Clinical Competency Leader Course: Re-Establishing Performance Expectations

Purpose: The purpose of this initiative was to engage leaders and re-establish performance expectations related to medication administration and specimen labeling after the organization identified an increase in the number of near-miss and patient safety events (SE) in fiscal year (FY) 23. Using the electronic safety event reporting system, ambulatory care clinical quality consultants (CQC) identified that there was a 1% increase in the amount of medication and specimen errors between FY22 & FY23; this did not meet the organizational goal for FY23 (10% decrease in the number of associated SEs). Reduction of safety events has been found to be positively related to effective leadership styles. CQCs identified a need to provide education to ambulatory care clinical leaders due to the increase of events that were affecting the quality of patient care. The CQCs designed and implemented a clinical competency leader course to ensure leaders were aware of the correct processes for medication administration and specimen collection and to enhance leadership confidence.

Description: CQCs conducted a gap analysis that led to the identified need for a clinical competency leader course. Clinical competency courses have been shown to enhance awareness of safety and quality outcomes for staff. Root cause analysis (RCA) of SEs identified common themes: incorrect medication given, no order placed in the electronic medical record (EMR) for a medication, and specimen collection errors (mismatched specimen labels, incorrect site marked on label, specimen misplaced and unable to be analyzed). With data showing an increase in SEs related to these themes, CQCs created a standardized competency assessment course for ambulatory care clinical leaders. The course combined didactic and hands-on learning in the simulation lab and allowed participants to roleplay various scenarios. The course emphasized the importance of leaders setting expectations and working collaboratively with staff to identify gaps in clinical processes that lead to SEs.

Evaluation: The course has resulted in increased leader confidence and awareness of SE reporting. Additionally, the course has fostered an environment of collaboration between leaders in various clinical areas. There is predicted to be a 5% decrease in related SEs for FY24 because of this course.