Making optimum use of staff makes sense in its own right. It has also been repeatedly advocated for in the context of health care reforms, and there is an abundance of literature on performance management. Why then is performance management absent from most health systems from the developing world, or limited to ineffective staff appraisal methods?
Since 1997 a research project funded by the European Union has been examining staff performance management by health care and service organisations from around the world. Preliminary evidence suggests that most health care organisations have piecemeal approaches to performance management that fail in getting the best out of staff. Staff appraisal may even lower staff performance since the goals of supervisor and appraisee are often to keep a clean sheet and avoid undue attention. The large number of health care organisations still using closed appraisal systems, where the appraisee is not informed of the outcomes of appraisal, demonstrates the general lack of commitment to effective performance management.
Only four out of 18 organisations covered in our study had developed effective or promising performance management systems. What their experience and that of others suggests is that for performance management to work it must fulfill certain essential characteristics relating to its design, to the basic conditions of work and to the external environment. Using preliminary research results the authors reflect on the prerequisites for successful introduction of performance management systems which are appropriate for under-resourced, over-centralised and largely dysfunctional national health systems.
Learning Objectives: At the end of the session participants should be able to: 1. Define performance and performance management in the context of national health systems. 2. Assess the extent and potential of use of performance management approaches in health care organisations from the public sector of low and middle-income countries. 3. Describe the essential elements of a Performance Management System and the ways to introduce performance management in national health systems. 4. Identify ways and tools for researching performance management in health care organisations
Keywords: Performance Measurement, Policy/Policy Development
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The presentation draws on 18 case studies covering health care organisations, public and private, from 9 countries
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.