Online Competency Assessments for Mod Complex

Same.  We have discussed the possibility of putting the quiz/questions portion we do for the assessment online, then print a completed page to come do the observation with.  Not sure if we are going to do that just yet.

We use HealthStream online learning management system at our facility, it is used for education system wide.  We have courses built for each POC instrument and have policy review, quiz, and a checklist.  The checklist breaks down the 6-step competency process that the evaluator signs off on.  The employee completes their portions (reviewing policy/procedure and taking the quiz) and then the evaluator can complete the checklist after the observation is completed.  

Because I have to meet operators anyway to sign off on direct observation, I quite frankly still find paper to be the most expeditious way to accomplish mod-complex (not waived) competency assessment.  We pick days where patient caseload is expected to be low; I am already there with them to do a best practices review, the direct observation of a patient sample and QC, and we wrap up with the quiz which they hand back to me.  No reminder emails, no checking and rechecking to see whether they have completed tasks online.  As folks providing direct care, they also tend to be people that are not checking work email very often, to even see that they have a task assigned to them, or follow-up emails to remind them they are overdue.  Not to mention the time involved for the POCC creating and maintaining accounts,  or answering questions like "I can't log-in or access the page!"    Just putting this out there in case you need to give yourself permission to continue to use something that is working for you.   There's lots of push to use the latest and greatest learning module program but at the end of the day, what you're already doing might be the best use of everyone's time overall.

Thank you - I completey agree James!  Our laboratory and POC team are ourselves not considered hospital employees and as such dont have access to the programs/modules/or even reports these online modules are designed to provide,  We also have testing personnel who are contracted physicians also in the same boat - do not check hospital email accounts, dont have access to modules, etc.  It seems to be more work with putting stuff online and policing people being able to access it, and complete it than there is to just stay on paper and physically getting in front of the users to get it all done at the same time. 

I am finding our educators give a lot of pushback to make everything available online to ease their burden but they don't understand our regulations and how sticky the observation portion of it can be.  I actually have a group of Anesthesiologists who want us to make the direct obs portion available via a Zoom call  and are refusing to believe me when I tell them they can't do that as stated in the requirements because "that's how they used to do it at other facilities".  Not to mention the logisitical nightmare of being on a Zoom call with 80 physicians whenever time is convenient for them on an individual basis. 

Our assessment is a 3 part bundle in HealthStream:
1 - PowerPoint reminder module
2 - Quiz
3 - Assessment that is filled out by a qualified staff member (the first question requires them to attest that they are qualified to assess competency)

One thing that we do is deny physician access to any POCT. The anesthesiologist has an RN circulator to perform the POCT. The POCC in San Antonio (3 major hospital systems) got together and had a gathering to discuss this issue in the early 2000's after TJC changed some standards. Two of the major systems did not allow doctors' access, one did. I don't think any of them allow it now. 
 
The perfusionists/credentialed staff that have access to the ISTAT come to me. They are on paper tests. 

MY POC "experts" (a BSN with training) scan a barcode with the demonstration that shows me which comp it is "6MONTH" or "ANNUALTEST" on the instrument, which is then in the middleware. The nursing experts receive clinical ladder letters from POCC used in the Leadership portion of the documentation.   The knowledge-based test is assigned on the electronic system. This process is also followed by RT using a BS degreed RT trainer. 

Electronic learning systems have reports.  (Who did not take this? Which questions are missed most often?) HR prints transcripts from the system which are in the employee files reviewed by inspectors. The system is usually controlled by the same educational people that want POC participation.  Since the electronic system is "theirs", Educational Resources deals with "I don't have access to the site." "Why am I locked out of the meter?" questions. I get e-mails from Educational Resources. 

Another thing to think about, "Paper" is a really difficult to scale as a program grows. Paper takes FTE....which POC usually doesn't have. I have 6 hospitals with two more opening by 2025 over a 70-mile radius. Currently, I have over 700 moderately complex operators. (3500+ waived) I have one full time POC only with the rest of the POC load on lead techs in the labs.  

POC is not the same from place to place. Electronic for me is the only way to track comps. As James said, use whatever it is that works best for you......

I do a 2 part assessment for initial, 6 month, and annual for non-waived.  I have the exam online that operators complete, then it goes to a Calendly page where they sign up for the direct observation with POC.  I meet them in the department at their appointment time and they run the sample and document it accordingly (known critical) and that documentation gets tied to their initial exam so when inspection time comes around it is all in one place.  It works pretty well and I'll go through the exams and send reminders to staff who forget to do the direct observation that they need to complete it to keep their access.