Effectiveness of educational and administrative interventions in medical outpatient clinics.

Abstract

This study examines the popular belief that increased educational supervision and increased administrative support in university outpatient clinics will improve physician performance, which in turn will improve the process and outcome of patient care. Positive effects on house officers' attitudes and better func-

Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review

“…Of the 17 studies included in this systematic review: six investigated patient health outcomes of 1746 patients [ 22 – 27 ]; 14 investigated process of care measures for 38,483 episodes of patient care [ 24 – 37 ]; and three studies investigated the health care experience of 1856 patients [ 25 , 35 , 38 ]. Five studies investigated direct supervision [ 25 , 31 , 33 – 35 ], six studies investigated debriefing/reflective practice [ 22 – 24 , 26 – 28 , 38 ] and five studies investigated a combination of direct supervision and debriefing/reflective practice [ 29 , 30 , 32 , 36 , 37 ].…”

“…Of the 17 studies included in this systematic review: six investigated patient health outcomes of 1746 patients [ 22 – 27 ]; 14 investigated process of care measures for 38,483 episodes of patient care [ 24 – 37 ]; and three studies investigated the health care experience of 1856 patients [ 25 , 35 , 38 ]. Five studies investigated direct supervision [ 25 , 31 , 33 – 35 ], six studies investigated debriefing/reflective practice [ 22 – 24 , 26 – 28 , 38 ] and five studies investigated a combination of direct supervision and debriefing/reflective practice [ 29 , 30 , 32 , 36 , 37 ]. Four studies investigated clinical supervision of medical professionals [ 25 , 28 , 34 , 35 ], seven studies investigated clinical supervision of nursing professionals [ 23 , 29 – 32 , 37 , 38 ], two studies investigated clinical supervision of allied health professionals [ 22 , 24 ] and three studies investigated supervision of a combination of health professions [ 26 , 27 , 33 , 36 ].…”

“…Five studies investigated direct supervision [ 25 , 31 , 33 – 35 ], six studies investigated debriefing/reflective practice [ 22 – 24 , 26 – 28 , 38 ] and five studies investigated a combination of direct supervision and debriefing/reflective practice [ 29 , 30 , 32 , 36 , 37 ]. Four studies investigated clinical supervision of medical professionals [ 25 , 28 , 34 , 35 ], seven studies investigated clinical supervision of nursing professionals [ 23 , 29 – 32 , 37 , 38 ], two studies investigated clinical supervision of allied health professionals [ 22 , 24 ] and three studies investigated supervision of a combination of health professions [ 26 , 27 , 33 , 36 ]. Clinical supervision was conducted weekly in three studies [ 25 , 26 , 28 ], fortnightly in two studies [ 23 , 30 ] and monthly in four studies [ 29 , 32 , 33 , 37 ].…”

Blood pressure control in private practice: a case report.

“…Nothing was found suggesting this to be true; for example, only four known deaths (aged 65, 68, 78 and 92 years) occurred among the group of 206 during the years studied; b) Alternatively, the results may have reflected the fact that these patients came from higher socioeconomic strata and presumably represented a highly educated group. However, Despite these disconcerting figures, it is likely that visits to private physicians' offices for the care of hypertension, already accounting for 7 per cent of total visits, will substantially increase as the national effort to detect and treat high blood pressure accelerates. It may not be possible, however, to provide effective response to this growing demand through exclusive reliance on conventional patterns of care such as described here.…”

“…By contrast, the shortcomings of hospital clinics where considerably fewer hypertensives receive care have been repeatedly detailed, and the data generated have sometimes been used as a basis for improving effectiveness. [6][7][8] The purpose of this report is to describe an analysis of the treatment of hypertension undertaken in a private physician's practice. All charts were reviewed, and patients meeting the following criteria were classified as hypertensive: a) blood pressure 2 160/95 at the last visit if over 30 years of age; b) blood pressure 2 140/90 mm Hg.…”