Three key considerations for implementing clinical supervision in healthcare settings

key considerations for implementing clinical supervision in healthcare settings | team supervision | Tempo Therapy and consulting

13 Mar 2024

What might be some important considerations for workplaces when seeking professional supervision for healthcare staff? What are some of the key issues to consider when implementing clinical supervision? What are the barriers? And how can organisations ensure the best return on their investment? See below to set your workplace up for successful outcomes in supervision.

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Content analysis revealed that (barriers to clinical supervision 'CS') were predominantly clustered around structural impediments (operational workload/staffing issues), CS-specific factors (lack of appropriate supervisors) and the institutional context in which CS provision was located (workplace culture, fear of judgement, management concerns).

1. Barriers to engagement in clinical supervision

Research reveals that barriers to engagement in clinical supervision for healthcare workers can be summarised under four key areas:

  • Operational and staffing needs
  • Adequately trained and skilled supervisors
  • Confusion regarding the purpose of clinical supervision for healthcare workers
  • Workplace culture

Operational and staffing needs

Lack of time, timetabling challenges, the pressure of busy work environments and high caseloads, and concerns around budget constraints are some of the key operational barriers to clinical supervision as outlined in the literature.

Adequately trained and skilled supervisors

Whilst there is growing recognition for the value of clinical supervision for healthcare teams, there is a lack of sufficiently trained and skilled supervisors. Given that group supervision is one of the most efficient modes of supervision delivery, supervisors also need to be proficient group facilitators.

Confusion regarding the purpose of clinical supervision for healthcare workers

Whilst clinical supervision is well known within the psychosocial workforce, it appears to be a poorly understood concept in healthcare organisations.

Specifically the literature identifies the following misunderstandings:

One of the major resisting forces was the lack of knowledge of clinical supervision. Staff members were also suspicious about clinical supervision being linked with line management.

The literature supports the view that line management supervision and clinical supervision need to be separate entities in order for nurses to accept and agree to clinical supervision.

Workplace culture

Tempo's Helping Professionals Interview Series highlights the often-challenging cultures that exist in healthcare organisations. An analysis of clinical supervision in medical settings confirms that organisational structures, and team and worker attitudes, can impede engagement and openness to participation in this type of support. This is exacerbated by clinicians' tendencies to put others first.

2. Creating a safe space for clinical supervision

It is clear that there is confusion regarding the content, purpose and value of clinical supervision, and that workplace politics and culture, are impacting its accessibility, engagement and participation within healthcare settings.

How can workplaces create safe spaces for clinical supervision so that staff understand its purpose, what is involved, and feel a sense of certainty and trust that it will be a safe and confidential space?

Here is a list of recommendations from the research:

  1. Educating staff about the purpose, value and content of clinical supervision.
  2. Finding and appointing "workplace champions of clinical supervision to shift workplace culture and acceptance of clinical supervision".
  3. Being creative and flexible with contracting and / or delivery of supervision to ensure availability to staff, particularly when considering the needs of shift workers.
  4. Keep line management separate from clinical supervision.
  5. Engage an external clinical supervisor and keep the location of supervision sessions separate from the work space to ensure more engagement and less interruptions.
  6. Having a clear process for contracting with supervisees / teams and establishing a clear agenda.
  7. Carefully consider the needs of your staff in relation to who participates, group size and style - open and closed groups offer different possibilities depending on the needs and availability of staff.
  8. Group size is important - optimal number of participants is between 6–8 people.
  9. Consider length of clinical supervision - research confirms that sessions lasting over an hour offered more value and effectiveness for participants.
  10. Training for both supervisees and supervisors is essential to ensure best outcomes for workers, teams, organisations and service users.

3. Considering finances and return on investment

Mental health conditions present substantial costs to organisations. However, through the successful implementation of an effective action to create a mentally healthy workplace, organisations, on average, can expect a positive return on investment (ROI) of 2.3. That is, for every dollar spent on successfully implementing an appropriate action, there is on average $2.30 in benefits to be gained by the organisation.

Taking resources of time and money out of any budget can be a tall order for any service.

However, with recent statistics confirming that 84% of healthcare workers experienced burnout in 2022, and increasingly high levels of worker distress and anticipated withdrawal from the workforce, it is imperative that the mental health of clinicians is supported in the workplace.

The cost to healthcare services due to absenteeism, presenteeism and compensation claims can be reduced by thousands if you have a mental health plan and offer effective support to staff.

See the information summarised in the infographic below:

Creating a mentally healthy workplace Return on investment analysis Report

Creating a mentally healthy workplace: return on investment analysis. Beyond Blue & PricewaterhouseCoopers Australia (2014). • Beyondblue (Organisation) PricewaterhouseCoopers Australia (PwC). (2015).

In addition to the monetary return on investment, there is increasing interest in the concept of 'Quality Improvement Return of Investment'; that is, "any value that is seen to be of importance, utility, or usefulness".

Thusini, Milenova, Nahabedian & Grey outline the health and social care value to organisations in terms of:

  • Organisational outcomes
  • Patients, family, carer, and societal outcomes
  • Staff outcomes

Clinical supervision can be an important aspect to a comprehensive plan of support for healthcare staff that delivers financial return on investment and a quality return on value that supports staff and ultimately service users.

For information on how Tempo might be able to support your staff or teams through clinical supervision, contact Minky here.

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Header image: Jason Goodman