Hospitals traditionally define competency in terms of credentials, academic reputation and training, but have begun to realize that poor performance is seldom due to clinical or technical inadequacies. Usually, problems contributing to bad outcomes are personal.
Disciplinary issues, poor performance and high turnover are frequently about behavior, according to Select International's report "Developing a Hospital-Wide Behavioral Competency Model — a Practical Primer," by Ted Kinney, PhD, and Bryan Warren.
Hospitals should expand their definition of "competency" to include the behavior and associated outcomes of the entire staff instead of focusing on the clinical and expert competency of their clinicians, but this means more than simply adopting new policies. According to the report, process changes must be united with a culture of focus on patient interaction, complying with procedures and regulations, attention to detail and a willingness to hold colleagues accountable for their behavior.
By creating a coordinated organization-wide competency model, hospitals can set the framework for developing operational consistency. Using such a model, employees are selected, trained, evaluated and compensated based on a consistent set of knowledge, skills, abilities and motivation their position requires for success, according to the report.
While the basic ideas of developing competencies to drive human resource functions are the same across all organizations, healthcare organizations pose extra challenges, the report said. These include the complex, often fragmented organizational structures, disparate talent and hiring approaches and a relatively new focus on patient satisfaction.
For example, hospital leaders often make "respecting patients" a core value. The competency model provides answers to questions like, what does respect for patients mean in daily actions? What behaviors show respect for patients? How are the competencies that lead to these behaviors defined? How are candidates and employees evaluated for these behavioral competencies?
To prepare for some of the challenges hospitals face when diving into the construction of a behavioral competency model, the report offers some recommendations for designing an effective model.
1. Behavioral competencies should have three parts. According to the report, each behavioral competency should have a definition, positive indicators and negative indicators. Including both positive and negative indicators is instrumental in providing feedback when evaluating an employee's strengths and developmental needs in the same competency area.
2. Less is more. According to the report, 90 percent of the time, competency analysis is over-wrought, leading to a myriad of "one-off" competencies instead of fewer, distinct and meaningful competencies.
3. Competencies should build off one another. The competency model should be designed so competencies build on each other so the behavioral expectations of the senior leaders directly support the goals and strategic plan. Hospital leaders must be responsible for defining what kind of behavior is required at every level of the organization to fulfill shared competencies.
4. Don't depend on automated competency tools. While these programs may enhance collection of competency analysis data, they often use incomplete logic and inaccurate algorithms to determine competency profiles, according to the report. Instead, competency experts should be consulted to analyze the data, determine the competency format and ensure the ideal number of meaningfully differentiated profiles is achieved.
5. Understand the big picture. Behavioral competencies can be used for hiring, promotion, career planning, development, succession management, compensation and performance management, so it is important to develop competencies with a goal in mind.