CBPPSIT Meeting Minutes

March 3, 2000

The meeting was called to order at 10:05 A.M.

The December 7, 1999 meeting minutes were accepted as written.

Polly Walker chaired the meeting and Lynne Jett recorded the minutes.

CalNoc

The discussion on outcomes with the researchers from CalNoc, Diane Brown and Nancy Donaldson, was deferred until the April 19 meeting, to be held in Oakland at the Samuel Merritt College (directions). The meeting will convene at 9:45 to accommodate business before the discussion with CalNoc.

Task Timelines

Discussion on timelines for current tasks.

March 10 Implementation Oversight Committee (IOC) meeting

April 19 next CBPPSIT meeting in Oakland

May 1 Pilot site notification

June 1 Grant money awarded to designated organizations

June 8 CBPPSIT meeting in LA; General pilot sites announcement.

There was some discussion about the timeframe and the overall feeling that we are not ready to implement a pilot site at this time. Since there is still so much work to be done, the group expressed concerns about meeting deadlines without having a process and outcomes in place. The group decided it was necessary to assess the existence of the EII competencies in other health care agencies prior to measuring them.

Kathy Dietz, Fresno, presented the Partnership 2000 Model for the team’s review. The model is a partnership between service and education, is competency based and includes a "bridge" course from student to practitioner. This model parallels some of what is articulated in the Competency Based Practice Model.

The committee had an extensive discussion on the goal of the team project. It is unclear and it will be difficult for us to create an evaluation process for pilot sites that provides valid data.

Some questions raised by the committee include:

Are we looking at the patient outcomes related to the level of practitioner? Is the actual outcome a process for establishing congruence between the college’s Nursing programs and the health service institutions that employ the new nurse graduate? What is the role of colleges in measuring the competencies? Based on our ambiguity related to the process, we may have difficulty naming a pilot process that will give us valid outcomes.

• If we are asking for evidence that these competencies exist, what would be the involvement with CalNoc?
• Could we use their data on educational preparation in our documentation?
• Should we ask questions that target the "competent" level of nursing practice as described in the competencies?
• How can we narrow the work for the pilot sites?
• How can we work with CalNoc to collect some of the data or use some of their data around level of competency in participating sites?
• If our criterion calls for CalNoc sites, are we limiting ourselves to acute care areas only?
• If CalNoc will collect our data and we consequently award them the $12,000, is there a conflict of interest?
• Are there graduate students out there who would find this project interesting for a thesis project?

Cal-State LA Assessment Tool:

Judy shared the clinical rotation assessment tool used at Cal-State LA that demonstrated assessment of some of the competencies. She offered to share the tool with the team for use as a validation tool for pilot sites to assist with their demonstration of current practice.

IOC Objectives: (CSPCN Competencies)

A telephone conference with Karen Sechrist assisted the group to focus on the objectives of IOC. Her suggestions included focusing on two or three sites, asking if the competencies are feasible in practice. Consider it an alpha site pilot and ask the sites to demonstrate the applicability of the levels of competency to service.

Brainstorming regarding all these concerns resulted in the following points:

• This will be a descriptive study
• 2 sites will be selected--one in the North and one in the south
• They will be CalNoc sites
• We will ask the question, "Do the CSPCN competencies exist in the service setting?"
• Are nurses practicing in a role that allows them to demonstrate those competencies?
• Does the institution evaluate the nurse using those competencies?
• We will focus on a limited number of those competencies.
• There needs to be "rewards" for the participants.
• Service payoff
• Include them in the database and share our findings with them
• A CEO carrot in recognition, publication recruitment and retention, and being part of a large statewide project
• Education payoff
• If the competencies are valid then education can actually meet the needs of service
• The terminal objectives will meet the needs of service

The following conclusions were reached by consensus:

• The first phase of this project will identify if service uses a model similar to the CSPCN model and how they then validate the competencies that they identify.
• We will ask service sites to share their "levels" and their evaluation tools.
• Each member of this task force will submit service site competency and evaluation tools.
• We will look at their tools and the CSPCN model to compare and contrast the competencies. The focus will be on the nursing care provider role competencies. The goal is internal consistency of the tools. The competency level questions to be answered in the process are: Is it measured? Is it standard? Do they exist?

There are two ways to do this "comparison". Hire a researcher to do the actual process using the $12,000 to fund the expense, or select a task force from within this group to do the work and fund their expenses.

There is consensus from the group on the process. Each member of the team agreed to solicit and submit the following documents from service providers in their areas: Job Description (RN only); Performance standards; Performance evaluation criteria.

The application subgroup will create a letter explaining the project and ask for submission of the requested documents. The letter will be mailed to members of the team to assist in their solicitation of the documents. The team members will mail the documents to Arlene so she can prepare them for the next meeting.

This will be the first step to answer the final question:

• Do the CSPCN competencies exist in practice?

• Can they be measured and validated?
• Do they compare to the outcome objectives of Education?
• Can they be linked to outcome data collected by CalNoc?
• Can we say that competency levels affect patient outcomes?

Addendum From the IOC Meeting – Friday, March 10, 2000

Arlene Sargent presented the recommendation of the Pilot Site Committee to the IOC. Judy was also present to assist with the committee report. After some discussion by the IOC, it was decided to allocate $5,000 for the purpose of analyzing and comparing the job descriptions and evaluation tools with the competencies. It was suggested we consider Dana Rutledge for this purpose since she worked extensively with the competencies at the time they were prepared for publication.

Lynne Jett