Performance improvement initiatives may occur at various levels, including local organisations, specified geographic or administrative regions (eg area health service or state), and national and international levels. The aim and focus of measurement varies accordingly. At any level, performance assessment is about measuring against a specified standard. It may include measures to determine how well an organisation or system performs on identified dimensions in terms of its defined goals and objectives. These dimensions are numerous and vary in accordance with organisational size and complexity, type of services delivered, the stakeholders, and other characteristics of the organisation. For example, a teaching hospital might assess its performance on such dimensions as effectiveness, appropriateness, efficiency, safety, capability, accessibility and equity, Another organisation could assess performance on whether it provided improved health to customers, accurate and timely information for consumers on service delivery, and responsiveness to the expectations of populations.

After studying this chapter, the reader should be able to: • Define theories and concepts underpinning organisational performance improvement practices in health care. • Analyse international and local frameworks for improving organisational performance. • Demonstrate understanding of the steps required to implement a process for improving organisational performance. • Describe the advantages and limitations of standardised measures used to assess organisational performance. • Evaluate challenges and Opportunities for improving organisational performance.

After studying this chapter, the reader should be able to: • Identify the context and environment that influences managing people in the health care industry. • Describe and analyse a framework of theories strategies and skills which can guide managers in thinking about developing their own systems and practices. • Demonstrate understanding of policies, procedures and practices in managing people in health care services. • Demonstrate understanding of how organisational goals are achieved through working with people. • Identify some of the common situations that managers face that call for interpersonal skills.