Publication: Developing Strategies for Improving Health Care Delivery : Guide to Concepts, Determinants, Measurement, and Intervention Design
Date
2010-06
ISSN
Published
2010-06
Author(s)
Bradley, Elizabeth H.
Pallas, Sarah
Bashyal, Chhitij
Berman, Peter
Curry, Leslie
Abstract
This report is a user's guide for
defining, measuring, and improving the performance of health
service delivery organizations. The authors define six core
performance domains: quality, efficiency, utilization,
access, learning, and sustainability and provide a
compendium of metrics that have been used to measure
organizational performance in each of these six domains. The
compendium, which includes 116 distinct categories of
metrics, is based on a detailed literature review of
peer-reviewed empirical studies of health care
organizational performance in World Bank client countries.
Based on reading of the literature, the authors define seven
major strategy areas potentially useful for improving
performance among health care organizations: 1) standards
and guidelines, 2) organizational design, 3) education and
training, 4) process improvement and technology and tool
development, 5) incentives, 6) organizational culture, and
7) leadership and management. The authors provide
illustrations of facility-level interventions within each of
the strategy areas and highlight the conditions under which
certain strategies may be more effective than others. The
authors propose that the choice of strategy targeted at
organizational level to improve performance should be
informed by the identified root causes of the problem, the
implementation capabilities of the organization, and the
environmental conditions faced by the organization.
Citation
“Bradley, Elizabeth H.; Pallas, Sarah; Bashyal, Chhitij; Berman, Peter; Curry, Leslie. 2010. Developing Strategies for Improving Health Care Delivery : Guide to Concepts, Determinants, Measurement, and Intervention Design. Health, Nutrition and Population (HNP)
discussion paper;. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/b0e974da-a81c-52aa-8c19-3c2794b7f1ec License: CC BY 3.0 IGO.”