Varag|rg a C|rcurc|s|or 3erv|ce

Crapler 9
Crapler 9: Record Keep|rg, V&E ard
3uperv|s|or
1
Learn|ng 0bject|ves
escr|oe lre |rporlarce ol record |eep|rg, ror|lor|rg ard
eva|ual|or |r ra|e Rl serv|ces
0ul||re lre process ol supporl|ve superv|s|or
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 2
Hode||ng the |mpact of H6 on h|V Preva|ence
and |nc|dence
w||||ams et a|., 200:
100 upla|e ol VC cou|d averl 2.0 r||||or reW |rlecl|ors ard 0.3 r||||or
dealrs over 10 years |r suo-3ararar Alr|ca
Cou|d averl 5.Z r||||or reW |rlecl|ors over 20 years
Hesesan et a|., 200:
50 upla|e ol VC cou|d averl 32,000-53,000 reW |rlecl|ors |r 3oWelo, 3A,
over 20 years. Preva|erce Wou|d dec||re lror 23 lo 11
Nage|kerke et a|., subm|tted:
Preva|erce |r Nyarza Prov|rce, Kerya, Wou|d dec||re lror 18 lo 8 over 30
years W|lr 50 upla|e ol c|rcurc|s|or over 10 years
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 3
$ouroe: Kale lar||rs, uNAl3, ec 200.
Record Keep|ng, Hon|tor|ng and Eva|uat|on
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 1
how do we know when a s|ck pat|ent |s
respond|ng to treatment?
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 5
Sick patient, e.g., with fever
Assessed (Hx/Exam/Labs)
Diagnosis made, e.g., malaria
Admitted (if severe)
Treatment given (e.g., ACT)
WeII patient
Stop treatment
Discharge
e.g., Periodic monitoring of:
Patient's complaints
Vital signs e.g., TPR
Temp chart
Repeat blood smear/staining
Fac|||ty |nd|cators
P|arrers a|so requ|re |rlorral|or lo ra|e dec|s|ors aooul roW oesl lo sperd lre
lac|||ly's scarce resources lo reel lre reeds ol c||erls. Trey reed arsWers lo lre
lo||oW|rg quesl|ors:
Are We reacr|rg our largel aud|erce?
Car We prov|de lre recessary serv|ces? (For exarp|e, do We rave lre appropr|ale
equ|prerl, lre slall, lre drugs?)
Are our serv|ces ol r|gr qua||ly? (For exarp|e, do lrey reel ral|ora| ard
|rlerral|ora| slardards?)
o our serv|ces reel lre reeds ol our c||erls?
Are We relerr|rg c||erls Wro reed |l?
Are our pal|erls gell|rg rea|lr|er?
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or
what |s Hon|tor|ng?
Vor|lor|rg |s the rout|ne assessment
(e.g., da||y/rorlr|y/quarler|y) ol |rlorral|or
or |rd|calors-re|aled orgo|rg acl|v|l|es lo:
Track progress loWards lre prograrre largels or
perlorrarce slardards
lderl|ly lrose aspecls lral are Wor||rg accord|rg lo p|ar ard
lrose lral are |r reed ol adjuslrerls
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or Z
Eva|uat|on
Eva|ual|or relers lo lre reasurererl ol
roW rucr lr|rgs rave crarged as a resu|l
ol lre |rlerverl|or(s) |rp|ererled
Vu|l|p|e laclors re|aled lo crarge
A lorra| eva|ual|or lr|es lo derorslrale
roW rucr a spec|l|c |rlerverl|or
corlr|ouled lo lre ooserved crarge
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 8
0es|red
Perlorrarce
0es|red
Perlorrarce
Actua|
Perlorrarce
Actua|
Perlorrarce
0es|red
Perlorrarce
0es|red
Perlorrarce
Actua|
Perlorrarce
Actua|
Perlorrarce
ap
lrlerverl|ors
Purpose of Eva|uat|ons
Assess progress rade al a parl|cu|ar po|rls |r l|re (r|d-
lerr or erd-ol-projecl eva|ual|or)
Assess progress loWards acr|evererl ol sel oojecl|ves
Prov|de leedoac| or Wrelrer largels are oe|rg rel
lderl|ly reasors lor successes ard la||ures
Prov|de a oas|s ol lulure p|arr|rg
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 9
Hon|tor|ng and Eva|uat|on
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 10
|ntervent|ons
6hanges (pos|t|ve
or negat|ve}
H&E
An Effect|ve Hon|tor|ng 8ystem |mp||es.
A|| those |nvo|ved know what |nformat|on |s needed
ard oy Wror
The too|s needed lo co||ecl lre |rlorral|or are ava||ao|e
A|| those |nvo|ved know how and when to report lre
|rlorral|or
0ne person |s respons|b|e for mak|ng sure the system
|s work|ng (lral |rd|calors are up-lo-dale, records are
oe|rg proper|y |epl, ard dala are reporled lo appropr|ale
parlrers)
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 11
Hon|tor|ng and Eva|uat|on (cont.}
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 12
Program
8tart
Program
End
8et Program
0bject|ves
6|rcumc|s|ons performed
E E
H H H H
Het Program
0bject|ves
6|rcumc|s|ons performed
T|me
Hethods of Eva|uat|on
Rev|eW ol ava||ao|e
records ard reporls
3uperv|sory assessrerl
3lall se|l-assessrerl
Peer assessrerl
C||erl leedoac|
(e.g., lrrougr ex|l
|rlerv|eWs)
Corrur|ly survey
Fac|||ly corpar|sor
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 13
Types of 0ata 6o||ect|on Too|s
Pal|erl record lorrs/case roles
0ulpal|erl c||r|c reg|slers
Adr|ss|or/|rpal|erl reg|slers
0peral|rg roor reg|slers
3pec|a| lorrs:
VC adverse everls lorrs
ealr reporl|rg lorrs
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 11
T|ps for "Cood 0ata" 6o||ect|on
urderslard lre dala
Record lre dala every l|re
Record a|| ol lre dala
Record lre dala |r lre sare Way every l|re
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 15
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 1
' The c||n|c|ans need lo |roW Wro |s
respors|o|e lor lre record sysler, to
ensure staff record data accurate|y
and re||ab|y, ard lo |roW roW ard
Wrer lo reporl serv|ce- ard pal|erl
rea|lr-re|aled |rlorral|or.
Remember.
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 1Z
"|n Cod we trust.
A|| others, p|ease R|NC
0ATA."
$ouroe: 0AP.
0ocument your work and the resu|ts, so that others can
|earn from you!
Uses of Pat|ent Hon|tor|ng |nformat|on
rer |l cores lo record |eep|rg ard ror|lor|rg,
|nformat|on |s good because |t can be used. e are
co||ecl|rg |rlorral|or or|y lor lral reasor.
0ata that cannot be used shou|d not be co||ected.
loWever, |l |s rol urcorror lral qu|le uselu| dala go
urused.
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 18
8upport 8uperv|s|on
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 19
how 0o 8|te 8taff React to the Arr|va| of
the "Trad|t|ona|" 8uperv|sors?
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 20
ThE TRA0|T|0NAL
8UPERV|80R8
LET'8 RUN,
Th08E CUY8
ARE hERE
ACA|N
T8 RURAL hEALTh 6ENTRE
how 0o 8taff React to the "8upport|ve"
8uperv|sor?
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 21
PARA0|8E
hEALTh 6ENTRE
8UPP0RT|VE
8UPERV|80R
H|KE,
wEL60HE !
wE ARE CLA0
T0 8EE Y0U
h| !
EVERY0NE
"Trad|t|ona|" 8uperv|s|on
Trad|t|ona| approaches lo superv|s|or erpras|ze "|nspect|ng"
lac|||l|es ard check|ng |rd|v|dua| perlorrarce.
Trad|l|ora| superv|s|or focuses on f|nd|ng fau|t or errors and then
sanct|on|ng lrose respors|o|e, or lrougrl lo oe respors|o|e, lor
lrose errors.
Trad|l|ora| superv|s|or causes negat|ve fee||ngs ard |l rare|y
resu|ts |n |mproved hea|th serv|ces.
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 22
"8upport" 8uperv|s|on
A|so ca||ed "fac|||tat|ve" superv|s|or
3uperv|s|or lor perlorrarce ard qua||ly |rprovererl
focuses on:
Tre goa| ol prov|d|rg r|gr-qua||ly rea|lr serv|ces
A process ol corl|ruous perlorrarce ard qua||ly |rprovererl
A sty|e of encourag|ng, |nc|us|ve and support|ve |nteract|on
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 23
Coa| of 8uperv|s|on
Tre goa| ol superv|s|or |s to promote and ma|nta|n the
de||very of h|gh-qua||ty hea|th serv|ces. lr a lrad|l|ora|
sysler ol superv|s|or, lr|s goa| |s oller |osl or al |easl |s
rol apparerl lo lrose oe|rg superv|sed. 8y c|ear|y slal|rg
lral lre goa| ol superv|s|or |s lre de||very ol r|gr-qua||ly
rea|lr care serv|ces, lre superv|sor car lrarslorr lre
sorel|res regal|ve |rpress|or ol superv|s|or |rlo a
pos|l|ve ore.
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 21
The Performance |mprovement (P|}
Framework
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 25
2. Cet and Ha|nta|n 8takeho|der Agreement
1. 6ons|der
|nst|tut|ona|
6ontext
88on
Soa|8
$rraree8
u|rure
|enr ano
ommunry
Per85eor;e8
. el|re
0es|red
Perlorrarce
4. escr|oe
Actua|
Perlorrarce
8. Hon|tor and Eva|uate Performance
5. F|rd
Rool Causes
. 3e|ecl
lrlerverl|ors
7. lrp|ererl
lrlerverl|ors
0ap
Performance and 0ua||ty |mprovement
(P0|} Process
Tre P0l process ercourages lre rarager ard r|s lear lo:
3el perlorrarce slardards
Va|e sure lral slardards are rel
F|rd oul Wral |s r|rder|rg or re|p|rg acr|eve des|red perlorrarce
lderl|ly ard |rp|ererl Ways lo |rprove perlorrarce ard qua||ly
Regu|ar|y ror|lor ard eva|uale roW slall are perlorr|rg corpared lo lre
slardards
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 2
|||ustrat|ve |nd|cators for
H6 8erv|ces
Nuroer ol c||erls rece|v|rg VC serv|ces |r doror- or
goverrrerl-supporled lac|||l|es
Percerlage ol rer urdergo|rg VC Wro exper|erce ar
adverse everl
Percerlage ol VC procedures perlorred accord|rg lo
slardards
Percerlage ol VC c||erls Wro are course|ed aooul llv
Percerlage ol VC c||erls Wro rece|ved ar llv lesl
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 2Z
8ummary
Tre rarager ol a ra|e reproducl|ve rea|lr c||r|c ras
d|verse ro|es |rc|ud|rg ersur|rg qua||ly course|||rg
serv|ces, |og|sl|ca| raragererl ol esserl|a| supp||es,
overs|grl lor qua||ly record |eep|rg, ard ror|lor|rg ard
eva|ual|or ol lre prograr, as We|| as supporl|ve
superv|s|or.
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 28
8ummary (cont.}
To reel lrese respors|o|||l|es, lre c||r|c rarager rusl oe
|roW|edgeao|e aooul lre des|red |eve|s ol perlorrarce lor
lre serv|ces oe|rg prov|ded, roW lo assess currerl |eve|s
ol perlorrarce, ard roW lo Wor| W|lr olrer c||r|c slall lo
ara|yze rool causes ol |radequale perlorrarce ard l|rd
so|ul|ors lor |derl|l|ed proo|ers.
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 29
Crapler 9: Record Keep|rg, V&E ard 3uperv|s|or 30
Photo credit. Dipo Otolorin