Introducing QI Tools and Approaches

Whole-Site Training Approach

APPENDIX FSession C

Facilitative Supervision for Quality Improvement Curriculum

2008

Staff Have Needs for:

Facilitative supervision and management

Information, training, and development

Supplies, equipment, and infrastructure

Some Weaknesses of Conventional Training…

Training and supervision are not linked.

Trainees often cannot apply new knowledge to their work.

Follow-up is lacking.

Trainees are often selected inappropriately.

Expanded needs for training cannot be met at centralized level.

How can such situations be avoided?

When Training Is the Answer: Whole-Site Training Approach

An approach to training that:

Views a service-delivery site as a system and treats staff as members of the team that makes the system work.

Meets the learning needs of all staff at a service-delivery site.

Makes training more cost-efficient.

Whole-Site Training Approach

Types of training

Service orientations

Knowledge updates

Skills training

Locations of training

On-the-job training

On-site training

Regional or centralized training

Whole-Site Training Approach: Six Elements

Linking supervisory and training systems

Assessing a site’s learning needs and planning to meet them

Focusing on teams, not just on individuals

Tailoring the level of training to the needs of different employees

Expanding the locales where training occurs

Building sustainable capacity

Changing the Role of the Supervisor

Help identify training needs

Act as catalyst for change

Serve as trainer or identify appropriate resources

Help sites access training resources

Help sites plan training

Monitor training and results

Follow up routinely with trainees

Ensure that staff have equipment, supplies, and clients with which to apply newly acquired knowledge and skills

Assessing Site Learning Needs and Meeting Those Needs

Site staff and supervisors identify gaps in quality of care through the use of COPE or other self-assessment tools.

On-site and off-site supervisors help to identify skills and other learning needs during supervisory visits by means of medical monitoring checklists and other assessment tools.

Site staff participate in planning and organizing training, orientations, and updates.

Building Sustainable Capacity

Supervisors routinely facilitate all aspects of training.

Training follow-up becomes routine. Many staff are involved in training. Sharing of knowledge and expertise is

encouraged. Problem solving becomes part of the

performance improvement (PI) mindset. The impact of staff turnover is lessened.

Assuring Quality of Use of Whole-Site Training Approach

Well-trained supervisors—effective monitoring of training and post-training performance

Access to specialized training resources, when needed

Adequate training handbooks and evaluation tools

Type of training and training location are appropriate to learning needs

Establishment of site resource libraries

Benefits of Whole-Site Training Approach

Demystifies training

Involves everyone

Encourages mentoring

Provides a foundation for sustainability

Produces long-term benefits (change in organizational culture)

Inreach (1)

Inreach is a strategy for informing clients and staff within a facility about other services available, and for referring clients to services in other facilities, according to the clients’ needs.

“The purpose is to reduce missed opportunities for providing services to clients.”Lynam, P. F., et al. 1994. Inreach: Reaching potential family planning clients within health institutions. AVSC Working Paper No. 5. New York: AVSC International.

Inreach

Reduce missed opportunities to provide needed services to clients

Establish linkages and referrals between clinic’s departments

Provide signs and information for clients

Inreach: How?

• Signs, posters, and educational materials are made available.

• Staff from one department provide health talks for clients in other departments.

• Staff share information about key services.

• Staff are oriented about different services so they can orient clients in turn.

• Other services are promoted.

• A system for referrals between services is established.

• Integrated services are made available.