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.