Competency Assessment

[WisKnow]

Good day to you all!

It's time for the AABB/CAP/JCAHO inspections again. Can you guys share your knowledge about competency assessment requirements? Any insights into the approach of direct observation using real specimens and prepared unknown samples for blind assessment will be highly appreciated. Do you perform all testing in parallel with direct observation and prepared unknowns? Please share your templates if you have. Thanks!

 

[R1R2]

I have used both types of specimens - real and fake.   I prefer the fake (expired unit of red cells and plasma).   I can make up a lot of fake specimen and can use one for each associate.  By using a fake specimen, the answers are known and will be the same for each tech (I don't have to remember what the results should be if using a different patient sample for each tech).   All DOs are done with the fake specimen.   Results are recorded in LIS and on any worksheets.    Any instrument maintenance is included in the testing DO.   A test is included for each test system.       I am sure there are so many other ways to accomplish competency.  I have attached a CMS document that I have found very helpful. 

how-lab-personnel-competency-assessments-041316.pdf

[AMcCord]

For every test 'system', you must evaluate competency with all of the following elements:

1. Direct observation - test performance, including patient preparation, specimen handling, processing, testing, performance of instrument maintenance, function checks
2. Review recording and reporting test results, review worksheets, QC records, PT results and preventative maintenance worksheets
3. Written exercise to assess knowledge of policies and procedures, problem solving skills
4. Verbal questions which are related to the task or job performance to assess knowledge of lab and Blood Bank policies, procedures and problem solving skills
5. Survey participation - must analyze samples according to policies and procedures used for patient testing and must get the 'correct' results
6. Practical w/ wet samples to assess test performance - can use previously analyzed samples or blind samples

So, if I'm evaluating competency for the test system 'antibody detection', I would observe the tech performing an antibody screen. I can ask them to use the Echo and repeat the test manually. They would be expected to perform any necessary QC. The sample they are using could be a patient sample from normal work flow OR I could use a wet sample (blind sample)/survey sample. Using the second option covers 2 elements in one observation. In addition, while the tech is working I would ask questions about how the testing was performed, what he/she would do if a particular problem arose, instrument trouble shooting questions, what if blood is needed before the screen is finished, etc. That's 3 elements covered. Once they've finished with the sample, I can review their documentation and that would cover all or part of the 4th element, depending on what they did.

The more elements I can pack into the direct observation time, the quicker the tech is checked off. In this example, if I included questions about antibody detection - problem solving, method, etc in the written exercise, fifth element checked off. Once that person has done a survey sample, element #6 is covered.

 

Edited May 16, 2016 by AMcCord

[WisKnow]

I appreciate every reply. But my question really is, do you have to do all testing both with live specimen and prepared unknown samples? Does the regulation require that all tests be performed on both live and prepared samples in parallel?Thanks again.

[R1R2]

No it doesn't.   It also does not require you to test an example of each possible result, for example a positive weak D or positive fetal screen etc.  

Edited May 16, 2016 by R1R2

[AMcCord]

19 minutes ago, R1R2 said:

No it doesn't.   It also does not require you to test an example of each possible result, for example a positive weak D or positive fetal screen etc.  

Agree