CLINIC SUPERVISOR'S MANUAL - Management Sciences for Health

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iv INTRODUCTION The purpose of this manual is to provide a set of flexible, adaptable tools and guidelines to facilitate quality clinic supervision. Extensive resources are available which deal with improving supervisorsupervisee relationships. This manual does not attempt to repeat the ideas in those resources, but rather to provide concrete tools for organising and carrying out the complex and multi-faceted task of the clinic supervisor. Materials provided here have been drawn from a number of sources, all of which have been field tested to at least some degree. The ultimate aim of the manual is to support supervisors in their role of improving the quality of care in clinics. Clinic supervisors can influence the quality of care at clinic level through both their administrative roles and their technical support role to service providers in guiding the provider-client interaction by: Ensuring that the resources are in place to provide technically correct care: • adequate numbers of staff with appropriate skills • drugs, clinical supplies and equipment • procedures, guidelines, norms and standards • a maintained infrastructure Ensuring quality services from the client perspective: • services are available at adequately convenient hours with enough staff • respect from all staff and consideration for privacy and confidentiality Tools are available in this manual to address these various aspects of quality. Supervisors or teams of supervisors in different departments or organizations are encouraged to adapt the tools to meet local needs. For instance, some clinics are small and others very large, some urban and some rural. Some are visited regularly by doctors and some never, while some are supervised by provincial authorities and others by local governments or even private agencies. Experience has shown that a clear supervisory policy governing all elements of the supervisory process is vital to enable the development of quality supervision. A provincial policy on supervision will clarify important issues found to be an impediment to effective supervisory processes. We have found that such a policy is essential before regular well structured supervision of clinics can be expected. Each province must develop its own policy.
INTRODUCTION GUIDELINES FOR THE PREPARATION OF A PROVINCIAL POLICY ON CLINIC SUPERVISION Elements to consider: - Understand and clarify the structure of the clinic supervisory system - Indicate the regularity and duration of supervisory visits - Define the activities and components of a supervisory visit - Define the responsibilities of provincial and district authorities to ensure effective supervisory practises The structure of clinic supervisory system • Who takes responsibility for supervising clinic facilities? What authority do they have? How is the authority designated, delegated and accounted for? • What is the relationship of the supervisor to the district structure? Where are supervisors drawn from? What is the nature of their designation as a supervisor? The relationship, authority and responsibilities of the supervisor to other institutions and the district should be defined in writing. • How do other visiting personnel (persons from specific programs, specialists or other occasional visitors such as pharmacy, lab etc) relate to the supervisor? How are requests, comments, instructions forwarded to clinic staff by other visiting personnel (Clinic supervisor – programme manager relationship)? The regularity of supervisory visits • Ensure that clinic visits have to occur in a regularly scheduled and planned manner. This will enable optimal use of the time of the supervisor and assure that clinic personnel have adequate opportunity to interact with the supervisor and to participate in the various activities for which she is responsible. • Define the obligation and rights of the clinic staff in preparing for and receiving the visit: expectation of participation, reducing patient load during scheduled hours set aside for supervision activities like staff training etc • Indicate the duration of visits and how best this is to be done – once monthly longer visits versus more frequent but shorter visits. Frequency and duration should be defined, along with the various options allowable (eg: minimum of 4 hours in the facility per month in one or more visits) The activities and components of a supervisory visit • Understand and define the activities and components of a visit. These are guidelines attempting to specify what the activities of supervisors are and may be adapted according to needs (Annexure 1). • Time to prepare for the visit – follow up of previous visits, prepare in-service training, paperwork for visit, check with program managers to determine their inputs • Time for follow up after visit to look into resolution of problems found, contact various services on behalf of the clinic and prepare written reports • Link to activities the necessary responsibility and authority in writing to act on behalf of the clinic. A clear statement of the authority of clinic supervisors will enable the clinic supervisor to source the needed resources required in support of the clinics. v
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SECTION 6 REFERRAL SYSTEM GUIDELINE
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SECTION 9 NATIONAL NORMS AND STANDA
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SECTION 11 CLINICAL TIPS • Introd
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COUNSELLING SKILLS Why do nurses ne
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TUBERCULOSIS A thin and ill-looking
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ASTHMA What do I need to know about
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DIARRHOEA Why discuss managing acut
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HIV/AIDS: Prevention ACRONYMS FOR H
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HIV/AIDS: Prevention (cont.) � Du
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CONTRACEPTIVE SERVICES (cont.) �
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Checklist Counselling Contraceptive
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DRUG MANAGEMENT What is meant by "R
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CLINIC SUPERVISOR'S MANUAL - Management Sciences for Health

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