Designing an Organizational Performance Management System

Our health department staff members are working to align our strategic goals with our ongoing quality improvement efforts. As a part of this endeavor, we are looking to create an engaging Performance Management (PM) system that gives us the data and information that we need. Are there any existing models that provide guidance on designing such a PM system?

Response by Les Beitsch, MD, JD

In this paper titled "Performance Management and Cultural Transformation Using the PDCA Approach," the authors describe a framework for public health organizations to facilitate the successful transition from performance measurement to active, real-time use of data for performance management. Three performance management models are used as examples. Each one shares the common purpose of providing timely operational intelligence to help make informed decisions at all levels of the organization. The preferred model selected (whether one of the three examples or another model) should reflect the culture, desired future state, and resources of the public health agency. The following key questions are addressed: How are standards operationalized? How are targets established? What mechanisms are available to help prioritize the areas that need improvement? How do we make quality improvement into a system?

Click here for a downloadable PDF of the paper.


Submitted by phutchinson on

The new paper cited in Dr. Beitch's response above is a great resource. We struggled with trying to understand how to develop an organization-wide PM system based on Turning Point, given the lack of information about how to apply the model. This article explains how PDCA has the elements of Turning Point and can provide the framework for your PM.

whitneyw's picture
Submitted by whitneyw on

Are there case studies of public health organizations that have successfully implemented the three performance management models described in the above paper? Thanks!

cgizzi's picture
Submitted by cgizzi on

I especially like this comment in your paper: "For a PM system to be most effective in driving change to improve performance, everyone in the organization should be engaged. It should become an integral part of the way everyone does their jobs and not just another thing they have to do. To the extent possible, their engagement should be as users of the system, so it’s important that everyone in the organization understands how they can use the information in the system to do their jobs better, improve program performance, and ultimately be more effective in improving population health." I agree completely and also think this is one of the most challenging parts of implementing a successful PM system. Do you have any examples of how public health departments have engaged staff at all levels in using a PM system?

Cindan Gizzi
Tacoma-Pierce County Health Dept.