Inspection and supervision terms are oftentimes used interchangeably in many applications. There is, however, a notable difference between the terms. Also, there is a significant difference between the scope of work done by inspectors and supervisors. This article unfolds these difference to clear the confusion in interchangeable usage of these two terms.
Difference Between Inspection And Supervision Pdf Download
Inspectors in any job setting could be tasked with the roles to ensure that work is done effectively and perfectly. The inspection may be scheduled on a time to time basis whereas supervision, on the other hand, is oftentimes continuous.
In the education system, head of departments or school principals may act as supervisors of the teaching team to ensure that they continually teach. An inspectorate team may do fault-finding and fact-finding on the supervisors to proof if they are doing their supervision roles and responsibilities properly. A supervisor may issue a task to a subordinate and later inspect to see if the task has been completed. This shows some overlaps, although minor, between inspection and supervision. But, supervision is generally continuous, and supervisors are thus present on a day-to-day basis to ensure that tasks are being carried out as instructed.
Supervision may be hierarchical from immediate supervisors to senior management in any organization. The roles and responsibilities of supervisors are mainly the same across all organizations. Other organizations may incorporate inspection roles and responsibilities in supervision scope of work. This is what creates an interchangeable usage of the terms and thus a confusion.
Inspectors are the professionals who carry out inspections. They may schedule the time frame to conduct inspections. Inspectors are not necessarily the order-givers. They may act as middlemen between relevant authorities and their subordinates to ensure that rules, safety or quality standards are being accomplished. Inspectors may make recommendations for improvement of systems. The work scope may be broad from on organization or government to the other.
The member must establish, maintain, and enforce written supervisory procedures regarding the supervision of all OSJs. In all cases where a member designates and assigns one on-site principal to supervise more than one OSJ, the member must document in the member's written supervisory and inspection procedures the factors used to determine why the member considers such supervisory structure to be reasonable and the determination by the member will be subject to scrutiny.
Article 111 (1b) of Directive 2001/83/EC requires that Member States have a system of supervision including inspections at an appropriate frequency based on risk, at the premises of the manufacturers, importers, or distributors of active substances located on its territory.
If there is a mutual recognition agreement (MRA) in place between the countries where the site is located and the European Community, the results of GMP inspections carried out by the MRA partner authority are normally recognised by the EU authorities.
The approach to risk identification, mitigation, review and communication should be iterative, and integrated into the pharmaceutical quality system. This should provide senior management supervision and permit a balance between data integrity and general GMP priorities in line with the principles of ICH Q9 & Q10.
In 2012, the MoH initiated a national Supervision, Performance Assessment, and Recognition Strategy (SPARS) to increase capacity in medicines management and pharmacy practices in the public sector, with the objective of building a foundation towards GPP certification of all public health care facilities [11, 16]. SPARS is based on supportive supervision. Supervisors are public district staff with formal training in medicines management including a two-week classroom instruction followed by 5 days of practical exercises. The role of supervisors is to visit participating public health care facilities about every 2 months. At each visit, supervisors use a standard instrument to measure the facility performance in five areas of medicines management: prescribing, dispensing, reporting and ordering, stores management, and stock management. The SPARS instrument includes a total of 25 indicators, 4-7 in each area. All indicators are scored 0/1. The data collected is entered on- or of-line into a data base that has inbuilt data checking and controls to clean and increase data quality [17]. Many of the SPARS indicators are similar or partly similar to the GPP inspection indicators with an indicator overlap of 73 %. During each visit, supervisors also provide tools such as stock cards, stock books, Uganda Clinical Guidelines, dispensing trays, dispensing envelopes, thermometers, and the national standard operating procedures manual. SPARS was initially rolled out in 45 districts (40 %) in Uganda, with encouraging results: after four SPARS visits, facilities achieved on average a 64 % improvement in medicines management and reached a score of 17.4 out of 25 [11, 16, 18].
GPP indicators with significant differences in compliance score between intervention (SPARS supported) and comparative facilities. Indicators classified as Major (Ma) and Minor (M). *Identify indicators that are different (no overlap) from SPARS indicators
Hospitals tended to outperform lower level of care facilities, possibly because certification rules favor better equipped facilities: a facility obtains accreditation only if it passes all critical indicators and all but one critical indicator depend on building infrastructure. Ensuring good performance in this area requires financial investments to implement infrastructural improvements related to roofing, walls, water and sanitation, and spacing. Most other areas where GPP is found challenging can be addressed by behavioral and procedural changes. The relatively higher proportion of hospitals included in the comparative group (10.5 %) than in the intervention group (5 %) could have confounded these results as they are generally better resourced. However, the certification results and differences between groups did not change after excluding all hospital level data from the analysis (results not shown).
Another possible explanation for the lack of difference in certification is the size of the reference sample which was considerably smaller than the intervention group and for this reason probably not representative even though it was comparable in terms of level of care and type of facilities (government or PNFP). The small number of the comparative sample reduces the power of this study to find significant difference between intervention and comparative facilities. A comparative sample of 388 facilities would have been necessary to detect a difference of 10 % between the two arms with a power of 80 %.
Our study suggests the benefit of preparing facilities for accreditation through a GPP strengthening strategy, such as SPARS. SPARS-supported facilities performed better than comparative facilities, had higher overall GPP compliance score and outperformed the comparative facilities in passing major, and minor indicators. There was no difference in compliance score for critical indicators between the two arms. One explanation could be that critical indicators mainly assess structural conditions, such as wall, floors, roofs, water and sanitation for which supervision has limited influence. Further, of the indicators in which intervention facilities outperformed comparative facilities, all were indicators covered and regularly monitored by the SPARS intervention except for cleanliness of the counting tray that is not part of the SPARS indicators or supervision. Shelving was provided as part of SPARS, and most intervention facilities are now able to store medicines in a more systematic and organized manner, which underscores the considerable impact of improving infrastructure. Comparative facilities outperformed intervention facilities for one indicator covered by the SPARS intervention: patient knowledge, an indicator that much depends on availability of dispensing envelopes known to frequently be out of stock at lower level facilities. 2ff7e9595c
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