Employee competence and performance-based assessment - A College of American Pathologists Q-Probes study of laboratory personnel in 522 institutions

Objective.-To survey employee competence assessment practices in department s of pathology and laboratory medicine and provide suggestions for improvem ent. Design.-A 3-part study consisting of a questionnaire about current competen ce assessment practices, an evaluation of compliance with stated competence assessment practices using personnel records of 30 employees, and a writte n appraisal of competence of 5 specimen-processing staff members per instit ution. Setting.-A total of 522 institutions participating in the College of Americ an Pathologists 1996 Q-Probes program. Main Outcome Measures.-Institutional competence assessment practices, compl iance of each institution with their own practices, and determination of co mpetence of specimen-processing personnel. Results.-Of the participating institutions, 89.8% had a written competence plan and 98.1% reported reviewing employee competence at least yearly. Gene ral competence was reviewed by direct observations (87.5%), review of test or quality control results (77.4%), review of instrument preventive mainten ance (60.0%), written testing (52.2%), and/or other methods (20.8%). In 8.6 % of institutions, employees who failed competence assessment were not allo wed to continue their usual work. On review of records of 14029 employees f or adherence to the laboratory's general competence plan, adherence was 89. 7% for direct observations, 85.8% for review of quality control and test re sults, 78.0% for review of instrument records, and 74.0% for written testin g. Employee failure rate ranged from 0.9% to 6.4%, depending on the compete nce evaluated. Adherence to an institution's plan was 90.4% for new employe es, 93.1% for computer skills, 95.8% for laboratory safety, and 92.1% for c ontinuing education. When a written competence assessment was given to 2853 specimen-processing staff members, 90.0% responded satisfactorily. Conclusions.-Opportunities for improvement in employee competence assessmen t are numerous, and we provide several specific suggestions.