For the first decade of my career, I started every shift as a registered nurse hoping to move my patient’s prognosis in the positive direction. Providing compassionate and effective patient care always took the focus. Patient safety was just part of this mix.
However, after transitioning into healthcare staffing, I relinquished patient care to the clinicians I placed. The significant variance in the skills and abilities of my applicants was shocking. Yet, the industry lacked reliable evaluation tools to help me minimize the patient risk associated with placing the wrong hire.
Finding myself in a bit of an ethical dilemma, I knew I couldn’t stay comfortable with the status quo. Over the next several years I hired Clinical Nurse Consultants to develop specialty-specific job knowledge exams. The inception of our flagship company in 2004 - NurseTesting.com - grew from this void in pre-hire assessing. I enjoyed a front row seat in watching validated clinical competency testing become the norm in healthcare hiring.
But, the evolution in pre-hire testing did not stop there. The Institute of Medicine estimated nearly 1.5 million Americans experience an adverse event due to a medication error each year, costing the health system nearly $3.5 billion in extra costs. Additionally, medication errors account for at least one patient death every day and nearly 1.3 million patient injuries each year in the U.S. alone(FDA, 2011).
We saw an opportunity to dramatically reduce these numbers by arming the industry with evidence-based assessments offering higher reliability in predicting employee success.
First we added validated math ability and perceptual ability assessments. In the time of linking quality initiatives and outcomes to reimbursement, it was imperative that healthcare professionals gained insight into understanding and performing a root cause analysis at every level when it came to preventable medication errors.
Then The Joint Commission reported that miscommunication between caregivers during report transitioning plays a role in an estimated 80 percent of serious preventable adverse events.1 This solidified the idea that the way in which clinicians communicate in health care impacts the delivery of care to patients. Possessing strong interpersonal skills is vital to the collaboration that must exist.
After conducting one of the largest and most comprehensive test validation research projects in the history of the nursing profession, we added behavioral aptitude testing and situational judgement assessments to our library while rebranding as Prophecy Healthcare. Knowing that collaboration impacts patient safety illustrates how important it is for professionals to work together using effective communication style. Individual differences will always exist within a team, however, it is critical for nurses to possess interpersonal skills that include teamwork, collaboration, and conflict resolution to function effectively as team members.
Giving healthcare facilities and staffing organizations insight into identifying how a candidate would interact with others, while illuminating a candidate’s personality characteristics, including ability to work in teams and handle different clinical environments, help ward off communication breakdowns before they impact patient safety.
So, in response to my self-posed question, yes. I have leveraged my unique vantage point to impact patient safety through pre-hire assessments, but has it been enough?
With staggering statistics still illustrating the need for advancements in patient safety, the journey is not over. This reflection has reignited my passion for innovating products impacting patient safety. I hope our next solutions further empower clinicians, the source of where safe patient care is provided, to learn how to perform at their optimal level, both clinically and collaboratively.
The Joint Commission. Center for Transforming Healthcare’s Hand-Off Communications project. Joint Commission Online. (2010a). Available at http://www.jointcommission. org/assets/1/18/jconline_Oct_ 21_10_update.pdf