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Facilitative * Supervision. “ a process implemented by many parties…” Together!. What is supervision?. The process of “directing and supporting staff so that they may effectively perform their duties.” 1. What is Facilitative / Supportive Supervision?.
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Facilitative* Supervision “ a process implemented by many parties…” Together!
What is supervision? The process of “directing and supporting staff so that they may effectively perform their duties.”1
What is Facilitative / Supportive Supervision? A process that promotes qualityat all health system levels by strengthening relationships, focusing on identification and resolution of problems, and helping optimize the allocation of resources.2
Supervision: essential functions Management, education, and support • Set objectives / expectations • Monitor performance / provide feedback • Ensure supplies • Address training and development needs • Solve problems jointly • Motivate and support providers to improve performance
Why supportive supervision? MAQ/ program review for RH in developing countries: Evidence from the past two decades: need to change not only the frequency, duration and structure of supervisory encounters, but also the nature and objective of supervision to make it more supportive and facilitative.2 US / UK literature review on post-graduate medical education and clinical practice: Single most important factor associated with better supervisory or performance outcomes was the quality of the supervisory relationship.3
What is Supportive Supervision? • Involves multiple parties • Leadership team • External supervisors • Facility quality improvement (SS/CQI) teams • Peers • Community committees • Focuses on the results of processes and program outcomes (data-driven) • Fosters relationships and teamwork
What is Supportive Supervision? • Facilitates a culture of communication and problem solving • Monitors individual performance against expectations
Lessons learned for using supportive supervision • Top management must be committed • Requires motivation on the part of supervisors and staff alike • Takes time and investment to establish • Should be integrated into the existing HRM system, not as a parallel system
Lessons learned • Requires simple, short, locally appropriate and tested tools • Some decision-making authority must be decentralized
References 1. Marquez, Lani and Linda Kean, “ Making Supervision Supportive and Sustainable: New Approaches Problems”, MAQ Paper no. 4, 2002; USAID. 2. Kilminster S.M. and Jolly, B.C. (2000). Effective supervision in clinical practice settings: a literature review. Medical Education, 34, 827-840. 3. Rowe K Alexander, Don de Savigny, Claudio F. Lantana, Cesar G Victora, “How can we achieve and maintain high-quality performance of health worker sin low-resource settings?” the Lancet August 9, 2005 4. D.K. McNesse-Smith, “The Influence of Manager Behavior o Nurses’ Job Satisfaction, Productivity, and Commitment,” Journal of Nursing Administration vol. 27, no. 9 (1997): 47-55. 5. Barkauskas, Violet, H. “Perspectives about and Models for Supervision in the Health Professions”, University of Michigan, nd. 6. Coles, Tom, “Evidence-based Supportive Supervision for Health Workers: a practical system for improving family planning services”, unpublished internal document, John Snow, Inc, October 2005. 7. Walsh, K. et al (2003) Development of a group0 model of clinical supervision to meet the needs of a community mental health nursing team. International Journal of Nursing Practice, 9, 33-39. 8. Loveinsohn, B.P., ET Guerrero, S.P. Gregorio, “Improving Primary Health Care through Systematic Supervision: A Controlled Field Trial,” Health Policy and Planning vol. 15, no. 3 (1984): 112-120.