FC03-05 - Quality of care and patient outcomes: a randomised trial of clinical supervision in mental health settings in Queensland, Australia

Abstract

ObjectivesHistorically, the treatment of mental illness in Australia has been inadequate. Clinical Supervision [CS], a structured staff support arrangement, has shown promise as a contribution to the clinical governance agenda; however, little is yet known about CS implementation issues. This study aimed to examined the effects of providing regular Clinical Supervision to nursing staff who worked in mental health settings, on their levels of personal well being, the quality of care they delivered and the outcomes for patientsMethodsA large scale landmark Australian randomised controlled trial [RCT] of CS, funded by the Queensland Treasury/Golden Casket Foundation [A$248,000], was located in 17 mental health facilities, across the State. The RCT trained 24 Supervisors and tracked their subsequent year-long personal experience [the Intervention] using psychometrically established instruments, supplemented by qualitative data, which was also collected from mental health nurses, other clinical staff, patients and administrators.ResultsSupervisors and Supervisees were found to value Clinical Supervision. The positive effect this had on the quality of care and patient outcomes was demonstrated in a controlled setting within this RCT, but remained elusive across a broad front. The importance of the prevailing service/managerial culture to the outcome of CS implementation was revealed.ConclusionsNovel findings will help to conceptualise Clinical Supervision education, management and policy decision making in the future. They will provide the basis for the best contemporary advice for service development and/or a framework for future CS evaluation, sufficient to be tested in another environment with other mental health disciplines.