Does clinical supervision of healthcare professionals improve quality of care? A systematic review

Mr David Snowdon1,2, Professor Sandy Leggat1, Professor Nicholas Taylor1,2

1La Trobe University, Bundoora, Australia, 2Eastern Health, Box Hill, Australia

 

Title: Does clinical supervision of healthcare professionals improve quality of care? A systematic review

Aim: To determine whether clinical supervision (CS) of health professionals improves (1) process of care, (2) patient outcomes and (3) patient experience.

Method: Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching reference lists and citation tracking. Two reviewers independently applied inclusion/exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument (MERSQI).

Results: Fifteen studies across multiple health professions (medical (n=4), nursing (n=7), allied health (n=1) and combination of nursing/medical (n=3)) met the inclusion criteria. The included studies were of high quality, with a mean MERSQI score of 12.6/18. Meta-analysis was not performed due to clinical heterogeneity of the included studies. Ten of 11 studies investigating 36,852 episodes of care found that CS improved process of care in nursing (n=5), medical (n=3) and cardiopulmonary resuscitation team professionals (n=2). Three of six studies investigating 1,474 patients found that CS of mental health professionals (n=2) and cardiopulmonary resuscitation teams (n=1) improved patient health outcomes. None of the three studies investigating 1,856 patients found that CS had an effect on patient experience.

Significance to Allied Health: CS of health professionals is associated with a significant improvement in compliance with processes that are associated with enhanced patient outcomes. There is little evidence about the direct effect of CS on patient outcomes although preliminary evidence that CS of mental health professionals is associated with an improvement in patient mental health outcomes.