Items 1 - 11 ... The manager's role in a human resource management system, ... A manager
must have critical human resource management and human relations ...
Financial Management • •STRUCTURE • Human Resources • SUSTAINABLE DEVELOPMENT
Series 2 ORGANIZATIONAL
MANAGEMENT
• Impact • Assessment • Career Development • Strategic Planning • SYSTEMS • Supervision • Objectives • Monitoring and Evaluation • SUSTAINABILITY •
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Module
2
Human Resources Management
Human Resource Management Introduction ❐ Before you begin Recruiting and hiring staff Personnel files Personnel policies ❐ Rewards ❐ Work schedules and time sheets Compensation and benefits Leave Grievance and termination policies Staff development Motivation and staff morale Types of supervision ❐ Check your supervisory style Steps in planning and conducting effective facilitative or integrated supervision Keys to supportive supervision A word about integrated supervision Staff performance appraisal ❐ Steps in planning and implementing an appraisal system Getting the best from an appraisal interview Summary
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Table, Figures and Exercises Figure 1: Figure 2: Exercise A: Figure 3: Exercise B: Figure 4: Figure 5: Figure 6: Figure 7: Figure 8: Exercise C: Figure 9:
Model skills matrix Model time sheet Staff development opportunities Motivators, satisfiers, and the job Motivators Recommended supervision process How integrated supervision works Roles and tasks of supervisors and employees in appraisal Participatory continuum diagram (Appraisal) Employee readiness for appraisal Q&A: Do you have an effective appraisal system? Do’s and dont’s of performance appraisal
Annexes Annex Annex Annex Annex
A: B: C: D:
Staff appraisal form: Sample one Staff appraisal form: Sample two Service delivery point/quality assurance checklist Preparing a tailored supervisory checklist
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Introduction Basically, managers need three skills for effective management: human relations, conceptual, and technical skills. Human relations skills are critical for managers at all levels. They contribute to the manager’s ability to bring out the best in people. This, in turn, will help organizations achieve priority goals and objectives, since good staff performance, exploitation of potential, skills development, and positive attitudes are essential ingredients for overall organizational advancement. Human resource management requires skills in training and developing staff, motivating and bolstering staff morale, administering personnel policies, supervision, and staff appraisal. The manager’s role in a human resource management system, therefore, is to institutionalize sound policies affecting the recruitment, selection, performance, training, morale, job satisfaction, and development of all persons who report to him or her. This module will enable a manager to: h
Develop staff using on-the-job and off-the-job techniques for improved job performance. h Institute various motivating initiatives to boost staff morale, willingness to work, and job satisfaction. h Prepare and adopt personnel policies that meet staff and organizational objectives. h Establish an effective supervisory system that will assure optimal staff performance and overall program effectiveness. A manager must have critical human resource management and human relations skills to get the very best out of all staff members. A manager must be proactive in assessing staff needs and the organization’s human resource management system’s effectiveness. A manager must anticipate where and when, in the context of his or her organization, new initiatives or systems improvements may be required. At a minimum, human resources policies should be reviewed in their entirety at least once every three years. Make sure that selected policies, especially those affecting salaries and benefits, remain up-to-date, (e.g., taking into account changes in laws, increases in salary levels within comparable organizations, and new organizational policies). A good human resource management system gives a high degree of consistency, predictability, and fairness to the often difficult and dynamic interpersonal relationships affecting staff and managers. Good – and clear – human resources management policies can make a significant difference in an organization’s ability to achieve its goals and objectives or to sustain programs without undue turmoil or confusion.
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Critical human relations skills include: ˚ ˚ Effective Communication
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Group dynamics/ Team Building Appraising Staff Performance
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Motivating Subordinates
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Training and Developing Staff
Administering Personnel Matters
Elements of a good human resource management system Before You Begin... Determine your organization’s “Sensitivity Quotient” Tick if you have: ❏ Written personnel policies that have been updated within the last three years ❏ A personnel handbook ❏ Clear, detailed procedures for recruiting and hiring ❏ Staff appraisal systems ❏ Separate confidential personnel files for each employee ❏ A system of written, weekly time sheets for each employee ❏ Formal staff development mechanisms including inservice training, internships and externships, graduated increases in job responsibilities, study tours, sabbaticals, subsidized studies ❏ Clearly defined career ladders and written job descriptions ❏ Mechanisms to recognize or reward exemplary performance ❏ Procedures or systems manuals or guidelines covering key programs or activities ❏ Formal staff supervision mechanisms and systems, including mechanisms for feedback and workload review or reallocation ❏ Salary or benefit surveys or studies ❏ Clear grievance procedures that are viewed as fair and transparent ❏ A clear, current organogram that shows positions, units, levels of authority, supervisory relationships, and coordination responsibilities (see also Module 2: “Organizational Structure”)
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You can initially assess your organization’s human resources management by the number of boxes that you were able to tick. This module will help you identify and address other issues so that your management of human resources can be improved.
Recruiting and Hiring Staff Recruiting and hiring new staff is one of a manager’s most important roles. Often, new hiring occurs as a result of organizational expansion or implementation of new programs. Sometimes, hiring occurs to replace a departing employee or to address gaps resulting from normal staff attrition. A manager should institute a rigorous, fair process that draws in staff who may work with the new employee, or staff who have good instincts or judgement about the candidates’ suitability or “fit” within the organization. One way to get consistent and useful input from staff or other managers is to constitute an interview committee or panel to screen applications, “short-list” those who seem most appropriate, interview and rank short-listed candidates, and recommend the person who should be hired. Before recruitment begins, always prepare a job description for the new position, or review and update the existing one. A job description will clarify the skills, traits, and professional experience needed to carry out the job.
Tips on Recruiting... Caution and Care Are Called For
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☛ Prepare or revise an appropriate job description ☛ Make sure you advertise the position inside the organization, and in wellread or effective local media. Clearly describe duties, terms and conditions, and skills or experience required. ☛ Develop selection criteria related to the job description. ☛ Convene an internal panel. Let the panel review all applications against the selection criteria and prepare a short list (usually 3-5 candidates) of those who should be invited for an interview. Send a formal letter of inviting short-listed candidates for an interview. The letter should clearly state the time and place for the interviews, and whether candidates should bring additional materials (e.g., writing samples). The interview panel should use a scoring sheet or format to ensure consistency. A model is found in Annex B. References of the top two candidates should be checked by the manager to ensure confidentiality. Further interviews with the most likely applicant may also be needed. Send a letter to confirm the appointment and the first day of work. It should also include the salary, terms and conditions, job description, an employee handbook, and an organogram (if available.)
Personnel Files Each organization should have confidential personnel files for each full-time and permanent part-time employee. These files should be managed by the Personnel Administrator, Administrative Officer, or, as is the case with smaller organizations, the Finance and Administration Officer. At a minimum, personnel files should contain; h h h h h h h
Letters of appointment A job description Salary records Records for annual, sick, or other leave Records covering employee benefits, including insurance Letters of commendation Records covering statutory deductions (e.g., national pension schemes, taxes, national medical insurance, etc.) h Deductions from pay or standing orders requested by the employee h Letters of warning or reprimand h Letters of resignation or termination Sometimes, personnel files also include time sheets for a quarter or the year in question. Generally, travel expense reports or other forms filled out by the employee are filed separately by subject. Personnel files must be kept strictly up-to-date and confidential. This generally means that they are kept in a safe place under lock and key with restricted access. No employee should see the records of another unless s/he is authorized (e.g., the person who prepares payroll). Usually, national laws govern how long personnel records must be retained after an employee has left the organization. It is prudent to obtain written permission from an employee before disclosing any personnel matters relating to him or her to outsiders.
Skills Matrix Since staff members are an important organizational resource, it is useful take a survey of employees (usually once every 2-3 years) to determine the kinds and levels of skills that they have. This can be very pertinent information when managers or supervisors are: h Making decisions about staff deployment for new or special initiatives h Organizing training or staff development activities to bolster skills h Seeking resource persons to assist with training or technical assistance within the
organization or with partners or communities h Assessing gaps in skills and knowledge within the organization that must be bridged.
Figure 1 shows a model skills matrix. It can be distributed to staff to fill out after a discussion of the uses of a skills matrix at a staff meeting. Results of the skills matrix exercise can serve as the basis of a personnel data bank. Staff should be cautioned to be honest about their levels and kinds of skills in completing a skills matrix. No points are given for ticking the most boxes! It is not a competition among staff to see who can ‘demonstrate’ the most extensive experience base. Managers and supervisors may have to ‘revise’ some of the information
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General categories Financial management Institutional development Quality of care Adolescent health Research and evaluation MIS Training IEC Clinical services CBD Integration
Task oriented skills Training Training strategy development Curriculum development TOT (specify type of trainers) Protocol/guidelines development Training materials development Management of training
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Systems MIS development Management systems development (including supervision) Financial management systems dev. Logistic system development IEC IEC strategy development IEC materials development IEC campaign planning Services Service delivery materials dev. FP clinical skills development Contraceptive tech. update training Infection prevention skills development CBD procedures guidelines devel. Counselling dev. (specify type) Program development Needs assessment Proposal development Project/program budgets devel. GFR analysis Research and evaluation Research proposal development Catchment area survey Project/program evaluation Data analysis and report writing Cost-effectiveness analysis
Institutional development Institutional dev. assessment Strategic planning Income gen./fundraising planning Sustainability planning
Level of skill
Years Expr.
Name
Years Expr.
Level of skill
Name
Years Expr.
Level of skill (High, Med./Low)
Areas of expertise/experience
Name
Figure 1. Model skills matrix
provided by staff based on their own (i.e., the managers’) assessment of the staff persons’ skills and abilities.
Personnel policies Clear personnel policies guide both managers and staff. Personnel policies cover an array of issues affecting job requirements, tenure, entitlements or rights, rules and regulations affecting staff, and other matters. They are usually articulated in standard operating procedure manuals, staff handbooks, or operational manuals. They outline an organization’s policy and administration, salary, compensation and benefits, working conditions, staff development approaches, grievance procedures, paid leave, retirement, promotions, job classifications, privileges and a host of other issues. Written policies ensure clarity or common understanding, facilitate optimal worker productivity, and foster job satisfaction. Managers should therefore invest in establishing and enforcing compliance with appropriate and effective personnel policies. Organizations should conduct thorough orientations for all incoming staff. At a maximum, an orientation should cover: all personnel policies; responsibilities, tasks, and elements of the job description; and reporting, supervisory, or coordination and communication lines. A more complete — and preferable — orientation should include: exposure to field work and collaborating agencies or partners; visits to communities covered by programs or activities; and structured interactions with colleagues to complete a project or work product. Organizations should also determine a reasonable timeframe for probation before an incoming employee is confirmed. This period allows managers and supervisors to monitor a new staff person’s performance, demeanor, and “fit” with the tasks he or she has been hired to undertake. Confirmation must always be in the form of a letter.
Remember... Key personnel policies generally include ¨ ¨ ¨ ¨ ¨ ¨ ¨ ¨
Staff appraisal policies Career ladders Reward policies Work schedules Compensation and time sheets Leave Grievance and termination Disciplinary procedures
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Rewards Staff performance should determine whether and what kinds of rewards are given. They can be monetary, (e.g., salary increments and bonuses) or non-monetary, (e.g., public acknowledgement of a task well done). Recognition is an important incentive to spur continued good performance. Organizations should establish and follow written guidelines governing such awards and the basis on which they are given should be clearly spelled out.
Work schedules and time sheets Work schedules and time sheets are complementary components for planning, reporting on, and monitoring work by individual employees. Every organization should introduce and require time sheets from each full-time or regular part-time employee. Time sheets allow supervisors to monitor levels of effort, work load, and individual staff contribution. Time sheets are also used to allocate (and predict) program, activity, or organizational costs.
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Figure 2 is a simple time sheet that can be adapted for use by most organizations. It shows time spent each working day of the week and has a column that can be used to record overtime or – if desired – specific program or activities codes that can be used to segregate costs. For example, if a staff member is working on several programs or activities, he or she may be asked to indicate how many hours were spent on each activity daily. If codes are to be used, a uniform coding system should be introduced and tied into accounting or financial management systems. Time sheets should also be signed by the staff member and the supervisor each week. Time sheets are usually filed in individual files by employee or in a common timesheet file covering all employees by quarter. Work schedules, or work plans, are covered in greater deal in Series II: Module 1. In preparing work schedules, the following questions should be considered: h h h h
What is to be done? Where will the activity take place? When will it take place? Who will perform the task?
Individuals should prepare weekly, monthly, or quartely schedules depending upon their organizations’ planning cycle. Usually, individual schedules relate to a unit, departmental, or organization-wide work plan. That is, the individual schedule must relate to plans and targets of the entire program or organization if goals and objectives are to be achieved. Managers and supervisors should use work schedules and time sheets to determine and monitor levels of effort, allocate work load, and assess performance. For further details refer to Series II Module 1 “Workplans”.
Figure 2. Model Time Sheet Location/Unit Name Title
Period covered (week starts with Sunday’s date)
Sun
Mon
Tues
Wed
Thurs
Frid
Sat
Total
Time in Time out Time in Time out Total #Hrs. Special codes/overtime
Total hrs worked Employee’s Signature
Supervisor’s Signature
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Compensation and benefits In order to motivate clear provisions outlining compensation and benefits should be built into a personnel policy. These may include salary ranges, time in service before leave, bonuses, raises, house and transport allowances, personal medical or life insurance policies, subsidiary training, etc. Wherever feasible, an organization is advised to establish salary “bands” or ranges and grades so that staff know what they will be paid when they attain a certain job level. These ranges must be periodically reviewed and adapted so that compensation remains competitive with other comparable organizations. The best way to do this is to conduct a salary survey by asking comparable organizations about their compensation policies.
Leave Periodic absence from work for recuperation improves staff performance. Staff should be encouraged to take leave as specified in personnel policies. There are several types of leave that are routinely provided for staff. In most countries, national labor laws or policies affect an organization’s leave policies (e.g., maternity or sick leave). Leave for each staff member should be routinely monitored. If possible, staff should receive periodic statements on the amount of leave they have taken, and the amount that remains for the year. Remember that annual leave is like money. Usually, an organization must pay departing employees for all unused annual leave they have accumulated prior to their departure; unused sick leave is almost never paid to an employee. Therefore, keeping accurate count of vacation or leave is in an organization’s — and a staff person’s — best interest.
Type of leave
Usual duration
Casual leave Annual leave
3 – 5 days 14 – 30 working days depending on staff seniority 2 – 3 months (or 60 to 90 working days) Not more than 1 year Usually earned at the rate of 1/2 or 1 day per period cummulated (Duration as supported by doctor’s report)
Maternity leave Study leave Sick leave
Grievance and termination policies A grievance policy is standard in most organizations. It is usually outlined in the conditions of service for employees and describes the formal procedure through which employees’ complaints are submitted, processed, and resolved. (See Series I, Module 3 on “Conflict Management”).
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A termination policy, also standard, usually describes the grounds for employee dismissal and employee rights when this occurs. Occasionally, problematic situations call for a fair hearing and an appropriate review and decision-making process. Employees generally have the right to avail themselves of these processes. Some organizations establish disciplinary committees or other standing “bodies” to hear all matters requiring disciplinary action or employee grievances before final termination. Whatever method is chosen (i.e., individual, supervisors’ review up the hierarchical chain, or a committee), this is an area where rights and procedures (for staff, supervisors and the organization) must be carefully and precisely detailed. Legal advice or review in establishing such procedures is useful.
Staff development Staff members are an organization’s most valuable resource. Managers should invest in staff by continually providing opportunities for them to improve their skills and acquire new ones. For a manager, a pivotal role to develop the people who work with or in key programs and activities. Staff development and manager-staff interactions touch on all five basic operations in a manager’s work (see next page). After staff roles and responsibilities and placement within the structure are clarified, staff development focuses on training for specific skills or knowledge of procedures needed for good job performance. It essential to make personal and career growth opportunities available so that employees feel that they are bettering themselves and becoming more productive members of the organization. Training or skills building can be both formal — for example, in-service training — or informal, such as on-the-job training.
Food for Thought... There are 5 basic operations in the work of a manager:
1st A manager sets goals and objectives. 2nd A manager organizes. 3rd A manager motivates and communicates. 4th A manager measures by establishing yardsticks or benchmarks of individual or organizational performance. 5th A manager develops people, including herself or himself.
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There are several good reasons why staff should be trained and developed, including: ¨ ¨ ¨ ¨
Enlarged pool of skilled staff at all levels of the organization Improved individual job performance with resulting improvements in overall organizational effectiveness Improved service to customer/clients Increased staff motivation
Exercise: Identifying Staff Development Opportunities A good exercise for you and your staff is to identify potential staff development opportunities. Using the format below, list potential staff development initiatives or activities, and the action
steps that must be taken to institutionalize them. Then, determine what existing policies are implicated, who should take the lead, what resources are needed, and what time frame is realistic for implementation. This exercise may result in very useful communication: you as a manager will gain a deeper appreciation of staff aspirations, and staff will perhaps better understand some of the organization’s limitations and constraints that affect or limit staff development initiatives.
Exercise...
The exercise above lists various methods managers can use to develop staff. Which of these or what others, are appropriate to my organization?
How many opportunities for staff development can I think of?
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Here are some ideas [tick as appropriate]: ❏ ❏ ❏ ❏ ❏ ❏ ❏ ❏ ❏ ❏
Refresher training, workshops, and seminars Specialized training to meet new challenges Increased or structured participation in decision-making for areas affecting the staff person’s job Study tours Internships or exchanges with collaborating agencies, NGOs, educational institutions Job rotation programs that enable staff to learn the jobs of others. Providing materials for self-study On-the-job training sessions or updates Implementing concrete career paths or programs Leadership of special initiatives or projects
Here are some other ideas that are relevant to my organization (fill in the blanks) • • • When initiating some of these staff development activities, here are some planning issues a good manager must consider. Use the format below to guide your thinking, planning, and implementation.
Staff development opportunities/ action steps (place in priority order as appropriate or feasible in your organization)
Organizational Persons policies responsible/ affected persons to be consulted
Resources needed
Time frame for completion
Opportunity A: Key Action Steps: 1. 2. 3. 4. 5. Opportunity B: Key Action Steps: 1. 2. 3. 4. 5. Opportunity C: Key Action Steps: 1. 2. 3. 4. 5. Opportunity D: Key Action Steps: 1. 2. 3. 4. 5.
Motivation and staff morale The best thing that can happen to a manager is to have a highly motivated staff. Motivation refers to feelings that affect behavior. It is something within us that impels us to action. It may be a need, an idea, a belief, a shared vision, an emotion, or an organic state. Because all human beings need encouragement, feedback, and stimulus, motivation actually affects the way we perform and our level of comfort within the organization. Different people are motivated by different factors. The chance to tackle new types of work, scope to use own initiative without close supervision, encouragement and recognition for work well done, and opportunity to take responsibility are factors described as motivators or “growth” factors. These give a worker a sense of personal accomplishment through the content of the job and the organizational dynamics of completing new tasks.
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Organization policy and administration, supervision, working conditions, interpersonal relations and salary are described by theorists as “hygiene” or “satisfiers (which lend to maintaining the employer-employee relationship ” factors. These factors rarely motivate workers by themselves, but when they are in a healthy state, they create satisfaction; when they are unhealthy, they turn into dissatisfaction. They are environmental factors that surround the job but are not inherent to it. Figure 3 shows the relationship between motivators, satisfiers, and the job.
Some tips on motivating and enhancing staff morale
¨ Concentrate heavily on motivators or ¨ ¨ ¨ ¨
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¨ ¨
¨
growth factors for staff motivation. Provide adequate incentives to ensure optimum productivity. Recognize individual abilities and interests. Recognize cultural and perceptual differences. Provide regular opportunities for advancement, training, and development. Give praise and appreciation often and publicly where possible. Provide opportunities to staff in proportion to their performance and ability. Give financial and non-financial rewards commensurate with good performance.
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Figure 3: Jobs, motivators, and satisfiers
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Exercise
Motivators During a staff meeting, use this format to access what really “motivates” your staff. Staff responses might give you clues about the best, or most effective, initiatives you could undertake to increase staff motivation and interest.
Ranking Those Things Which Motivate Us... Indicate with a tick the ranking of what motivates you as an employee. Chosing “1” means that the issue is a significant motivator. Number 10 means the motivator is the least important. You can add your own “motivators” if you like.
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ISSUE a. b. c. d. e. f. g. h. i. j. k. l. m. n. o.
1
2
3
4
5
6
7
8
9
10
Good relations with colleagues / team spirit Job security Good relations with supervisors Chance to tackle new types of work Shared vision or goals Financial rewards or bonuses Non-monetary recognition or encouragement Training opportunities Ability to take initiative without close supervision Clear roles and responsibilities Upward mobility / career ladder
After tallying the responses, give feedback to your staff about the issues that seemed to be the most or important motivators. Do staff answers influence or change your planning priorities in any way?
Types of supervision Supervision can be technical, administrative and interpersonal. Increasingly, managers understand that supervision must be facilitative, not punitive. Technical supervision requires supervision of a given task, observing whether the set procedures are being followed and expected standards are being met. The supervisor should be technically competent and should make use of available procedures, standard manuals and protocols, which the workers are aware of and use during their normal daily work. Administrative supervision (which is akin to program supervision) generally entails monitoring the progress made in implementation of activities and utilization of resources. Timeliness and compliance with rules are also considered. Interpersonal supervision examines the relationships between supervisees and their peers, subordinates, bosses and even customers/clients. It focuses on specific behavioral aspects, such as the attitude, motivation, team spirit and conflict resolution and management. A supervisor’s effectiveness can be further enhanced if supervisory styles are skillfully varied from time to time in response to different situations or staff needs. As organizations reduce vertical programs and integrate services, more managers are establishing team-based or integrated supervision. This module section focuses on supervision, a vital component of human resources management. All managers at every level and in all parts of an organization have supervisory roles and functions to perform. A manager’s level usually will indicate the kinds of human resource management functions for which he or she is responsible.
Supervisor • Monitors program or facilities staff performance • Enforces standards of practice, protocols, guidelines • Solves immediate staff problems • Provides on-the-spot TA or training • Oversees distribution of supplies
Middle Manager • Plans and manages programs • Directs staff • Monitors budgets • Orders and allocates supplies or conducts respurces • First line appraisals
Top-level Manager • Articulates and facilitates development of consensus on long-term strategic vision • Sets policy • Facilitates development of long-term program plans • Seeks, acquires, and distributes funds and resources • Selects, hires, and posts higher-level staff • Serves as liaison with organization’s governing structure(s)
A supervisor’s main function is to help workers perform their duties at the highest possible level. Guidance, support and staff development should be provided by a supervisor for the purpose of improving performance of the staff and the entire organization. Supervisors are not perfect! A supervisor may not always understand how his or her contacts can affect subordinates. Supervisory conduct or attitudes may fall under 3 broad categories.
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AUTOCRATIC – The supervisor expects the supervisee to do what he or she (the supervisor) wants. The supervisor acts as “Mr or Ms Know-It- All” and is rude and harsh. The supervisee’s views are usually ignored.
LAISSEZ-FAIRE – The supervisor gives no direction at all to supervisees and completely abandons supervisor roles.
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PARTICIPATIVE or DEMOCRATIC – The supervisor consults with supervisees before judgements and decisions that affect the employees’ work are made. The supervisor molds a team in which all views and contributions are valued.
Bright ideas... Check your own supervisory “style”... Do You:
Yes
No
Some times
Unsure
1. Set individual performance objectives with an employee so that he or she knows what is expected? 2. Have regular contacts with staff through meetings and structured supervisory sessions? 3. Prepare written supervisory session plans and/or schedules? 4. Provide systematic feedback that is designed to help staff solve problems or improve performance, or to give guidance, assistance and support? 5. Periodica;;y review staff job descriptions, assignments, and workload? 6. Praise staff publicly or in writing? 7. Conduct informal discussions or brainstorming sessions to obtain staff views? 8. Give staff an opportunity to critique you or other managers or overall organizational performance? 9. Give clear, written instructions, assignments, or deadlines? 10.Review staff records and work place conditions? 11.Delegate responsibility appropriately? 12.Correct or criticize employees in the presence of others? 13.React negatively to staff members’ ideas? 14.Discuss one staff members short-comings, problems, or attitudes with another? 15.Insist on knowing every detail about each activity?
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Do You:
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No Sometimes Unsure
16.Restrict contacts among staff members or between staff and board members? 17.Insist on performing multiple jobs or functions even when they are the responsibility of specific staff members? 18.Review and give feedback on written reports, documents, presentations, or program proposals? 19.Monitor and ensure availability of adequate equipment, materials, and supplies? 20.Limit networking or representational activities to yourself or a very few senior managers?
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If you have been honest in your self-assessment, the results will probably be an eye opener. You will likely detect some areas that warrant attention or improvement. However, to provide some “guidance” in interpreting the results, if you answered “yes” to Items 1-11 and 18-19, you are probably a democratic or participative supervisor. If you answered “no” to 1-11, but yes to most of 12-17 and 20, you are probably more autocratic. If you answered “sometimes” or “unclear” to most of the questions, you are probably a laissez faire supervisor who should sharpen your supervisory skills and focus.
Steps in planning and conducting effective facilitative or integrated supervision STEP I Prepare or review the organization’s projects or broad supervision plan. The plan should include statements of: ❏ ❏ ❏ ❏
Levels at which supervision will be done Who will be supervising whom and how often (frequency) Purpose of supervision at each level Broad aspects of performance of workers to be supervised.
The manager should make use of the most current organizational chart in clarifying staff levels, reporting relationships, tasks or job elements, and coordination responsibilities.
STEP II
Prepare a supervision schedule or plan. A supervision plan of three to six month duration is recommended. The plan is a timetable for supervision and includes dates, times, place or people involved and aspects of the work to be supervised during supervision meeting. This plan also allows a supervisor to give advance notice of the meeting to the staff.
The 6-month supervisory plan1 Health unit (Area)
April
May
June
July
August
September
Namisambya
Thurs 5
Fri 11
Wed 13
Fri 10
FLE
RH
FLE
Wed 4 FLE Mon 23 VHW
Fri 14 RH Fri 28 HCM
Wed 11
Thur 10
Wed 6
Fri 13
RH
FLE
RH
VHW
Kisozi
Fri 13 RH
Wed 9 FLE
Fri 8 RH
Thurs 26 FLE
Wed 22 FLE
Thurs 20 RH
Bugulumbya
Thurs 19 RH
Fri 18 FLE
Thurs 21 RH
Wed 4 FLE
Thurs 16 FLE
Wed 12 RH
Naminage
RH Wed 8 RH Tue 30 HCM
Wed 26 FLE
Key to activity code RH Curative FLE Family Life Education HCM Health Committe Meeting IMM Immunization VHW Village Health Workers
STEP III
Plan for supervisory sessions. ❏ ❏ ❏ ❏
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Review previous report of supervisee or facility staff. Review your (or the supervisor’s) last supervision visit report. Review job description(s) of the supervisee or staff. Make decisions on areas to strengthen during the visit such as problem areas to address, local targets, duties as per job description, procedures to follow in technical performance and logistic support needed. The supervisor should develop or use a checklist for these items. A model checklist for clinical integrated health service delivery is found in Annex C. Some tips on preparing checklists, whether for health or programs in other sectors, are found in Annex D. These checklists are for very comprehensive (usually annual) reviews. For spot checksor supervisory visits focused on identified or recurring problems or performance deficiencies, a summary or shorter checklists highlighting selected areas should be used.
Adapted from CAFS: Family Planning Programme Management, Module x, p.55
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STEP IV Select appropriate techniques and tools for your supervision. Ability to applying and using the techniques and tools appropriately will determine the supervisor’s effectiveness. Some examples of supervisory tools (instruments) and techniques that managers/ supervisors may use include:
TOOLS ❏ ❏ ❏ ❏ ❏ ❏ ❏ ❏ ❏ ❏
Job descriptions Checklists Policy manuals Procedure manuals Registers and records Reports Charts and graphs Workplans and schedules Guidelines for supervision Duty rosters
TECHNIQUES ❏ Supervisory/observation visits ❏ Interviews ❏ Meetings for specific purposes (e.g. problem-solving) ❏ Feedback ❏ Setting targets with supervisees ❏ Following up issues and problems ❏ Rapidly responding to requests for assistance
STEP V
Conduct supervision 22
A supervisory visit includes... ¨ ¨ ¨ ¨ ¨ ¨ ¨ ¨ ¨ ¨ ¨
Collecting information Identifying problems Providing encouragement Sharing technical information Assessing work conditions Finding possible solutions to identified problems Conducting OJT for staff Providing technical assistance Giving tips for improving performance Following-up from previous visits Providing feedback
When on-site... ¨ Review plan or objectives of visit during meetings with staff ¨ Explain how visit will be conducted [e.g., observation, individual meetings, ¨ ¨ ¨ ¨ ¨ ¨ ¨
informal training, Q & A sessions] Review observations and recommendations of last visit with staff Observe day-to-day activities [clinical/field, management, personnel] See how program areas interact Take note of client treatment and views Provide spot TA when feasible or appropriate Record issues or problems observed Note problems with equipment, supplies, commodities, drugs, space utilization systems compliance
Note Activity Areas... For most NGOs providing reproductive or other health services, there are three major activity areas— management, clinical and community-based. All personnel must also be supported in at least three ways. Elements include: CLINICAL ¨ Service provision and screening ¨ Counseling/IEC ¨ Client follow-up/Referral MANAGEMENT ¨ Activity planning ¨ Clinic organization ¨ Client management ¨ Resource management ¨ Supplies management ¨ Information management COMMUNITY-BASED ¨ Outreach and sensitization ¨ Distribution of supplies/accurate information ¨ Referral and follow-up PERSONNEL ¨ Staff motivation ¨ Professional development ¨ Conflict resolution For NGOs managing other activities (e.g. development, research, democratization, education, women’s empowerment, environment, conservation, etc.), the “clinical” activities will be replaced by those reflecting your organization’s primary focus. For example, in democratization, one might observe materials development, community outreach, civic education seminars, and liaison with local officials or community action groups. ¨ Supervision may be very frequent (for supervisors and supervisees working in
the same office/location) and less frequent (monthly, quarterly or half yearly) when supervisors and supervisees are separated by geography or distance. ¨ Supervisors or mangers at higher levels should occasionally visit in field to support field staff. ¨ Sometimes “group” or “team” supervision (in which a group provides supervision or more than one staff person is supervised simultaneously as in a facility review) reduces costs. Before leaving the site, conduct a problem-solving team meeting ¨ Discuss strengths and weaknesses ¨ Formulate short- and long-term solutions, and identify resources needed ¨ Give and get clear feedback ¨ Determine follow-up activities ¨ Set appropriate time for next visit ¨ Supervisors at all levels of the organization should produce periodic reports for their next level supervisors regarding activities that should be implemented over a specified period. Supervisors should provide feedback to supervisees on what they are doing well, where they need to improve, and how they can improve. The reports should also outline how the supervisor will contribute to these efforts.
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Keys to supportive supervision ❏ Be prepared! Give thought to what you wish to observe, accomplish, address, or correct. ❏ Review previous records and reports! Let your supervision build upon findings and recommendations from preceding visits. Ask yourself: “How much improvement has been evident? Are set goals and targets being met? How do clients feel about the services? What issues remain? What is the most feasible way to solve identified problems? ❏ Be thorough and professional during your visit! Try to cover all areas or, if this is a focussed supervisory visit, cover all aspects of the area to be supervised. Be methodical and use a written supervisory session plan that lists all the issues. Record your observations and findings and share these with the team before you leave. Follow up your visit with a written document – a letter, report, or format. ❏ Keep an eye on common or recurring problems and try to identify their causes! Is training needed? Can you give TA on the spot to correct a problem? Is the problem systemic or short-term? What resources are needed to resolve the problem or increase skills and efficiency? ❏ Use supervision as a motivating rather than punitive exercise! Look for ways of encouraging staff. Engage in joint problem solving with them. Ask for and listen carefully to their proposals and recommendations. They may have the best ideas.
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Figure 4 provides a schematic diagram showing the major tasks or steps recommended to reinforce supervision and make it more effective for the supervisor and staff. A good supervisor transforms these steps into an informal “checklist”, ensuring that s/he completes each step before, during, and after each supervisory visit.
Remember... If you want to be a good supervisor, try to show these additional qualities within yourself! ☛ ☛ ☛ ☛ ☛ ☛ ☛ ☛ ☛ ☛ ☛
Sincerely want to do your job. Create a record of success. Demonstrate the ability to grow. Be able to fit in your organization. Acquire management and supervisory skills training. Know exactly what is expected of you. Take initiative. Use the authority and trust given to function effectively. Show leadership qualities. Be open to constructive suggestions from any source. Acquire enough technical knowledge to protect you from making major mistakes.
▲
Review documentation
Prepare session plan
Prepare for visit
Figure 4
Personnel Issues
Assign responsibility for specific tasks
Make plan for implementating solutions
Analyze problems and solutions
Present results from supervision
Hold team problem-solving
Review individual performance issues
Streamline implementation plan
Debrief with clinic manager
Adapted from Miller, Janice and Wolff, James A., Editors. Management Strategies for Improving Family Planning Services: The Family Planning Manager Compendium. Page 363
2
Discuss plan for supervising selected activities
Discuss recommendation(s) from previous visit
Management Activities
Clinical/ community-based Activities
Review agenda (goals and objectives of visit)
Explain process for supervisory visit
Supervise activity areas
Meet with clinic manager
Recommended supervision process2
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▲
Prepare and communicate follow-up plan
Prepare report
Report on, provide follow-up
A Word About Integrated Supervision Pathfinder has pioneered a new supervisory technique that may reinforce an organization’s supervision of staff, programs, and services. Integrated supervision is an approach to supervision intended to continuously improve the quality of services delivered to clients by strengthening management at all levels of health care provision (See Figure 5). Integrated supervision is based on concepts of teamwork, empowerment, and accountability, whereby staff, individually or as a group, have the responsibility and the ability to make decisions about program, client or customer care, and facility management. Supervision becomes part of the daily, regular function of the facility or project site rather than simply an isolated event. As such, integrated supervision can only be implemented at sites or networks where there is management commitment to inaugurating this kind of change and an organizational commitment to the values of personal accountability, employee empowerment, and teamwork. Integrated supervision is linked to provider performance improvement (PPI), and is often a corollary to an organization’s effort to strengthen supervision or implement continuous quality improvement (CQI). Figure 5: How integrated supervision works Integrated Supervision
Supervisor Ensures
Supervisor Supports
Outcome
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Increased Organizational Capability
Empowerment Staff Commitment to Quality
Accountability
Teamwork
Continuous Quality Improvement
Improved Services
Client Satisfaction
Creating and maintaining an environment for continuous quality improvement (CQI) is facilitated with integrated supervision (IS). The basis for IS stems from the underlying principle that supervision is everyone’s responsibility, not just the role of the (traditional) supervisor. Because IS occurs at all levels (not just from the top down), individuals enjoy the freedom of empowerment and self-direction and being held accountable for their actions.
Integrated supervision is akin to using a team approach for supervision and monitoring. Like integrated supervision, a team approach recognizes the interdependence of staff and systems in service and program environments. Most organizations are moving away from supervising individuals, because individuals are rarely responsible for, or truly in control of, all of the factors or inputs that influence the level, quality, and consistence of their performance. For example, a clinic supervisor must depend on the finance and administration staff for supplies, pharmaceuticals or contraceptives, or even equipment or improvements in infrastructure. A program officer in a democratization and governance program will be dependent on the outputs of those who conduct research or design IEC or advocacy materials. Many programs benefit from the use of teamwork, where the main focus is problem solving and the supervisor serves as a facilitator who assists with skills transfer and reinforcement of standards.
Programs must ensure a firm foundation for integrated or team supervision by training personnel in norms, standards, and quality assurance methods. Teamwork and positive interactions among supervisors and staff should be emphasized as opposed to the usual hierarchical, “supervisor-as-inspector” approach. Since many staff learned their jobs, and learned about supervision, in the more structured hierarchical fashion, re-training in standards of practice, the culture of quality, and consumer responsiveness – as well as the new teamoriented supervisory techniques – may be required. Data from supervisory teams or interactions should be used to strengthen quality management; consultation with consumers to obtain feedback on the quality of services should also be systematically reviewed. Some organizations may want to incorporate these supervisory approaches as they develop or adapting CQI training materials and curricula for all levels and incorporate norms and standards of practice and quality management or quality assurance (QA) systems. Organizations may also want to implement a QA training master plan, focusing on changing and improving supervisory approaches.
Remember…Five Keys to Effective Team Supervision3 To be an effective team supervisor you must: ☛ Support your staff. ☛ Pay attention to the needs of your staff and to the external and internal environments in which they work. ☛ Be a teacher – devote yourself to educating your staff. ☛ Discuss problems with your staff and work with them to find solutions. ☛ Understand the needs and demands of your customers, clients, and stakeholders.
Staff performance appraisal Staff appraisal is an essential management, or supervisory, skill. The words “appraisal” is sometimes used instead of “evaluation” or “assessment” when staff performance is being judged. Often this system is described as performance planning and appraisal, since the performance based planning involves setting individual objectives against which the staff persons’ performance can be accurately judged. Staff appraisal can, therefore, be described as a process whereby the manager measures the actual contribution of each team member against standards, targets or operational objectives which have been agreed on by both the supervisor and his or her subordinates in an earlier planning phase. Appraisals are normally conducted by most managers twice annually: mid-year and end of year. The mid-year appraisal is usually less formal and highly interactive. As such, it gives a worker ample time to improve on-the-job performance. Good appraisal techniques increase
3
Adapted from Miller, Janice and Wolff, James, editors. Management Strategies for Improving Family Planning Services: The Family Planning Manager Compendium. “Improving Supervision: A Team Approach.” FPMD/ MSH, Newton MA, 1996
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the chances of optimal achievement of an organization’s objectives. Aspects of a staff member’s job performance that require improvement are identified; causal factors may include constraints resulting from the organization’s systems and procedures to the employee’s lack of skills. The discussion also gives the manager the opportunity to strengthen and develop his relationship with each staff member and provides additional insights into individual strengths and weaknesses. The appraisal discussion can ensure staff development since it not only allows a manager to develop strategies for strengthening areas where individual relevant skills are weak or lacking, but also can facilitate changing requirements of an individual’s job and his or her future direction within the organization. A staff member’s career path is extremely important. Effective appraisal discussions will enable individuals to know where they are heading and have ideas of future positions that might be suitable for them. Managers’ should not place too heavy a premium on form-filling to the detriment of the much-needed, yet often overlooked, interactions with their subordinates. This is especially true for a mid-term appraisal. A final appraisal should, however, be commemorated by a written record such as two sample appraisal formats found at Annex A. Managers’ effectiveness in handling appraisal discussions can be further enhanced, particularly in terms of generating greater feedback from subordinates, if a flexible approach to the handling of staff members is adopted. There is not a single “best” style of interacting, but a variety of styles, each appropriate to different circumstances, is appropriate.
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Steps in planning and implementing an appraisal system There are three steps in planning and implementing a staff appraisal system: Planning meeting at the beginning of the year: h Supervisor (appraiser) and the supervisee (appraisee) agree on standards, performance
targets, and other job expectations, using tools such as job descriptions, work plans, and project documents. During implementation of job duties and activities: h Interaction between the supervisor and supervises continue using various work tools to
reinforce staff. At the end of two work periods (6 months and 12 months respectively): h Appraiser and appraisee meet in an appraisal interview session. h Appraiser and appraisee engage in interactive discussions. h After review and discussion, appraiser and appraisee jointly set operational or
performance objectives, targets, and standards for the succeeding period. h Annually, a written analysis of the appraisee’s performance identifying areas for improvement, is prepared. Figure 6 shows the roles and tasks of supervisor and supervisee in planning and implementing systems for staff performance appraisals.
TOOLS A MANAGER CAN USE FOR EFFECTIVE APPRAISAL: ❏ JOB DESCRIPTIONS See Series 1, Module 2. ❏ PERFORMANCE STANDARDS These state conditions which will exist when a job is well done. In using this tool, the manager and subordinate should determine what is to be done and how results can be measured. ❏ SPECIFIC OBJECTIVES AND TARGETS Short-term levels of achievements which are specific, measurable and achievable. ❏ INCIDENT FILES Aids in the recall of good or bad performance, discussed and recorded at the time it happened. ❏ APPRAISAL FORMATS (See Annex A) Contains all elements of the job be appraised and recorded. Two sample formats are provided. Managers should use the appropriate tools at various stages in the appraisal process. Figure 6: ROLES AND TASKS OF SUPERVISOR AND EMPLOYEE
▼
▼
Clarify performance, standards, job duties, and expectations
TASK 1 Interpersonal contact
Clarify expectations with respect to job and supervisor
Provide coaching, feedback
TASK 2 Helping relationship
Perform job and develop personal strengths
Plan and conduct performance review
TASK 3 Appraisal interview
Appraise own job performance
Assist in development and approval of subordinates’ plans for self-development
TASK 4 Goal setting
Establish goals and plans for self-development, propose job objectives, timetables, and measurement
Source: Colby, J. D. and Wallace, R. L. “Performance Appraisal : Help or Hindrance to Employee Productivity.”
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Getting the best from an appraisal interview An appraisal interview should emphasize interaction and positive relationships between the appraiser and the appraisee. It should not just emphasize completing an appraisal form. Based on the readiness and maturity level of the appraisee, the appraiser may adopt various styles of managing the interview. An appraiser can, for example, personally complete an appraisal form, asking the appraisee to read over it and sign. This is a dominating style. On the other extreme end of the scale, an appraiser may ask the appraisees to fill in the form without the appraiser’s input, discussions, and feedback. This is the abdicating style and is equally unacceptable. However, in between these two extremes are the telling, advising, joint, and self-assessment styles which the appraiser can adopt during the appraisal discussion. Each one involves a progressively higher level of involvement by the appraisee. Figure 5 shows a participatory continuum of appraiser and appraisee involvement in an appraisal interview. Figure 7: Participatory Continuum Diagram
Low
APPRAISEE INVOLVEMENT
▼
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R4
R3
R2
R1
Abdicating Self-Assessment A4
Joint A3
Advising A2
A1
Telling
Dominating Appraiser Involvement
▼
High
High
Source: Roger Pryor. Performance Appraisal — A Fresh Approach. Henley Management Development and Advisory Services and Interactive Skills Limited, UK.
Managers should work towards helping their subordinates achieve preparedness for participatory styles of discussion. This generally means building upon other participatory interactions such as planning, assessments, job description reviews, etc. Sometimes, a manager can benefit from a more systematic review of an individual employee’s readiness for performance appraisal. As an exercise, a manager may use a format such as the one found in Figure 8 to review attitudes of each staff member. If he or she is not ready for appraisal, work on team building and staff development activities before implementing an appraisal system.
Figure 8: Employee Readiness for Appraisal
Appraisee Readiness High
Low Awareness of Standards Job Knowledge/Skills Attitude/Motivation Problem-solving ability Objectivity/ Judgement
Source: Roger Pryor Henley, Performance Appraisal—A Fresh Approach. Management Development and Advisory Services and Interactive Skills Limited, UK
Q&A Do you have an effective appraisal system? To answer this question, go through the following self-assessment exercise in reviewing your current appraisal system.
?
i) Do you [manager(s)] and your appraisees hold planning meetings where you set targets for the year? Yes No ii) Do you supervise and follow up with your subordinates regularly during implementation of job duties? Yes No iii) Does your organization have appraisal tools used by staff? Yes No iv) Does your organization use appraisal interviews in appraising staff? Yes No v) Does your organization use appraisal formats for appraising staff? Yes No vi) Do your supervisors and supervisees thouroughly review contingencies or constraints beyond the supervisees’ during appraisal? Yes No If your answers to all the above questions are “No”, you have not yet established an appraisal system. If your answers to questions i), ii) and vi) are No, your appraisal system is weak and needs to be strengthened and systematized.
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Process point...
Action required!!! Walk through the steps in planning and implementing an appraisal system, tools for effective appraisal, and getting the best from an appraisal interview to design an effective appraisal system for your organization and address key issues . In doing so, remind yourself once again of the Do’s And Don’t’s Of Performance Appraisal “See Figure 9” and develop your system to be as positive and effective as possible.
32 Figure 9: Do’s and Dont’s of Performance Appraisal You should do the following: 1.
2.
3. 4. 5. 6. 7.
8. 9. 10.
Communicate and give feedback often, not just at appraisal time to make the appraisal, less threatening. Appraise your own performance and how it may have affected that of the employee. Reassure your employee by building on strengths; give him or her confidence. Use a “we” attitude when discussing problems. Be candid. Keep the interview on track. Ask thought-provoking questions (not “yes” or “no”). Restate or reflect his or her statements. Listen – with warmth, frankness and real interest. Talk about job results, not just activities and incidents. Function as coach, not as inspector. Close by summarizing, planning together for improvements and changes. Write down the results.
But don’t!: 1.
Pile up comments just for the appriasal.
2.
Assume that all faults lie with the employee and that your performance has no impact on his or hers. Use negative words or too many negative criticisms. Use a “you vs. me” attitude.
3. 4. 5. 6. 7.
8.
Give insincere or excessive praise. Use generalities that cannot be backed up by specific examples. Dominate the conversation.
Place much emphasis on personality traits. 9. Be fussy, picayune or harried. 10. Be – or seem – rushed .
Summary Human resources are the most valuable resources of any organization and the most difficult to manage. Managers are hired because of the technical skills they possess but are often fired due to lack of human and interpersonal skills. Therefore, to be effective, managers should insist on training, motivation techniques, personnel policies, appropriate and supportive supervision, and performance appraisal skills. They must also be open and responsive to the stated and perceived needs and aspirations of their work force, and institutionalize systems that provide up-to-date information on these vital issues and mechanisms to respond to them effectively.
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Annexes
Annex A Staff Appraisal Form: Sample One Part I Personnel Data (To be completed by staff member or appraisee) Name: Qualifications with dates: Designation/Title: Department/Section: Duty Station: Date of Appointment: Name of Supervisor: Title of Supervisor: Key to the scores (for Part I and Part II below) 5 4 3 2 1
-
Excellent Very Good Good Satisfactory Poor
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Part II Duties and Responsibilities (key result areas/targets/operational objectives/ performance standards) List of duties/standards
1
Immediate Supervisor Signature:
2
3
4
5
Remarks
Part III Head of Department’s Scoring Employee attributes •
Attendance
•
Punctuality
•
Initiative
•
Resourcefulness
•
Ability to work independently
•
Relationship with colleagues
•
Integrity
1
2
3
4
5
Remarks
Part IV Strengths and Weaknesses (agreed on by Appraiser and Appraisee)
36
Part V Total Appraisal Score (calculated by appraiser consulting with appraisee)
Appraiser’s Signature: Date:
Part VI Comment by Appraisee
Signature: Date:
Part VII Comment by Chief Executive or his Designate
37 Signature: Date:
Part VIII Employees comments after feedback from CEO or Designate
Signature: Date:
ANNEX B: Review of Performance Against Competencies Appraisal Sample Two Please select those applicable to the individual and rate on a scale of 1 to 5 using Column A of Performance Rating Scale on the first page of this form. If the competency does not apply to this individual, please mark N/A against it.
SELF-RATING COMPETENCIES Technical Skills Possess the requisite skills Exercises the requisite skills People Management Skills Supports and works with colleagues to create team spirit Sets clear objectives Delegates
38
Monitors and evaluates Provides positive and negative feedback Communication Skills Language skills-French/ English Oral Communication Writing Skills Personal Organization/ Work methods Plans effectively Organizes/effectively Prioritizes effectively Meets deadlines Assumes responsibility Is able to work independently Works effectively in a team Builds and maintains client relationships Diversification Systematically tracks clients/ beneficiaries Maintains up-to-date c ountry diversification plans
1
2
3
4
5
APRAISOR’S RATING N/A
1
2
3
4
5
N/A
ANY COMMENTS
SELF-RATING COMPETENCIES
1
2
3
4
5
APRAISOR’S RATING N/A
1
2
3
4
5
N/A
ANY COMMENTS
Actively seeks new donors Reports regularly on status of marketing/diversification initiatives Personal Skills/Qualities Confident and Assertive Creative/Innovative Tolerant Accountable/Responsible Flexible/Adaptable Manages stress well Continuous learner Decisive Collaborative Respectful of others Self-starter/self-motivated
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Interview Scoring Format Please rate the applicant on a scale of 1 to 5 using the categories below. If the competency does not apply to this individual, please mark N/A against it. Ranking/Scoring: 5 = Excellent; 4 = Very Good; 3 = Good; 2 = Fair; 1 = Poor COMPETENCIES Technical Skills Management of RH programs Management of ARHS programs Experience with multi-sectoral or national programmes Programme design skills Medical training or degree(s) Training skills and experience Monitoring/evaluation skills Advocacy skills Other relevant skills [Please specify._______________ Communication Skills Language skills-English/ Other [Please specify__________
40
Oral Communication Writing Skills Publications [Please specify # and type: ____________________ Personal Appearance Clear, articulate communicator Neat appearance Enthusiastic about job Offers specific ideas about organizing work and activities Maturity
5
4
3
2
1
COMMENTS
Annex C Service Delivery Point/Quality Assurance Checklist Date of Visit:
Person(s) Conducting Visit:
Name of SDP/Location: Basic Information
1. Number of staff by cadre (currently filled/vacancies in authorized staff levels) CADRE OF EMPLOYEES
CURRENT
VACANCY
Registered Nurse/Midwives Enrolled Nurse/Midwives Registered Community Health Nurse/Midwives Enrolled Community Health Nurse/Midwives Physicians Anesthetists and Nurse Anesthetists Pharmacists/Assistant Pharmacists Medical Assistants Clinical Officers Health Education Officers Health Assistants
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Environmental Health Officers Laboratory Technicians Health Surveillance Assistants
2. Services Offered*
SERVICES OFFERED
YES
NO
HRS/DAYS OFFERED
Family Planning STD Diagnosis Treatment Antenatal Care
* This can be modified to reflect your organization’s staffing pattern and primary services offered or activities undertaken.
SERVICES OFFERED
YES
NO
HRS/DAYS OFFERED
0-5 Care Maternity Laboratory MVA Postabortion services Postnatal/postpartum counseling/ care VSC C-section Infertility Adolescent Services Other [Please specify]: Quality Assurance Issues: Issue
Exceeds
Accept.
Unaccpt.
Comments
Clinic Identification: Large, clear sign List of hours of services Reception/Registration Area
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Courteous reception Clean Adequate seating IEC materials available Client flow efficient, systematic Records available, filled Health care talks given Client Interview Area Adequate privacy Sufficient lighting Well ventilated Adequate counseling space IEC materials available Client Examination Area (please supply number of examination rooms available Adequate privacy Adequate lighting
Area for hand washing Clean Adequate water for clinic Garbage disposed by burning or burying
)
Issue
Exceeds
Accept.
Unaccpt.
Comments
Client Records Clear, up-to-date Complete (both client locator data—name, address etc. and complete medical history) Client follow-up-data (e.g., next appointment, referral) Stored in an orderly way for easy retrieval Kept confidential Supply Storage Area (Specific staff member with responsibility for supplies?
Yes
N0
Locked cabinet available Supplies kept off floors and away from walls Up-to-date records FEFO system used Expired items routinely discarded Equipment/Supplies (Please use exceeds if available, working; accept if available, not working unaccept. If not available at all. Please also supply the number for all equipment) Examination table Side work table/trolley Goose neck lamp Rotating stool Adult scale Blood pressure cuff Stethoscope Speculum Tenaculum Sound Uterine/pickup forceps Forceps containers Scissors Covered tray for sterile equip Basin for contaminated equip Sterilizer Linen or paper covers Trash container Adequate Supplies of: IUDs Condoms Oral contraceptives Syringes Sterile gloves
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Issue Cotton wool, gauze Jik/bleach Disinfectant Cleaning supplies Infection Prevention Housekeeping: Daily cleaning of examination table lamp Instruments properly decontaminated Instruments are cleaned immediately after decontamination with soap/brush Hands washed properly after examination/procedures/between clients/after removing gloves/use of toilet/blowing nose, sneezing, etc. High level of disinfection instituted (e.g. boiler/sterilizer exits on-site; items are boiled
44
for 30 continuous minutes; no items added during boiling; boiled items removed with forceps; items stored in sterile covered containers; boiling equipment used according to directions; boiler cleaned weekly with vinegar/water) Staff show knowledge of IP techniques Gloves used properly QA protocols on-site; staff trained in use Medical waste properly disposed of Staff Written job descriptions available for all cadres Greet clients properly
Exceeds
Accept.
Unaccpt.
Comments
Issue
Exceeds
Accept.
Unaccpt.
Comments
Staff Training in [ Please indicate]
