Using Technology to Close Gaps in Health Provider Performance Management

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By: Janet Matemu, Technology Manager, Jacaranda Health; Shalmali Radha Karnad, Clinical Programs Manager, Jacaranda 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.

Healthcare institutions face three common challenges in managing the flow of information using technology:

  1. Access to financial investment
  2. Ability of the system to integrate with existing systems
  3. Sufficient resources to implement the system

With creativity and customization, Jacaranda Health, a Nairobi-based social healthcare enterprise, has adopted an exciting solution to these information technology challenges through a popular cloud-based information management application.

For organizations like Jacaranda, having a centralized database management system is vital to building the evidence-base which supports and guides our clinical, organisational and financial decisions. We customized our information management application to track, report and manage clinical, human resource, marketing and financial data. Tracking our client flow and the most frequently accessed services allows us to plan and modify our staffing model and predict future human resource needs within the organisation. This type of integration allows for aggregation for multiple data elements and enables the monitoring and evaluation of key quality outcomes.

Amongst the multiple successful functions of this application, its role in human resource management has had a high impact within our organization. The development of a Jacaranda staff portal allows the consolidation of key staff performance measures in one location and assists ongoing tracking of data for performance evaluations, general feedback, and assessment of knowledge gaps to inform of organizational training needs. Effective performance management has been shown time and time again to enhance employee confidence, engagement in the organisation, and morale, as well as improving clinical quality indicators such as compliance with protocols and even patient outcomes. A human resources database makes performance management simpler, more objective and more streamlined through consolidation of all performance measures in a single site, reducing the manual work of collecting data from different sources to guide evaluations. Additionally, it allows for continuous updates as performance, skills and competencies are assessed during the year, and the generation of facility-specific standardised reports such as overall and comparative staff performance indicators.

blog-image1-8.7.2014Areas of measurement include:

Area 1: Jacaranda Health Onboarding

Upon hire, all staff undergo a structured orientation. Pre- and post-tests are administered to gauge staff members understanding of the orientation education, and individualised results are communicated to each staff member to establish clinical goals and reinforce organizational expectations.

Area 2: Adherence to Protocol and Good Clinical Documentation

We have developed medical documentation structured to capture critical information at each clinical touch point. We consider documentation integrity a key indicator of staff adherence to clinical protocols designed to inform care delivery. Auditing with the information management application reveals successes and opportunities in continuous practice improvement for staff.

Area 3: Ongoing Training and Continuous Medical Education (CME)

Staff receive an SMS-based pre- and post-test for ongoing CME activities. This system allows us to provide individual feedback on test scores for the identification of knowledge strengths and gaps; aggregate scores to inform on additional education and training needs; and identify opportunities for the revision of policies, procedures or protocols.

Area 4: Tracking Patient Encounters

Our data management system also houses Jacaranda’s electronic medical record and is able to track clinical services provided by team members. This informs our business metrics in understanding the number and type of services sought, client’s access of antenatal services within the first trimester of pregnancy per WHO recommendations and overall conversion rates of antenatal clients to deliveries at our facility. These metrics are equally communicated to internal stakeholders as they reflect the quality of care provided.

The implementation of the information management application has significant benefits despite minor challenges due to poor mobile network and internet connectivity. The next phase of the Staff Portal is to use staff performance data in validating and catalysing career progression internally and externally.

Our goal is to develop a system that can be replicated and adopted by others in the maternal health and broader healthcare field. Excitingly, the Staff Portal shows great promise for building a single location for all human resource evaluations and trainings, which helps staff and management track performance at Jacaranda Health. Visit the Jacaranda blog for updates and to reach out to us with questions as well!