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Table 2 Supportive supervision behavior and skill categories and linked indicators

From: Competency in supportive supervision: a study of public sector medicines management supervisors in Uganda

Behavior/skill category and definition Observation indicator checklist
Establishes purpose – Communicates the purpose and aims of SPARS and establishes it as ‘supportive supervision’. Outlines SPARS and its objectives
Outlines the objectives of the visit
Involves the in-charge
Explains the MMS are not here to police but work together as a team
Relates supervision to the bigger picture - patient/ health system/availability
Explains how SPARS will make their work more efficient in the long-term
Identifies problems – Empowers staff to identify problems as areas that need improvement, not as criticism. Discusses causes and has the facility take ownership of the problem. Follows up on problems identified at previous visit
Asks staff if they are experiencing any problems
Encourages deeper discussion - about the cause or solution to a problem’.
Encourages staff to identify facility problems
Uses performance assessment to identify problems
Prioritizes by focusing on the most important issue
Communicates effectively – Establishes rapport and acts with a considerate, sympathetic, open, and approachable manner. Is confident and competent, not arrogant or authoritative and establishes a relationship with supervisees so they look forward to and not dread MMS visits. Greets people by name
Voice audible
Jokes/lighthearted conversation
Creates a relaxed atmosphere
Clear and easy to understand
Sensitive and sympathetic
Good eye contact
Not rude, sarcastic, or arrogant
Promotes participation – Asks questions, promotes discussion, and listens. Assures that supervisees feel their opinions influence the outcome. They should own the program and not feel it is imposed from above. Acts like one of the team, not an outsider
Uses ‘we’ to discuss issues
Gets supervisees to ask questions
Asks supervisees opinion
Promotes discussion
Seeks consensus rather than instructing
Makes supervisees feel comfortable and not tense
Interprets data – Collects accurate data and correctly interprets data to assess performance. Uses performance assessment to motivate staff. Collects data for performance assessment
Explains data collection and how it relates to performance
Links data to performance, to quality of care and benefit to the community
Collects reliable data
Understands how to interpret data
Uses data to identify gaps/ problems
Encourages staff to interpret and discuss data
Solves problems – Promotes discussion and consensus so the facility owns the solution and is committed to implementing changes. The solution should be detailed and realistic. Discusses the cause of the problem
Involves supervisee - asks about their suggestions
Provides accurate and constructive advice
Suggests realistic solutions
Makes innovative and creative suggestions
Involves relevant people required to ensure the problem can be solved
Proactive—offers to follow up with decision makers
Uses tools – Uses SPARS tools and practices appropriately to ensure an objective and reliable supervision process that motivates supervisees and helps them understand priorities and expectations. Uses SPARS data collection tool, fills in the supervision book, sets targets, and fills out the spider graph to illustrate performance and achievements. Uses the data collection tool with SPARS indicators
Leaves a copy of the data collection tool at the facility
Displays the spider graph at the facility
Seeks supervisees views
Writes feedback in the supervision book
Writes targets in the supervision book
Gets the in-charge to sign the supervision book
Updates the spider graph
Uses the performance assessment as a tool to motivate supervisees
Sets targets – Jointly prioritizes realistic targets and makes implementation plan to address identified problem areas to ensure genuine commitment to improvement. Records targets in the supervisory book and follows up at next visit. Talks about targets agreed at the last visit
Sets targets to complete by next visit
Targets are specific, measurable, accurate, time bounds and realistic
Agrees on targets with staff
Sets timeframe to complete
Sets targets based on performance assessment weaknesses
Gives them tools, strategies, advice, or innovations
Educates –Allows adequate time to educate and instruct supervisee. Demonstrates, uses examples, and provides reasons to ensure the supervisee understands and can implement changes on his or her own. Is patient, clear, and persistent. Prioritizes time to build capacity (doesn’t just collect data)
Identifies gaps in skills and knowledge
Gives training when it’s needed
Physically demonstrates a task
Gives full explanations
Gives concrete, relevant examples
Ensures supervisee understands, have them demonstrate their understanding
Patiently repeats if they do not understand
Provides correct information and training
Provides constructive feedback – Conducts a formal feedback session on performance and targets with facility staff, supervisee, and In-charge at the end of the visit. Provides reasons not rules and encourages discussion to promote ownership. Gives feedback based on evidence from the performance assessment
Involves appropriate staff and in-charge in feedback if available
Praises where appropriate
Provides diplomatic, tactful, and constructive correction where appropriate
Does not only finds fault
Gives reasons rather than rules
Motivates—provides incentives for change
Doesn’t overwhelm
Assures continuity – Focuses on continuity to ensure ideas for improvement are not lost. Is mindful of facilities’ priorities and workload when scheduling. Follows up on the previous visit and sets dates for the next visit. Does not arrive unannounced
Discusses previous visit
Sets a date for the next visit
Discusses what needs to be done before the next visit
Has staff confirm what they will do before the next visit
Gives an idea what the objectives will be at the next visit