This is a continuation of the previous article on “Personnel Management/Supervision III” that appeared in the July 2011 issue, which discussed compensation, benefits, and incentives. In this article, we will discuss “appraising performance” and “competency assessment” for clinical engineers and biomedical equipment technicians (BMETs).

An important aspect of the biomedical/clinical engineering manager’s job involves “performance appraisal/evaluation” and “competency assessment” of the staff, which includes BMETs and biomedical/clinical engineers. Biomedical engineering staff need to know what is expected of them, rather than the staff trying to do what they think they are supposed to be doing.

The Joint Commission human resources standard that deals with competency assessment is HR.01.06.01, and performance evaluation is HR.01.07.01.

A close connection exists between “competency assessment” and “performance evaluation.” Competency assessment lets the supervisor know whether the employee has the specific skills and the ability to use those skills, and if the employee uses the knowledge necessary to perform his/her job. In addition to focusing on an employee’s competence, performance evaluations include other expectations, such as participation in education/training offered by the hospital, carrying out job responsibilities, and time management that have been established for the employee.

Competency

HR.01.06.01 requires that the staff is competent to perform their responsibilities. It has six elements of performance (EPs). The first EP requires the hospital to define the competencies it requires of its staff who provide patient care, treatment, or services. The second EP requires the hospital to use assessment methods to determine the individual’s competence in the skills assessed. The third EP requires that an individual with the educational background, experience, or knowledge related to the skills being reviewed, such as a supervisor, assess the staff’s competence. The fourth EP requires that staff competence is initially assessed and documented as part of orientation. The fifth EP requires that staff competence is assessed and documented once every 3 years, or more frequently as required by hospital policy, or in accordance with law and regulation. The sixth EP requires the hospital to take action when a staff member’s competence does not meet expectations.

One aspect of a manager’s job involves performance appraisal and competency assessment of the staff..

Evaluation

HR.01.07.01 requires that the hospital evaluate staff performance. It has three EPs. The first EP requires the hospital to evaluate its staff based on “performance expectations,” which are established based on the job responsibilities. This requires creating a performance-appraisal document with specific goals at the beginning of the performance period. It should define minimum performance expectations and also what constitutes higher than minimum performance expectations. The performance-appraisal document should be based on the staff’s job description.

The second EP requires the hospital to evaluate staff performance once every 3 years, or more frequently as required by hospital policy, or in accordance with law and regulation. This evaluation should be documented. Typically, staff performance evaluation in hospitals is conducted every year with a midyear review.

The third EP requires that when a licensed independent practitioner brings a nonemployee individual into the hospital to provide care, treatment, and services, the hospital review the individual’s competencies and performance at the same frequency as individuals employed by the hospital.

Competency Assessment For BMETS

Below you will find some items that can be included in the competency assessment for BMETs:

  • Knowledge/skill to utilize biomedical test equipment. This would include defibrillator testers, electrosurgical analyzers, electrical safety analyzers, ECG simulators, and digital multimeters.
  • Knowledge and understanding of proper use of personal protective equipment. This includes gowns, masks, gloves, and eye protection.
  • Knowledge and skill in the repair and troubleshooting of medical equipment, such as vital signs monitors, infusion pumps, defibrillators, ECG machines, electrosurgical units, beds, nurse call systems, imaging equipment, lab equipment, and other medical devices.
  • Adherence to electrical safety practices and precautions for working with energized circuitry.
  • Adherence to infection control practices when working on medical equipment and in patient care areas.
Competency Assessment for Biomedical/Clinical Engineers

Below are some items that can be included in the competency assessment for biomedical/clinical engineers:

  • Experience in the installation of complex medical equipment and networked medical systems.
  • Knowledge of developing human resources documents (eg, job description, interview questions) relating to the hiring of biomedical/clinical engineers and BMETs.
  • Knowledge of and the ability to interpret codes and standards related to medical equipment management in health care organizations.
  • Experience with developing and managing biomedical budgets and service contracts.
Performance Appraisal

A performance appraisal has mainly three purposes:

  1. It provides a forum for communication between the supervisor and the employee,
  2. It gives the supervisor the opportunity for the supervisor to provide feedback on an employee’s performance, and
  3. It creates an environment for employee development.
Performance Appraisal for BMETS

Here are some items to include in the performance-appraisal document for BMETs:

  • Maintain a monthly PM completion rate (95% for nonlife support equipment and 100% for life support equipment) for all assigned equipment within 1 month of issue.
  • Respond immediately to all emergency repairs.
  • Respond immediately to all urgent and Class I recalls.
  • Perform and document incoming inspections on all equipment.
Performnce Appraisal for BIiomedical/Clinical Engineers

Here are some items to include in the performance-appraisal document for biomedical/clinical engineers.

  • Participate in the hospital construction projects and space planning with respect to medical technologies.
  • Review maintenance contracts to decide the best service options—outsourcing versus in-house support.
  • Review medical equipment at the hospital, and periodically perform equipment replacement planning.
  • Perform budget forecasting and maintenance cost analysis and implement operations within budget.
  • Coordinate the implementation of new medical technology, including assessing installation and site-preparation requirements, managing project time lines, and monitoring installation.
  • Develop technical specifications for new equipment purchases and evaluate technical proposals from vendors.

Arif Subhan, MS, CCE, is the chief biomedical engineer, VA Nebraska-Western Iowa Health Care System, Omaha; adjunct assistant professor, biomedical engineering, University of Connecticut; and a member of 24×7‘s editorial advisory board. The suggestions and views expressed in this article are of the author. They do not represent the views of the Department of Veterans Affairs or the University of Connecticut. For more information, contact .

REVIEW QUESTIONS
  1. The Joint Commission standards require the hospital to assess staff performance____.
    1. Every year
    2. Once every three years or as required by hospital policy
    3. Once every two years
    4. None of the above

    See the answer

  2. The Joint Commission standards require that staff competence be assessed____.
    1. At the beginning of the employment
    2. Documented as part of orientation
    3. Both a and b
    4. None of the above

    See the answer

  3. If a staff member’s competence does not meet expectations, The Joint Commission standards require the hospital____.
    1. To take action to bring the staff member’s competence to the required expectation
    2. To conduct another competency assessment in 60 days
    3. To conduct another competency assessment in 6 months
    4. None of the above

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  4. Performance appraisal has the following purposes____.
    1. A forum for communication between the supervisor and the employee
    2. It allows the supervisor to provide feedback on an employee’s performance
    3. It creates an environment for employee development
    4. All of the above

    See the answer

  5. The following are some items to include in the performance appraisal document of a BMET____.
    1. Maintain a monthly PM completion rate of 95% for nonlife support equipment
    2. Maintain a monthly PM completion rate of 100% for life support equipment
    3. Respond immediately to all emergency repairs.
    4. All of the above

    See the answer