Editor’s Message – Supervision in Care Management: Managing Quality
Editor – Jennifer Voorlas, MSG, CMC
Guest Editor – Phyllis Mensh Brostoff, CISW, CMC
This issue of the New Journal of Geriatric Care Management explores a topic that has not yet been addressed in much depth before – supervision in care management practices. Since there are no formal standards of supervision, we cannot make assumptions about the place of it in a care management practice/agency. Currently, the only references in the current NAPGCM Standards of Practice are to “consultation,” with no standard defining or requiring supervision:
- Standard 3: The Right to Privacy: “The GCM should not disclose identifying information when discussing clients for teaching or training or consultation purposes unless the client has consented to disclosure of confidential information.”
- Standard 4: Recognition of the GCM’s Personal Values and Beliefs: “The GCM should be cognizant of their personal and professional value system and beliefs through a continuous process of self-reflection and/or case consultation.”
- Standard 8: Definition of Role: “The GCM should accept only those roles and responsibilities for which he/she has the skills, knowledge and training. He/she should recommend consultations with other experts as needed.”
The National Academy of Certified Care Managers (NACCM) definition of professional consultation/supervision is:
“an ongoing process of consultation and performance appraisal for the purpose of maintaining and improving the quality of one’s care management practice. Professional consultation / supervision may be conducted by professional peers, mentors or supervisors in formal and/or informal arrangements. Activities may include face-to-face, individual, group or peer review of performance, record review or audit, case review, or client satisfaction survey/analysis. The content of professional consultation/supervision should include discussion of care management issues, ethical issues, care plan development and care management interventions, use of clinical skills and core care manager functions. The supervision may be provided onsite, electronically or via teleconference.” 
This definition of supervision may be useful in building the culture of quality based on “evidence-based practice strategies” which Robert Applebaum and Anthony Bardo challenge us to do in their comprehensive history of care management, Long Term Care Management Turns 40: what we know and what we don’t know.
Harriette Grooh begins this process by her review of multidisciplinary teams in care management practices and discussion of how these teams can improve practice. Phyllis Mensh Brostoff presents insights into how professional care managers can use an evidence-based practice tool, The Predictive Index, to improve their supervision of the para-professional workers they are often called upon to supervise.
Building on NACCM’s in-depth knowledge of what care managers actually do, the editors present An Accountability Rating Model: Using NACCM’s Care Manager Tasks: Content Domains and Task Statements to Measure Your Practice and/or Supervisees. We hope that our members will try this out as a way to begin to build individual evidence-based practice strategies through evaluating their practices and/or their supervisees.
In addition, two sets of quality assurance measures are offered: one for client satisfaction surveys and the others to measure the benefit of supervision in a care management practice. A consistent approach to measuring client satisfaction and supervision is a goal NAPGCM may well be able to help members pursue in the near future, while acknowledging how supervision styles and frequency vary among geriatric care managers. Attaining and maintaining quality assurance is an ongoing process.
Explaining the importance of the place of supervision in the certification process, Monika White and Cheryl Whitman present an overview of Supervision and Certification, which emphasizes the importance of setting the bar for our professional standards.
Susan Birenbaum’s article opens this dialogue by exploring the dilemma of the sole practitioner in evaluating their own performance and avenues to achieve this end. Furthering the discussion, Helene Bergman’s case study lends insight from her own practice model of supervision, and includes both the supervisor’s and supervisee’s perspectives. Also from a sole practitioner standpoint, Debbie Drelich’s article discusses the value of peer supervision, and what constitutes a good supervision group.
Steve Barlam discusses the core competencies of the LivHOME supervision model and how they are taught in his large agency. Vince Brim’s article provides insight into the importance of managing one’s own counter transference when working with clients as an element of the supervisory process.
Finally, Phyllis Mensh Brostoff’s case study demonstrates one form of root cause analysis and shows how “Asking Why Five Times” can be an effective means of problem solving and learning from mistakes to improve the care of clients.
Throughout this entire issue, the authors discuss, from a variety of points of view, methods for care managers to manage the quality of our practices and, therefore, improve the services we give to our clients. While exploring this topic, we have come to realize the important place of supervision as a means to achieve this end. On behalf of the New Journal Editorial Committee, we hope you enjoy this edition!
 National Academy of Certified Care Managers CMC Renewal Instructions, page 3