Promoting the culture of key performance indicators (KPIs) among primary health care staff at health district level: An intervention study

Abstract

Recently, identifying performance indicators and developing measurement frameworks have become crucial concerns. Our study first sought to analyze service statistics of Primary Health Care (PHC) facilities for the years 2017 and 2018 to develop PHC key performance indicators (KPI).This was then followed by a thorough discussion of these KPIs with staff and service providers. Finally, re-rating these PHC (KPI) changes by analyzing service statistics infographs for 2017 and 2018 relative to 2019. El-Aiat Health District-Giza Governorate and its 15 PHC facilities served as the study's setting. A quasi-experimental intervention design was used based on operation research with quantitative and qualitative data analysis. The pre-test consisted of a mathematical analysis of service and vital statistics for 2017 and 2018 to calculate composite indices and create infographs (simple colored matrices) for these indices. The intervention included two discussion meetings (2 h each). It included reviewing the Performance Knowledge Matrices (infographs) with the service providers for subsequent problem specification, solving, and suggestion extraction to enhance performance. The SWOC (Strengths, Weaknesses, Opportunities, and Challenges) framework was used to analyze the qualitative data extracted from these conversations. Among the identified flaws were a deficiency in the number of physicians and nurses, inadequate training, insufficient work environments, and a lack of moral appreciation and recognition for the staff. The proposed solutions include providing health education services by nurses and follow-up services in certain units via home visits and mobile clinics. Post-test also entailed analyzing service and vital statistics for 2019 and redisplaying KPI infographics. Four of fifteen PHC facilities achieved a positive response based on the staff-suggested info-action-based intervention, according to our findings after comparing data for the pre-intervention and post-intervention periods of 2017-2018 and 2019. We concluded that reviewing the information derived from the "knowledge performance colored matrix" inspired district and PHC service providers to identify their weaknesses (avoided them as much as possible) and their strengths (practiced the solutions they suggested themselves) in the meetings which eventually improved their performance. Ultimately, the outcome scores and impact indicators of the provided PHC services were enhanced.

Keywords: Composite indices; Effectiveness; Intervention; Knowledge matrix; Primary health care; Primary health care indicators.