Performance and Quality Improvement
Jhpiego has developed a performance improvement process to
support health systems in achieving desired institutional and individual
results. The goal of performance improvement is the provision of high-quality,
sustainable health services. Results are achieved through the
standards-based
management and recognition (SBM-R) approach, a process for improving the performance and
quality of health services. SBM-R is the systematic utilization of
performance standards as the basis for the organization and functioning of
these services, as well as the rewarding of compliance with standards through
recognition mechanisms. Using this process also helps ensure transfer of
learning to the work place, where services are delivered to our ultimate
clients: women and families.
SBM-R follows four basic steps:
- Setting standards of
performance in an operational way
- Implementing the standards
through a streamlined and systemic methodology
- Measuring progress to guide
the improvement process toward these standards
- Recognizing the achievement
of the standards
This process begins with the development of evidence-based
operational standards in a specific area of health service delivery, such as
infection prevention. The performance standards developed are included in an
assessment tool that can be used for self, peer, internal and external
assessments at the facility level. The implementation of the assessment tool
leads to the identification of performance gaps that need to be reduced or
eliminated. Local health managers and providers can then analyze the causes of
the gaps and identify and implement appropriate interventions to correct the
lack of knowledge and skills, an inadequate enabling environment (including
resources and policies), and/or lack of motivation to close these gaps.
Local health workers are encouraged to focus on action and
begin with simple interventions (the “low hanging fruit”) in order to achieve
early results, create momentum for change, and gradually acquire change
management skills to address more complex gaps.
Partial improvements are rewarded during the process using
a combination of measures including feedback and social recognition (e.g.,
ceremonies, symbolic rewards). The global achievement of compliance with
standards by the facility is acknowledged through a recognition mechanism
that should involve institutional authorities and the community.
More Information
For related Jhpiego publications and materials, see
Publications. For additional
information on Jhpiego's experience and capabilities in this area,
contact us.
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