Preface What is the Competency Companion? Why assess ...

Preface
What is the Competency Companion?
This document is a companion volume to the Technical Resource Manual for
Hospital Transfusion Services (2 nd Edition), produced by the TraQ (Transfusion
Medicine Quality Management) Program.
The Competency Companion to the Technical Resource Manual for Hospital
Transfusion Services is a quality assurance tool to help facilities ensure that staff
and supervisors are familiar with, understand, and are competent to perform the
tasks covered in the Technical Resource Manual guidelines. The Competency
Companion enables facilities to record direct observation and written evaluation
of test procedures and blood component manipulation. The Competency
Companion constitutes an essential part of a total competency assessment
package.
Why assess competency?
Quality outcomes require a quality design and consistent, standardized processes
that work the same way time after time. Procedure manuals provide the
foundation for a quality program, but manuals, on their own, are not enough.
There must be a means of ensuring that personnel responsible for performing the
procedures know what to do, know why they are doing it, and are doing it
correctly.
Training is the key to complying with standards, government regulations, and
accreditation requirements. Proper training is a prerequisite for the production of
high quality test results and safe blood products. Training in a technical college
or university instills the basic knowledge and skills needed to understand and
apply scientific principles to practice. Once staff are hired, orientation and
training programs emphasize specific organizational needs as they apply to
testing and provision of laboratory services. Traditionally, this is where current
training systems in Canada have stopped.
The next rung in the training ladder is continuing competency assessment, which
is the only way to assure that personnel have the ability to consistently perform
tasks within their job descriptions. All staff, including supervisors, should be
assessed for all knowledge, skills, and attitudes required to perform their jobs
competently.
What does competency assessment entail?
Internationally, requirements for competency documentation are cited by many
countries and organizations. ISO 9000 regulations refer to training and to the
requirement for workers to be “certified” in their skills. The European Union
Competency Companion to the Technical Resource Manual for Hospital
Transfusion Services
Introduction
Page i of iv

(EU) guide to GMP refers to continuing training. In the United States,
competency assessment is required by several agencies and regulations, including
the Clinical Laboratory Improvement Amendments of 1988 (CLIA ’88), the Food
and Drug Administration (FDA), and the Health Care Financing Administration
(HCFA).
Currently there is no regulatory requirement for competency assessment in
transfusion service laboratories in Canada. However, both CSA Standard Z902-
04 and CSTM Standards for Hospital Transfusion Services have personnel
requirements that include training, competency assessment, and records.
Facilities must identify training needs and develop training programs, including
initial and ongoing training; develop, maintain, and document formal
competency assessment programs; assess competency following training and at
regular intervals thereafter; assess effectiveness of training programs at least
annually; implement SOPs and important changes only after staff training is
complete; maintain documentation of qualifications, training, competency
assessments, continued competence; and implement remedial measures to
correct inadequate performance.
Although CSA Standards are norms of behaviour and best practice, not
regulations, Health Canada encourages health organizations to follow the
practices and procedures in the CSA Standards as they represent the current
industry standard for safety. Health Canada will use the CSA Standards as one of
several tools employed to develop new federal regulations for blood and blood
components.
The TraQ program recommends that assessment of competency be done upon the
completion of orientation, annually, and as required for performance
management of technologists who rotate or work in the transfusion medicine
area of the laboratory.
Competency programs should evaluate theoretical and practical knowledge of
procedures that include, but are not limited to:
• testing of proficiency samples;
• review of work records and/or Quality Control (QC)/Quality Assurance
(QA) records;
• written evaluation; and
• direct observation of test procedures.
How to implement the Competency Companion
Competency assessment is a process that takes large parcels of time to implement
and ongoing resources to maintain. Organizational and time management skills
are paramount in successful implementation.
Competency Companion to the Technical Resource Manual for Hospital
Transfusion Services
Introduction
Page ii of iv

The trainer should be an expert staff member with good communication and
feedback skills. This person (or persons) may be a supervisor or an experienced
technologist working in the transfusion service. Ideally he or she should have
“train the trainer” education and/or instructional skills training.
The responsibilities of the trainer and the responsibilities of the trainee are
outlined in separate sections at the start of the Competency Companion. Each
individual participating in competency assessment should have the opportunity
to read these sections.
The remainder of the Competency Companion consists of a series of checklists,
written evaluations, and answers to written evaluations that correspond to
guidelines in the Technical Resource Manual for Hospital Transfusion Services
(2 nd Edition).
The checklists provide predetermined sequences, or cascades, for direct
observation of procedures, which take into account the need for prerequisite
knowledge and competence to perform some of the more complex tasks. More
information is provided in the section on trainer responsibilities.
The written evaluations include questions dealing with theory, technique and
interpretation relevant to the guideline and are designed to be answered in
writing by the trainee. Written evaluations should be available to all
technologists to complete as time permits.
Answers to the written evaluations are also provided and referenced to the
applicable guideline whenever possible. These answers should be available to all
staff to review as required, either individually or with the trainer.
Evaluation of Success
Effective competency assessment is an objective of the TraQ program.
Parameters such as the number of repeated tests, incident reports, and error logs
would be indicators of improved performance.
We Welcome Your Feedback
The Competency Companion will be reviewed and updated regularly in
conjunction with the Technical Resource Manual. We welcome all user
suggestions for improvement. Please complete Guideline A.002 (in the Technical
Resource Manual) to submit feedback and let us know what amendments or
additions would be helpful in meeting your needs.
Competency Companion to the Technical Resource Manual for Hospital
Transfusion Services
Introduction
Page iii of iv

Contributors
This Competency Companion was produced by the British Columbia Provincial
Blood Coordinating Office under the direction of the British Columbia Ministry of
Health and Ministry Responsible for Seniors.
FIRST EDITION
Project Leader
Kathy Chambers ART
Lead Writer
Diane Krancenblum ART
The Competency Companion was developed simultaneously with the Technical
Resource Manual for Hospital Transfusion Services. It was developed and
reviewed by the Transfusion Medicine Technical Resource Group (TRG),
consisting of:
Carol Stanley, ART (Chair) | Leslie Bisgard, ART | Kathy Burnie, FCSLT
Kathy Chambers, ART | Debbie Dau, RT | Nancy Harvey, ART
Sharon Herd, ART | Heather Mah, BSc, RT | Nancy McFarlane, RT
Kathy O’Shea, BSc, MT (ASCP), SBB, ART | Willa Osis, RT | Cathy Villar, ART
Editorial assistance: Shannon Selin
Administrative assistance: Carol Griffiths
SECOND EDITION
Writing Team
Pat Letendre, BSc, RT (IH), MEd | Bev Padget ART | Maureen Patterson ART
Reviewers
Laverne Finch | Sheila de Groot, BSc, RT | Maureen Wyatt ART
Administrative assistance: Aimee Beauchamp
Waiver of Liability
The information contained in this document is intended to serve as a guideline
only. It is in no way intended to represent a provincial requirement for
transfusion medicine practice. Neither the contributing authors nor the British
Columbia Provincial Blood Coordinating Office shall be liable for any actions,
claims, damages, costs or obligations that may arise from the use or misuse of the
material contained within.
Competency Companion to the Technical Resource Manual for Hospital
Transfusion Services
Introduction
Page iv of iv