WVRHEP/AHEC Competencies
The Institute of Medicine (IOM) of the National Academies Report, "Quality Through Collaboration: The Future of Rural Health Care," (2004) (portions excerpted below), indicates there are five core competencies for health professionals.
These core competencies are followed in interdisciplinary learning as well as service learning projects for health profession students participating in the WVRHEP/AHEC Program as much as possible.
The five core competencies are:
- Provide Patient-Centered Care
- This competency requires knowing and respecting patients' differences, values, preferences, and expressed needs. The focus is on shared decision making and care management. Research indicates that patients involved in care decisions and management have better health outcomes, lower costs, and higher functional status than those not thus involved (Bodenheimer et al, 2002a,b' Lorig et al., 1999). This competency also incorporates a focus on population health (pp. 81-82).
- Work in Interdisciplinary Teams
- This competency involves health professionals from varied disciplines who collaborate, communicate and integrate care to ensure consistent high quality. An interdisciplinary approach is especially relevant to rural health care given the higher frequency of chronic illness in rural versus urban populations (USAC, 2004). The involvement of a range of clinicians with varying knowledge, skills and experience is particularly important to the ongoing chronic illness, and interdisiplinary team approach is important for the provision of acute care, such as when a patient in the immediate care of rural emergency medical technicians is transported to the emergency room of a rural or urban hospital (pp. 83-84).
- Employ Evidence-Based Practice
- Providing evidence-based care requires that clinicians be skilled in accessing the current knowledge base, including literature syntheses (e.g., Cochrane Collaboratives) and practice guidelines promulgated by professional organizations and other reputable sources (French, 1999; Grad et al., 2001: Rosswurm and Larrabee, 1999; Walshe and Rundall, 2001). This competency further requires that clinicians be able to integrate evidence with clinical expertise and patient values (pp. 84-85).
- Apply Quality Improvement
- All health care professionals should possess a basic knowledge of quality improvement theory and the ability to employ quality measurement and improvement tools in their practice, including measuring quality in terms of structure, process, and outcomes in relation to patient and community needs. Improving patient safety (i.e., reducing errors), for example, involves (1) developing a culture of safety in the health care system that encourages and rewards individual and organizational behavior directed at safety improvements, (2) establishing reporting and analysis systems to capture near misses and injuries and to conduct root-cause analyses to identify the factors that contributed to errors and (3) redesigning care processes to reduce the likelihood of errors occurring and mitigate harm when they do occur (IOM, 2004d) (pp. 85-87).
- Utilize Informatics
- Building an ICT infrastructure to support care delivery is critical to achieving the six quality aims. Knowledge is shared and information flows freely. Elements of and ICT infrastructure for health care include electronic health records, clinical decisions-support tools, and telehealth capabilities, with a focus on such areas as knowledge management, error reduction, and information acquisition. Such an ICT infrastructure has far-reaching implications for the way in which care is delivered and for the roles of health professionals and patients (pp. 87).