Healthcare is complex. While many industries have standards of practice for tasks performed, the complexities in healthcare make standardizing competencies challenging. Beyond the differences in medical history from patient to patient and the need for facilities, departments, and teams to have flexibility in how they operate day-to-day, other essential obstacles make standardizing healthcare competency management challenging, including:
Because healthcare and patient needs are complex, it can be an obstacle to standardizing competencies. Plans must be flexible and meet the needs of the department, care team, and, most importantly, the patient. That’s why Dossier has created an all-in-one digital competency management platform that enables 100% visibility, supports end-to-end management, and provides an easy solution that keeps everyone in every department one step ahead. Learn more about how we can help your organization, schedule a quick demo.
Contributor: Ryan Owens
PharmD, Editorial Director, Special Publishing American Society of Health-System Pharmacists (ASHP)
Despite advancements in healthcare technology and medication safeguards, medical errors continue to occur at a high rate within health systems. A recent study by Bates et al published in the New England Journal of Medicine helped quantify the landscape of medication safety within inpatient sites.1 Bates and colleagues analyzed data from 11 Massachusetts hospitals and over 2,800 random admissions during 2018. Key findings of the study are noted in Figure 1 below.
The most common type of adverse event was an adverse drug event, followed closely by surgical or other procedural events. The authors also found that adverse events were higher among older patients and men. Event rates were noted to be higher among larger hospitals as well.
Figure 1: Key Findings
The study did have some limitations, such as a low population of Medicaid and uninsured patients and study sites limited to one geographic area, which could limit its applicability to other hospitals. However, it is one of the more comprehensive studies to critically examine adverse events from multiple sites as a follow-up to findings from the landmark Harvard Medical Practice Study in 1991.2
The findings of this study indicate that individual hospitals and the healthcare system at-large continue to have room for improvement regarding patient safety and delivery of care. The authors noted a few key elements are essential to help enhance safety standards within an organization and include:
Accurate and appropriate measurement of adverse events for organizations, which can often be complex to achieve, is an initial step to improving safety.
Appropriate safety culture
Given the implications to overall patient care, improving safety should be a top priority for organizations. While a multi-targeted approach for improvement should be included, one recommended avenue can be through continuous staff education and training. Regular, ongoing competency-based training can help staff remain up to date in their knowledge and skills by educating on the latest guidelines and standards of care. Examples of potential competency-based training topic areas are included in Figure 2.
Ensuring staff are competent in specific areas related to their roles and responsibilities can help elevate the care provided to patients. Competency-based training also allows staff to receive a refresher on fundamental topics and assimilate new knowledge on changes in treatment recommendations. Training can also be tailored to the specific practice area and individual needs of a staff member.
Figure 1: Competency-based Training Topics
Competency-based training can be a valuable tool to not only help improve safety, but also provide continuous professional development for staff. The American Society of Health-System Pharmacists (ASHP) have developed a full suite of digital competency trainings and assessments to manage and monitor competency completion among pharmacist and pharmacy technician staff. With Dossier’s robust competency platform and the power of ASHP’s Competency Assessment Centers content, you’ll have the perfect formula for a successful pharmacy.
To learn how ASHP’s Competency Assessment Centers content and Dossier’s competency management tool can help your organization, schedule a quick demo.
Bates DW, Levine DM, Salmasian H, et al. The safety of inpatient healthcare. N Engl J Med 2023; 388:142-153.
Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in hospitalized patients — results of the Harvard Medical Practice Study I. N Engl J Med 1991;324:370-376.
Competency-based training helps healthcare workers achieve the required outcomes for the particular tasks staff are asked to undertake. Competency develops throughout one’s career by way of education, skills training, and experience – but the current process is broken. And Dossier is here to help fix it.
Quality is a critical element of the care journey. A competent, skilled, knowledgeable healthcare team delivers superior care. However, paper-based competency education and management create opportunities for duplication and make reporting on competency progress, especially across departments, virtually impossible. Additionally, because these blind spots in reporting exist, learners have to re-demonstrate competencies from one department to another due to a lack of inter-departmental transparency.
Digitizing competency plans such as onboarding, orientation, sign-offs, etc., helps preceptors and healthcare staff work more efficiently and eliminates duplication.
Additionally, departments, facilities, and enterprises shifting to digital competency management can:
Reduce Variability in Care Delivery
Digitizing competencies helps to reduce variability in care delivery because the digital platform allows one plan to be shared with any individual, department, facility, or the entire health system. This consistency in training and development is essential for improving quality. Not only does this minimize the margin of error by way of variations in plans, but it also eliminates duplication of work – helping create more time for training and patients.
Improve Interdepartmental Transparency & Collaboration
A digital competency tool also allows departments to collaborate on plan development and updates, as well as monitor progress.
Scale with Ease
Shifting to digital competency management allows for best-in-class digital practices and provides hospitals and health systems with a scalable tool.
Improve Healthcare Workforce Readiness
Have confidence in knowing your team is ready to respond to any emergency situation at any time because plans can be created, updated, assigned, and shared with individuals, departments, facilities, or the entire enterprise in minutes.
To maintain or improve quality and patient outcomes, digital competency-based training is necessary. Not only does it support healthcare organizations in the value-based care model, but it also helps to optimize resources and eliminate duplication of work. By digitizing and going paperless, healthcare workers are supported by a system that helps them provide optimum care.
To learn how Dossier’s all-in-one competency management tool can help your organization, schedule a quick demo.
Healthcare organizations are adopting technologies to improve workflows, efficiency, and patient care, and staff are grateful. One area in need of digitization that would greatly benefit healthcare staff is competency management. Paper-based competency management is a drain on healthcare resources and is contributing to staff stress.
Did you know:
Preceptors spend precious time chasing colleagues, binders, and paperwork trying to get an accurate view of progress. The problem is, paperwork is missing, checklist signoffs are incomplete, plans are outdated versions, and no one has the time to hunt down all of the documentation.
Thankfully, there’s a better, more efficient, and more effective way to manage competencies that healthcare staff appreciate.
Digitizing competency management with Dossier benefits every team member, because it allows for:
Updates to competency plans in real time – no more using personal time to update paperwork; users get a big-picture view of progress; this real-time information exchange allows team members to better manage what’s expected of them
The benefits don’t end there. Going digital also helps healthcare workers:
With all-in-one competency management tools, from Dossier, staff are empowered and in control of their learning. They see what is required of them at all times. Preceptors have an immediate view of progress. And leadership gains confidence in knowing there won’t be any surprises on survey day.
Patients have high expectations when it comes to the level of care they receive. If staff are hurriedly moving about and seem rushed, patients view the interaction negatively. By helping care teams work more efficiently, staff free up time, and can better meet their patients’ needs.
As healthcare workers continue to be overburdened and overwhelmed amid staffing shortages, equipping them with digital tools that improve efficiency and create more time in their day becomes increasingly important. Explore how Dossier can help your care team.
Electronic health records were introduced to the U.S. healthcare system in the 1960s. For the first decade, they were mostly used by the government and large healthcare systems. By the 1980s, the software became more affordable, and adoption spread. By the 1990s, the technology could be found in most medical offices. The Internet age elevated the benefits of digital records. Today, EHRs are no longer considered a luxury; they are a medical necessity. The technology has transformed a heavily paper-based system into a paperless one – helping cut costs and improve productivity and efficiency.
The digital age of healthcare has followed three phases:
Cloud-based systems allow for continuous improvement. For example, patient data can indicate there are opportunities for improvement within a certain procedure. When that data are digitized and accessible, quality can be monitored more closely, and data can be leveraged to improve outcomes and the patient experience.
Digital tools offer numerous benefits to healthcare organizations, the greatest of which are reducing costs and improving healthcare staff productivity. Like with EHRs, digitizing antiquated processes, such as orientation, onboarding, annual mandatories, skills checkoffs, and more, provides a ripple effect – staff become happier, updates become easier, competency tracking is faster, and waste is eliminated.
For those digitizing competency management, Dossier offers:
Unlike the massive financial commitment required by an EHR migration, transitioning to digital competency management comes at a much lower price point. Plus, the return on investment for digitizing competencies begins on day one due to eliminating paper, binders, and storage and improving worker efficiency. When multiple departments use a cloud-based digital competency management platform, savings are compounded.
Many software implementation timelines can take 18 months or more because of extensive requirements gathering, systems integration challenges, security concerns, attrition – the list goes on. A cloud-based competency platform, like Dossier, takes the implementation timeline from months or years down to weeks.
There are numerous benefits of using cloud-based systems, including:
With Dossier, the resource lift on the customer side is minimized. How? A dedicated Customer Success Manager is assigned to each Dossier engagement. The CSM is responsible for helping clients onboard. All of Dossier’s CSMs have worked or are currently working as nurses in hospitals. Their experience in the field helps ensure customers’ competency plans are set up correctly from day one, and it expedites implementation and onboarding.
Having a dedicated CSM accomplishes three goals:
Hospitals and health systems typically have several learning systems that capture data about learner activities. Dossier easily connects to learning systems, adding significant value to current investments while providing visibility and reporting capabilities.
Shifting to digital drives immediate savings by eliminating paper, binders, and storage space. Add to that the time saved by improving operational efficiencies, and you can see how the return on investment begins on day one. When cloud-based systems are rolled out across multiple departments and facilities, the savings are immediately compounded.
In an age when healthcare organizations are struggling to contain revenue, delaying digitization becomes a harder argument to make. If you are curious about how much your organization could save, check out our Competency Calculator.
If you are interested in learning more, download Dossier’s Guide to Digital Competency Management.
Healthcare providers spend considerable time trying to reduce variability in how healthcare is practiced. The goal is to improve the quality of care and patient outcomes. One area of opportunity lies in competency management and shifting to digital.
The challenge: How can healthcare workers successfully reduce variability when competency management continues to be a paper-based process with significant duplication, growing waste, and opportunities for error by way of missing or incomplete documentation?
Healthcare workers are asked to raise the ‘quality’ bar but are not provided the tools they need to do so successfully.
We at Dossier know the importance of digital transformation in healthcare. We’ve experienced the benefits of electronic medical records. However, digital tools that would help healthcare workers meet, if not exceed, their competency requirements are deprioritized, which is surprising because the return on such investments is immediate.
Competency tracking is currently done on paper and housed in three-ring binders. Binders that are shoved in lockers or tote bags across facilities and taken home. This makes updates and reporting time-consuming, stressful, and error-prone – on the best days. There are countless opportunities for these critical documents to be lost, misplaced, or incomplete.
The current process for competency management is a massive resource drain. Time, money, space, and, most important, talent are all wasted. With our competency management software, you can help your facility be as organized and productive as possible.
Signs you need to go paperless:
It’s time to invest in digital tools that empower staff and enable them to work more efficiently.
It’s time to ban the binders.
“We need things to get easier” is a comment we often hear from healthcare leadership and care team members. Going digital accomplishes that and so much more. Shifting from paper to a digital competency management platform:
Going digital helps healthcare organizations and health systems improve their performance on the competency spectrum. Everyone improves when data is available in real-time and staff can immediately see when they are falling behind.
If you’re ready to see what your team could be saving by choosing Dossier’s competency management software, give our Competency Calculator a try or book a 15-minute demo to see the platform in action.
I am fortunate to meet and work with some really smart and admirable healthcare executives. I recently had the opportunity to speak with one such individual – someone I consider to be very strategic and forward-thinking. We discussed the outlook for 2023. Her priorities and outlook align very well with what we also see at Dossier and with our customers.
There is no doubt that there is a shift occurring in healthcare.
But what are we shifting to?
During the pandemic, we began speaking about ‘the new normal.’ It turned out that the new normal is everything but normal. We’re facing a shifting macro economy, global staff shortages in healthcare, budget constraints, a tripledemic (RSV, flu and COVID – at least for a while) to name just a few of our current obstacles.
How do we respond and stay agile while learning, improving and staying one step ahead?
Here are four key takeaways from our conversation that I think could be the baseline strategy for a lot of organizations over the next year. If executed properly, they can help combat soaring costs, ease resource pressures and help you better navigate the uncharted waters of the new normal.
Bring it on, 2023! We are ready!
The pandemic continues to add pressure to healthcare organizations across the U.S. From increased pricing for drugs and equipment to recruitment challenges to the great resignation, healthcare CFOs, HR and quality managers, and department directors are left wondering if there is an end in sight. Sadly, it may get worse before it gets better.
To put that into perspective, McKinsey estimates that for every 1 percent of nurses who leave direct patient care, the shortage worsens by about 30,000 nurses. The impact this will have on care delivery and the patient experience is concerning, especially when considering the aging population.
By 2030, 71 million Americans (about 20% of the U.S. population) will be 65+, a demographic known to have complex health problems, chronic illnesses, and disabilities. If things don’t change in the U.S. healthcare system, there will be more patients than nurses to care for them.
Aggressive international recruiting brings with it its own set of concerns and challenges. It’s a short-term fix to a long-term problem.
While filling the nurse pipeline is one solution, it takes three to four years to train a nurse. The U.S. would need to double the number of new graduates entering and staying in nursing every year for the next three years. The challenge is there aren’t enough nursing programs and educators to handle the influx. An analysis of graduating nurses shows the decline – dropping from an increase of 4 percent in 2019 to only 1 percent in 2020, far short of what’s needed to support our healthcare system.
And that’s just part of the healthcare crisis problem.
According to the Centers for Disease Control and Prevention, there have been more than 97 million COVID-19 cases, 1.06 million deaths, and more than 21 million hospitalizations in the U.S. This has placed an enormous strain on healthcare workers. When combined with rising costs for medications, equipment, etc., these numbers have resulted in billions in lost revenue.
More than 33% of hospitals are operating on negative margins, according to the American Hospital Association.
Many can’t get the nursing staff needed to increase surgeries and cover the budget shortfall. Typically, when there is a staffing shortage, the budget used not paying salaries can be reallocated for increased costs; however, hospitals were paying travel nurses to help address the staffing shortfall.
In 2019, hospitals spent a median of 4.7 percent of their total nurse labor expense for contract travel nurses. That number skyrocketed to 38.6 percent (median) in January 2022. Contract labor rates skyrocketed 213 percent compared to pre-pandemic levels. Medical supplies and drug expenses were up 20.6 and 36.9 percent, respectively.
When considering the financial impact these factors have had on healthcare organizations, it becomes clear that adding headcount isn’t going to fix the problem.
Digital transformation in healthcare translates to the ability to serve patients better digitally. It means adopting technologies to improve workflows, efficiency, and patient care. One area that could easily be improved involves shifting from paper-based competency management (for orientation packets, skills check-offs, and annual mandatories to name a few) to a digital competency management platform.
Only 20 percent of what staff needs to know is captured in learning management systems. The other 80 percent is competencies – knowledge, skills, judgment, and behaviors. Information that is critical to their roles, but currently captured on paper and stored in three-ring binders. This paper-based approach creates enormous waste and inefficiencies, further draining healthcare resources.
Consider the waste in paper-based competency management:
In the current paper-based competency management environment, when changes are needed, time is spent going into each individual’s plan, making changes, printing the changes, finding the staff member, finding the person’s binder, switching out the plans, putting the binder back, etc. When you multiply the time spent doing this by the number of staff members involved, the need to go digital becomes clear.
To improve patient outcomes by delivering better quality and focusing on safety, schedulers need to know and be able to track that team members have the skills, knowledge, judgment, and behaviors required for what’s expected of them. And they need that information at their fingertips – not spread across a hospital in lockers, on desks, and in storage rooms.
When plans are digital:
Paper-based competency management is a drain on healthcare organizational resources. Papers get misplaced. Plan updates are time-consuming. Staff, who are already overworked, are taking paperwork home with them to make updates – making their long workdays longer. The waste of valuable resources – time, money, and talent – contributes to the enormous burdens already felt by overworked care teams.
Modern healthcare organizations are undergoing digital transformations, the timing of which is greatly beneficial to those on the front lines of healthcare. While technology holds great promise to improve operational efficiencies, in turn improving staff satisfaction and retention, heavily manual processes need to be taken into consideration and prioritized.
Antiquated processes and systems can be viewed as a way of doing business, but in a digital age, it’s important for healthcare executives to understand where resource waste occurs. Currently, managing orientation packets, skills check-offs, and annual mandatories, for example, are paper-based, creating a drain on healthcare organization resources – paper, binders, storage space, and, most important, staff time. Updates are time-consuming and create more waste.
As healthcare organizations assess their digital needs, one area to prioritize is competency management. Digitizing competency plans means record updates can be made at the point of care – making data immediately available. Reports, either for departments or regulatory agencies, can be run in real time with just a few clicks.
While the benefits of digitizing competencies extend to healthcare executives and leadership teams, it’s the platform users who benefit the most. Here are six ways nurse educators benefit from shifting from paper-based competency management to digital.
In an age when staff shortages, especially among nurses, are on the rise, obtaining and retaining talent is critical. Onboarding becomes significantly easier for all involved when competency plans are digitized. Request a 15-minute meeting with Dossier to learn more about our cloud-based competency management software and how it can help improve your onboarding and training process.
Healthcare organization leaders are under enormous pressure to get their institutions operating in the black. Rising costs, staffing shortages, cybersecurity threats, and growing attrition rates are among their leading challenges. While faced with all this, healthcare workers must maintain an unwavering focus on the quality of care and meet the ever-changing demands of regulatory agencies. As healthcare executives invest in digital transformations to help combat some of these urgent priorities, Dossier’s competency management platform offers departments, facilities, and health systems the opportunity to modernize competency management by moving it to the cloud, which improves efficiencies, eliminates waste and strengthens job satisfaction. Our evidence-based ROI calculator demonstrates more than $1M savings for a 1,000-employee nursing department, which means more nurses seeing patients and significantly more confident staff.
Managers and directors greatly benefit from the transition to cloud-based competency management. Not only does the shift help to combat waste – no more papers, binders, or storage space, but managers and directors gain reassurance in their care teams. The training compliance is up to date and visible at any time, either for a Joint Commission survey or staffing and forecasting purposes.
Dossier digitizes competencies to help healthcare organizations better control their resources – time, money, and talent. Immediate benefits include eliminating competency plan redundancies, paper, binders, and storage space.
It sits on top of learning management systems – providing complete visibility so managers and directors can report on learner progress. In-system reminders allow managers and directors to nudge those falling behind. Having access to this level of data in real-time means leadership can ensure the right team is scheduled for every patient. Why? Because about 20% of what staff need to know is captured in the learning management system. The other 80% of what staff need to know pertains to competence – demonstrating the knowledge, judgment, behaviors and skills – for the roles they perform.
The outcome: better patient care
Along with better patient care, the benefits of digital competency management afforded to managers and directors include:
What do you like best about Dossier- Digital Competency Management?
Well, first, everything I do now is paper, and this program has taken that paper and almost fully automated it. Secondly, a dedicated team is setting up our facility/department-specific portfolio.
What do you dislike about Dossier- Digital Competency Management?
There is nothing that I dislike about this program/platform so far.
What problems is Dossier- Digital Competency Management solving and how is that benefiting you?
Dossier is giving me the ability to manage competencies in real-time and make them meaningful.
Survey Day can be stressful, and with paper-based competency management, it’s easy to understand why. The amount of time chasing people and papers is inefficient and ineffective. The margin of error is astronomical for paper-based processes, and it’s not hard to understand why. Papers get lost, shoved in bags, left in lockers, passed around, misplaced and taken home.
Learn more about our compliance audit tool.