Clinical supervision: outsider reports of a research-driven implementation programme in Queensland, Australia

AIM: The aim of the present study was to explore substantive issues related to the implementation of Clinical Supervision (CS). BACKGROUND: Historically, the treatment of mental illness in Australia has been inadequate. CS has shown promise as a positive contribution to the clinical governance agenda, as a structured staff support mechanism. EVALUATION: Within the wider context of a randomized controlled trial (RCT) of CS, semi-structured interviews (n = 17) were conducted with staff who worked alongside colleagues that attempted to implement CS. KEY ISSUES: Senior managers embraced CS and were disappointed when junior managerial colleagues did not hold a similar conviction, when tested by the realities of CS implementation. If CS was regarded as an additional activity, it stretched human resources and created inter-staff tensions. CONCLUSIONS: The personal testimony of these 'outsiders' spoke about the practicalities of implementing CS and the prevailing culture into which they were introduced. When perceived as a tour de force for culture change, CS was polarized as an opportunity by many, but also as a threat by some. IMPLICATIONS FOR NURSING MANAGEMENT: A single, cohesive and explicit management position on CS in each Health Service entity may obviate some of the impediments to CS implementation.