Draft Standard – January 2021
As of January 2021 a draft revised Standard of Practice on Clinical Supervision is awaiting external stakeholder consultation by Alberta Health. As the consultation process will be delayed due to the impact of COVID-19, the revised version has been made accessible for review by members. The revised Standard complements the recently revised Speech-Language Pathologists’ and Audiologists’ Guideline for Working with Support Personnel (January 2021).
This standard specifically refers to the clinical supervision of support personnel and/or speech-language pathology and audiology students. Support personnel or students are named as appropriate in each indicator, and the term “supervisees” is used when an indicator addresses both support personnel and students.
A regulated member of ACSLPA is responsible and accountable for services delivered by personnel under their direction and supervision (e.g., support personnel and speech-language pathology and audiology students).
To demonstrate this standard, the regulated member will:
a) Provide pertinent information to the client regarding the supervisee’s role and responsibilities and obtain client consent for services delivered in this manner.
b) Provide adequate on-the-job training and orientation to supervisees as it relates to the clinical and employment context.
c) Optimize both client safety and outcomes by considering the following when assigning clinical activities to support personnel:
i. the competence of the SP,
ii. the client’s individual needs, and
iii. factors unique to the practice environment.
d) Except as permitted by indicator e), refrain from assigning activities to support personnel that involve clinical interpretation.
Activities that involve clinical interpretation include the following:
i. Interpretation of assessment findings
ii. Initial discussion of clinical findings, treatment rationale, or prognosis with clients
iii. Determination of treatment goals and procedures, including the independent planning, development, or modification of treatment plans
iv. Completion and sign-off on formal clinical reports
v. Selection of clients for referral to other professionals or agencies
vi. Discharging clients from service
vii. Approval of clinical content in public education materials
e) Provide a clearly documented algorithm or flowchart to be used by support personnel when activities that have a component of clinical interpretation are assigned to them. The regulated member will only develop algorithms or flowcharts for use by support personnel when risk to clients regarding a particular activity has been adequately assessed and it has been determined that the risk can be adequately managed through use of a documented decision-making tool. The regulated member will instruct support personnel on the use of the flowchart or algorithm and will monitor their conformance.
f) Comply with applicable regulations and standards of practice regarding assignment and supervision of restricted activities to supervisees.
g) Determine the amount of both direct and/or indirect supervision that is required for support personnel under one’s direction and supervision. The regulated member should have sound rationale to support these decisions and should be able to articulate this rationale as required.
h) Monitor the services provided by supervisees on a regular, consistent basis, including client outcomes, modifying and/or reassigning service delivery as determined by clients’ needs.
i) Be available for consultation through some mode of communication or develop a plan for supervision coverage when they are not available.
j) Inform employers and clients of the need to discontinue services provided by the supervisee when the SLP/audiologist is not available to provide required supervision and a coverage plan or replacement supervisor is not available (e.g., extended absence, resignation).
k) Provide direction and supervision to SLP and audiology students who assign activities to support personnel and to support personnel who are mentoring and/or orienting other SP in training.
l) Inform the appropriate employer/manager if there are support personnel performance concerns, despite direct and indirect supervision, activity modeling, retraining, and communication regarding performance concerns.
m) Refrain from entering into an employment agreement whereby they clinically supervise the person who employs them (whether in a paid or volunteer capacity).
Clients are informed of the roles and responsibilities of the personnel providing services and that the services they receive are assigned and supervised by the speech-language pathologist or audiologist. Services are delivered in a safe and competent manner.