Coaching- Supportive

Supervision system in
PHC Kosovo
Revision of Gjakova checklist-TEG Advisory Group.
Hilary Adams- 5th April 2017
  Review and revise checklist developed by Gjakova
municipality
TEG group to revise and finalise checklist 6.4.17
Following
 Complete benchmarking activity using revised
Training checklist in municipalities
workshop Quality Care Coordinators +? Date?
 Complete a team ‘supportive supervision’ activity using
Agreed action a SWOT tool to feedback and joint problem-solving to
agree action plan in response to findings.
plan (April- Quality Care Coordinators and relevant heads/leads of
June 2017) speciality teams
  To review current checklists
- why do we want to complete checklist?
- what are the key areas we want to measure?
- reliable and valid- does it measure what I want?
- clear and simple to use- any duplications or gaps?
Objectives - responsive and specific enough?
- costs? Time required-staff, client? Resources?
 Make comparisons to international best practise and
‘Quality of Care study- Kosovo’ (AQH-2016)
 Develop a revised checklist to be used for pilot in
project municipalities
Not too many changes
Further revision after use
Time to complete and usefulness?
Gjakova checklist
Elements Indicators
Environment and safety Access, infrastructure/services, IP
Management Standards, supply, SM, planning, training, supervision,
Comm Plng (schools), referrals, intimacy
Customer care Health education, intimacy/privacy, MCH
communication, advising
Data Usage Usage, referrals
Technical competencies IP, K&S, follow-up
Client care Health education, follow-up
Satisfaction (staff and patients) SM, MCH approach, planning, infrastructure, Privacy,
supply, PF consultation, MCH counselling, comm
Clinical competence Documentation,
Gjakova checklist – specific checklists (=9 total)
Structure Process Outcome
Infrastructure Interviews Observations Client satisfaction
Assessment of Institution Data regarding utilisation Observation of nurses- Interviews with clients
immunisation service outside FMC

Interviews of nurses and Observing the pharmacy Client exit interviews

doctors (pharmacist)

Interview of the Observation of technical

management equipment of laboratory

Could specific checklists be ‘merged’ and simplified? More specific?

 - why complete checklist?
- what are the key areas we want to measure?
- reliable and valid- does it measure what I want?
- clear and simple to use
Infrastructure - any duplications or gaps?
- responsive and specific enough?
- costs? Time required-staff, client? Resources?
 Gjakova checklist
Assessment of institution
Clear signs, hours, services
provided
Pricelist
Mission-vision
Infrastructure
Info community health services
Health Edu- posters, videos
Waiting area- seats
Clean and in order
Electrical cables
Functioning fridges
Water and toilets
Waste management
Infection control
Stock management - pharmacy
Access programme-
Physical enviro-tools-equipment
(tool1)
(Additional to Gjakova)
Solid waste management- dustbins, Regular cleaning
equipment, trolleys
Hygiene Inventory list each room
Basic working equipment in room
including
- Stethoscope, BP cuff, BM
- Weighing scales
- ENT diagnostic
- Wheelchair?
Assessment of facility
management and administrationDisability access? patient rights?
(Tool 4)
4.2, 4.3, 4.4, 4.5, 4.6,
Quality of care study – AQH
Survey of infrastructure
Functional washing points near
toilet and in consultation rooms
Availability medical equipment
Availability advanced equipment
Tools to monitor child’s growth
Availability products and drugs
Power cuts
Contact numbers displayed
When last cleaned?
Specific? Measurable?
Length of time compete- who?
 - why complete checklist?
- what are the key areas we want to measure?
Process
- reliable and valid- does it measure what I want?
- clear and simple to use
Interviews - any duplications or gaps?
- responsive and specific enough?
- costs? Time required-staff, client? Resources?
 Gjakova checklist Access programme- Quality of
care study –
AQH
Data regarding utilisation Assessment Job expectations (tool2)
Usage family planning, ANC, MFMC (each provider)
No. referrals made / reports received Name 5 essential services at facilities
Your JD- name 4 key responsibilities
Interviews of nurses and doctors Management guidelines at facilities
Clear JD Alorgorithims displayed- eg disease/condition
prevention
Infrastructure
Monthly data reporting?
Understanding of how info used Staff motivation (Tool 5)
Training and Supervision- in last 3 months In-service training
Guidelines, standards and training Any supervisory follow-up related to training
Satisfaction level? Team work you attended?
Salary on time?
Promotion in last 3 years?
Rewarded last 3 years? (money, letter of
Could
appreciation, awarded best focus on key elements?
employer)
 Gjakova checklist - cont Access programme- cont Quality of
care study –
AQH

Interview of the management Assessment facility management and

Early detection measures- BP etc administration (Tool 4- part)
Side-effect last 6 months Health facility governing body meetings (date
List of updated daily meds (list) last, time)
School health educ and detection Conduct regular staff meetings (date last, time)
Monitoring of standards and checklists Mechanisms for referral for emergency
Infrastructure
Waiting time management When last external supervisory visit (date, time)
Client satisfaction
How address complaints?
Promotion health service
Understanding client needs
Inclusion community- meet with leaders
Satisfied with work?
Teamwork? Could focus on key elements?
Combine 3 into one for all
managers-leads/heads?
Is this relevant for this at the moment?
Monitor collecting- date of last report?
Combine with other checklists?
 - why complete checklist?
- what are the key areas we want to measure?
Process
- reliable and valid- does it measure what I want?
- clear and simple to use
Observations - any duplications or gaps?
- responsive and specific enough?
- costs? Time required-staff, client? Resources?
 Gjakova checklist
Observation of nurses-
immunisation service
Adherence to guidelines
Prep before
Follow instructions
Needle disposal
Next immunisation info
Observing the pharmacist
Infrastructure
Warm greeting
Ask about allergies
Give instructions for use
Possible side effects
Written info on package
Observation of technical
equipment of laboratory
Respect
Infection control
Needle disposal
Give information when results
Access programme- Quality of care study – AQH
Professional knowledge, skills and Clinical Observation survey -
ethics (Tool 3) observations doctors
All:
Adhere to principles of clinical history Adhere to principles of clinical
and physical examination (greets, history and physical examination
privacy, open-ended questions, - List of expectation e.g greets,
performs physical examination, medical record, concerns
investigations)
Apply infection control measures-
hands, sharp disposal, apron
Specific scenario
- DM
- HT
Scenarios- specific
- other
Follow clear assessment procedures
List expectations
Other medications being taken-
side effects
Additional: Doctors? DM or HT?
Outcome - why complete checklist?
- what are the key areas we want to measure?
Client - reliable and valid- does it measure what I want?
satisfaction / - clear and simple to use
feedback
- any duplications or gaps?
- responsive and specific enough?
- costs? Time required-staff, client? Resources?
 Gjakova checklist Access programme- Quality of care study – AQH
Interviews with clients outside Client satisfaction (Tool 6) Exit Interview Survey
FMC Satisfaction
Reason for visit Asked about your concerns
Knowledge and attitudes
Working hours acceptable? privacy
Waiting time and seat available Clear simple explanations
Friendly Opportunity to ask questions
Provide suggestions- opportunity Listen to concerns
Received advice
Infrastructure
Health education sessions
Lab test
Referral made?
Infrastructure- clean, signs, privacy
Would you recommend
Service used- specific (FP, PF,child
well-being)including information, side
effects, nutrition,
Medication prescribed available Combine- shorter?
Follow up scheduled?
Client exit interviews
Similar to above
 Who will complete?
How many?
What next? When?
Directions for use inserted on checklist?
Pilot- who?