensure accountability and measure competency.