Question about operationalizing performance management

Mon, 05/04/2015 - 12:20 -- Gina Febbraro

As we are new to developing a performance management system for our work in maternal and child health, I have a question regarding the pervasiveness of participation and measurement in a new performance management system.  In many articles and presentations, I have learned about the need to implement performance management and quality improvement across the entire organization and involve everyone. In other cases, I have read about measuring priority initiatives and identifying key measures knowing the time and capacity it would require us to apply performance management to everything we do.

Or is the overall goal that everyone participates but as we design the new system, we approach it incrementally applying it to priority initatives and expand throughout time?

Thanks for your thoughts. I am glad this forum exists!


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Submitted by christine.stickley on

I am not sure how large your organization is or what you mean by incrementally, but here is my two cents.

To me, performance management is a thought process and a way you assess the work you are doing on a continual basis.  It is a thought process that you utilize all of the time and not just for certain projects or once in awhile.  

Even if you implement a PM system throughout the organization in all you do, the reality is you will not be able to focus on and attack every issue identified by your measures at once.  You will have to prioritize the issues and work on implementing strategies to those more critical ones first and moving down the line as you progress.  Although you are focusing on implementing strategies to only some of the bigger issues, it is still important to monitor the other measures of the program continuously so you can identify trends, issues and whether you are accurately meeting the goals of the program.

So, in summary, I guess I say focus on the priority initiatives as far as strategies, but also work on tracking data and defining measures that provide insight on how the program is really doing.



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Submitted by johnsons013 on

We recently implemented a new performance management system too. Our new system takes more of the approach of implementing performance management and quality improvement across the entire organization and involving all levels of staff from each our departmental programs. Our implementation of the system consisted of developing the new system and then attempting to roll it out to the entire department at the same time.

We have learned a lot through this process. Simply stated, this new approach to performance management is a culture change for us. As such, this type of change takes learning, adapting, and time. If we could do the implementation of the system over again, one of the things we would have done differently is to have a more structured pilot test of the system (both the way of thinking/measuring and the actual computer-based system) with a section of the department and then followed that with a systematic expansion of the system across the department maybe over the course of a year or so. This would have allowed us to learn and adapt on a smaller scale before rolling it out the the entire department.

Doing a good pilot test will help you understand the technical assistance and training needs and challenges staff will have as they try and use the new system and it will allow you to position yourself to meet those needs from the start instead of trying to play catch-up after the system is already up and going. 

In the end though, I think performance management and quality improvement need to be infused into every part of the department.


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Stephen Johnson

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Submitted by Grace Gorenflo on

Hi Gina,

This is a great question.  The ultimate goal is to have everyone engaged in the performance management system, and the reality is that this will not happen overnight. You can use any number of incremental approaches, including an approach that begins with priority initiatives.  You can also begin with an established, routine intiative that is not necessarily a priority -- one that staff are quite familiar with, that would serve as an easy-to-understand foundation for your performance management system.  You can start with an initiative staffed by an opinion leader, with the thought that their influence can help bring others along as you expand your performance management system.  

PHQIX did a webinar on performance management not too long ago:  Stephen Johnson from Maricopa County reviewed their system.  While the webinar doesn't answer your question, it does provide a nice example of measures used in one performance management system (that you can see in the slides, without actually viewing the webinar, if you prefer).  This example might help you think about where to begin in your agency.  Other national organizations also have various performance management webinars and resources -- you can refer to PHQIX's partner's page for organizations that have these types of materials.

I hope this helps!

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Submitted by agoon on

I would strongly suggest talking with Heather Weir, Director of the Office of Planning, Partnerships, and Improvement in your agency. I heard her speak very knowledgeably on this topic in March at the Open Forum on QI in Public Health.

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Anne Goon, MS, RD, LD
Health Commissioner
Marietta/Belpre City Health Department