By Paige Sholar, Writing and Communications Intern, Penda Health
This post is part of our “Supporting the Human in Human Resources” blog series co-hosted by the Maternal Health Task Force and Jacaranda Health.
Penda Health has built a chain of quality primary care clinics serving Kenya’s poor. Within three years of establishing these clinics, Penda has overcome the challenge of poor provider performance through the use of non-financial incentives.
In Kenya, some clinics give their providers a revenue target every month, forcing the providers to act more like salespeople and sell unnecessary services. This method may allow the clinic to remain profitable but creates distrust between patients and providers and an environment that distracts providers from quality care.
Over the years, Penda has created a profitable new model that creates a trustful provider-patient relationship. Penda also focuses on creating a friendly work environment with motivating non-financial incentives where providers enjoy coming to work every day. During the development of this model, Penda has learned 3 lessons about how to motivate providers.
#1: Providers Will Work Hard to Improve Quantitative Quality Scores
Example of Quality Metrics: Percent of properly documented quality metrics for tonsillitis by Penda’s clinical officers
Penda Health implements quality metrics as a form of standardization that improve consistency of care, provide quantifiable data, and allow providers to utilize their training and knowledge for diagnosis. The best of both worlds, this method measures and promotes quality care.
The resulting data allow Penda to track the progress of each provider and highlight areas for improvement. When our data highlights a need for improvement, Penda provides topic-specific training until the providers consistently score well. After some resistance, our providers realized this data drove improvement and was not a punishment.
The results of each provider are made accessible to everyone and can be tracked month-to-month. We expected our providers to be competitive with each other, but we are still continually impressed with their desire to improve their own scores. Consistently communicating these quality metrics provides open communication within the clinic and constant feedback to each provider. Also, the transparency of these scores encourages our providers to train their peers.
#2: Providers Love Continuing Medical Education
Penda began offering continuing medical education courses to our providers to support evidence-based medicine while encouraging them to constantly learn and improve, which shows our commitment to the clinics and community. At these trainings providers receive additional information, interact with their colleagues, and leave empowered to treat patients with quality care. The providers receive a certificate after completing the course, which incentivizes completion of the entire course successfully.
After we established training of our own providers, we started inviting providers from other organizations and clinics to our trainings, which increases the medical abilities of the entire community. With outside providers attending the trainings, we encourage our providers to lead sections of the course. Our providers value this opportunity and love teaching their peers!
#3: Positive Feedback from Patient to Provider is Pure Gold!
We have invented ways to collect more patient feedback throughout each provider’s day.
- Patient Follow-up Calls: A new protocol requires our providers to call each patient after the clinic visit. The majority of patients is thrilled with this phone call. It is not uncommon for our providers to hear thank you, a blessing, or even joyful tears during these phone calls.
If the patient is not feeling well, the provider invites the patient back to the clinic for a free check-up. In both scenarios, the provider receives daily feedback directly from their patients, which increases provider morale as it demonstrates to each provider that patients value the quality of their care. Penda has created an intimate connection between patient, provider, and data where the provider feels empowered to affect the patient’s experience as well as outcomes.
- Patient Feedback: Each patient seen at our clinic completes a feedback form. The positive reviews are read aloud in our weekly team meeting with the name of the staff member who treated them! This is motivating since providers want to continue delivering high quality care so their name is associated with the positive reviews each week.
- Compliment Cards: Every six months each one of our staff members receives positive feedback through a “Compliment Card.” Each card includes 5-10 good comments from patients or staff. At our all-company meeting someone reads all of the compliments out loud. The public recognition of each provider is a morale booster and allows each provider to feel appreciated among their peers.
Penda Health has developed a model that uses non-financial incentives to leverage providers’ innate motivation to help people and to create a positive atmosphere where the providers continually strive to deliver the quality medical care.