Performance Management through Supervision, Monitoring and Evaluation

Performance Management throughSupervision, Monitoring and Evaluation Dr. Shahram Yazdani

The Importance of Regulatory Activities

Policy-Operation Mismatch Policies Public, Administrative, Clinical Operations Risk Reduction, Public Health, Clinical Services, Research, Education,… Health Outcomes

Policy Legislations Policy Evaluation Policy Implementation Policies are not self-implementable! Policies Public, Administrative, Clinical Policy Formulation Operations Risk Reduction, Public Health, Clinical Services, Research, Education,… Health Outcomes

Intra vs. Inter-sectoral operations Policies Public, Administrative, Clinical Intrasectoral Operations Intersectoral Operations Health Outcomes

Setting Regulatory Standards Policies Public, Administrative, Clinical Regulatory Standards Intrasectoral Operations Intersectoral Operations Health Outcomes

Performance Monitoring Performance Monitoring Policies Public, Administrative, Clinical Regulatory Standards Intrasectoral Operations Intersectoral Operations Health Outcomes

Performance Monitoring Regulatory Activities Regulatory Activities (Reward & Punishment) Policies Public, Administrative, Clinical Regulatory Standards Intrasectoral Operations Intersectoral Operations Health Outcomes

Regulatory Activities (Reward & Punishment) Policies Public, Administrative, Clinical Accreditation Licensing Financial Flow Regulatory Standards Performance Monitoring Regulatory Activities Intrasectoral Operations Intersectoral Operations Health Outcomes

Governance Policies Public, Administrative, Clinical Regulatory Standards Performance Monitoring Regulatory Activities Intrasectoral Operations Intersectoral Operations Health Outcomes

Intra-sectoral Governance Policies Public, Administrative, Clinical Intrasectoral Governance Intrasectoral Operations Intersectoral Operations Health Outcomes

Affecting extra-sectoral operations Policies Public, Administrative, Clinical Stakeholder analysis Advocacy Intrasectoral Governance Conflict Negotiation Intrasectoral Operations Intersectoral Operations Health Outcomes

Inter-sectoral Leadership Policies Public, Administrative, Clinical Stakeholder analysis Advocacy Intrasectoral Governance Conflict Negotiation Intrasectoral Operations Intersectoral Operations Health Outcomes

Inter-sectoral Leadership Policies Public, Administrative, Clinical Intrasectoral Governance Intersectoral Leadership Intrasectoral Operations Intersectoral Operations Health Outcomes

Policy Formulation Policy Legislations Policy Evaluation Policy Implementation Policy Implementation Policies Public, Administrative, Clinical Intrasectoral Governance Intersectoral Leadership Intrasectoral Operations Intersectoral Operations Health Outcomes

Stewardship Policy Making Intrasectoral Governance Intersectoral Leadership Intrasectoral Operations Intersectoral Operations Health Outcomes

Impact Evaluation Input for Policy-making Policies Public, Administrative, Clinical Intrasectoral Governance Intersectoral Leadership Intrasectoral Operations Intersectoral Operations Health Outcomes

Input for Policy-making Policies Public, Administrative, Clinical Impact Evaluation Operation Monitoring Intrasectoral Governance Intersectoral Leadership Intrasectoral Operations Intersectoral Operations Health Outcomes

HIS MIS The Importance of MIS & HIS Policies Public, Administrative, Clinical Impact Evaluation Operation Monitoring Intrasectoral Governance Intersectoral Leadership Intrasectoral Operations Intersectoral Operations Health Outcomes

Input for Policy-making Policies Public, Administrative, Clinical Impact Evaluation Health Research Operation Monitoring HIS MIS Intrasectoral Governance Intersectoral Leadership Intrasectoral Operations Intersectoral Operations Health Outcomes

Evidence Based Policy Making Policies Public, Administrative, Clinical Impact Evaluation Health Research Operation Monitoring HIS MIS Intrasectoral Governance Intersectoral Leadership Intrasectoral Operations Intersectoral Operations Health Outcomes

Inputs to Evidence Based Policy Making • What is the current body of evidence? • Systematic Review of International Literature • What are the evidence gaps that should be filled ? • Original National Research Evidence Based Policymaking • What is the current practice and success stories? • National and International Benchmarking • Comparative Studies • What is the unique specification and requirements? • Situation Analysis • What is the current mode of practice? • Performance Monitoring • What is the effect of previous policies? • Impact Evaluation

Information Regulation Finance Policymaking Mandates Provision Ideal Balance in Structure and Function in Public Sector

The Case of Hierarchical (Multi-level) Organizations

Organization 1 (O1) Organization 1-1 Organization 1-2 Organization 1-3 Organization 1-4 Organization 1-1-1 Organization 1-1-2 Organization 1-1-3 Organiza-4tion 1-1 Organization 1-1-5 Organization 1-2-1 Organization 1-2-2 Organization 1-2-3 Organization 1-3-1 Organization 1-3-2 Organization 1-3-3 Organization 1-4-1 Organization 1-4-2 Organization 1-4-3

Organization 1 Mission Objectives Goals Organization 1-1 Mission Objectives Goals Mission Objectives Goals

Mission Objectives Goals Mission Objectives Goals Mission Objectives Goals

Goals Objectives Mission Goals Objectives Mission Goals Mission Objectives

Goals Mission Objectives Goals Mission Objectives Goals Interventions Mission Interventions Objectives Interventions

Mission Goals Mission Objectives Goals Interventions Mission Objectives Goals Interventions Objectives Interventions

Mission Goals Mission Objectives Goals Interventions Mission Objectives Goals Interventions Objectives Main responsible Body Interventions Collaborating Bodies Responsibilities Coordinating Body Controlling Body

Organization 1 Mission Objectives Goals Organization 1-1 Mission Objectives Goals Mission Objectives Goals

Superior Organization Setting Goals and Objectives Planning Coordinating Monitoring Subordinate Organization Setting Goals and Objectives Planning According to Preset Goals and Objectives Implementation of preset plan

Scenario Superior Organization Setting Goals and Objectives Determining Interventions (Planning) Assigning Interventions to Agencies Monitoring Subordinate Organization Setting Goals and Objectives Planning According to Preset Goals and Objectives Implementation of preset plan

Hierarchical Structure and Hierarchy of Merits • Aligned and Assigned (Assumed) • Aligned but not Assigned (Assumed) • Not Aligned but Valued • Not Aligned and Not Valued

Related Terminology and Definitions

Measurement (اندازه گیری) • Measurement refers to the process by which the attributes or dimensions of some physical object are determined. • When we measure, we generally use some standard instrument to determine how big, tall, heavy, voluminous, hot, cold, fast, or straight something actually is. Standard instruments refer to instruments such as rulers, scales, thermometers, pressure gauges, etc. • To apply a standard scale or measuring device to an object, series of objects, events, or conditions, according to practices accepted by those who are skilled in the use of the device or scale.

Assessment (ارزیابی) • Assessment is a process by which information is obtained relative to some known objective or goal. • Assessment is a broad term that includes testing. • A test is a special form of assessment. Tests are assessments made under contrived circumstances especially so that they may be administered. • In other words, all tests are assessments, but not all assessments are tests. We test at the end of a lesson or unit. • To assess means To stipulate the conditions by which the behavior specified in an objective may be ascertained. Such stipulations are usually in the form of written descriptions.

Evaluation (ارزشیابی) • Evaluation is the systematic and impartial collection, analysis and interpretation of data needed to make decisions about an activity, project, programme, strategy, policy, topic, theme, sector, operational area, or institutional performance. • It aims at determining the relevance, impact, effectiveness, efficiency and sustainability of the interventions and contributions of the organizations.

Evaluation (ارزشیابی) Key elements: • assessment conducted at a single point in time (before, during or after). • focuses on determining whether what was planned actually happened, and why it did or did not happen. • Assessing: • relevance – whether the intervention was appropriate • impact – whether it made a difference in the lives of people • effective – whether it achieved what it set out to • efficient – whether it did so at the lowest cost • sustainable –whether it will leading to lasting change.

A4 A6 A10 A3 A7 A5 A2 A8 A9 A1 V1 V2V3V4V5V6V7V8V9V10 Evaluation Value Judgment

Audit (ممیزی) • Systematic, independent and documented process for obtaining evidence and evaluating it objectively to determine the extent to which audit criteria are fulfilled.

S3 S6 S7 S8 S1 S9 S4 S10 S2 S5 Audit A4 A6 A10 A3 A7 A5 A2 A8 A9 A1 V1 V2V3V4V5V6V7V8V9V10

Accreditation(اعتباربخشی) • The process carried on by an agency or association leading to some kind of formal decision (mostly Yes/No) about a institute, or specialized program of study based on implicit or explicit quality standards.

Yes/No Decision S3 S6 S7 S8 S1 S9 S4 S10 S2 S5 Accreditation A4 A6 A10 A3 A7 A5 A2 A8 A9 A1 V1 V2V3V4V5V6V7V8V9V10

Performance Management through Supervision, Monitoring and Evaluation