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Benchmarking to improve the performance of specialist doctors, Punjab
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Subject Area="Human Resources." Objective="Improved hospital services."
Details for Reform Option "Benchmarking to improve the performance of specialist doctors, Punjab"
Summary

Background: The Punjab Health System Corporation (PHSC) identified that there was low utilisation of government health facilities by patients. One of the main reasons was that health professionals were not motivated to deliver services. Action: In order to improve the work output from hospitals revamped by the PHSC, it was decided to set performance benchmarks for specialist doctors. Benchmarks of the activities were decided on the basis of average work output and bed strength of the hospital. Benchmarking of the activiites.htm The officer in charge of the medical institution assesses the performance of the specialist doctor where they are working. At district level Civil surgeon and Deputy Commissioner conduct the assessment and by Director M.D. PHSC and Secretary Health and Family Welfare at the state level. Explanation was called against those specialist doctors who have not achieved the benchmarks and are conveyed displeasure. Appreciation letter are awarded to those doctors to fulfil the set benchmarks as an incentive. Fact is also reviewed while recording their Annual Confidential Report (ACR). Results: (a) The increase in work output at health facilities was judged by the increase in utilisation: between 2000-2001, Out Door Patients visits increased from 5.13 million to 6.88 million. In Door patients visits increased from 2,68,916 to 2, 76,746. Major surgeries increased by 21% X ray increased by 56%. Laboratory tests increased by 19%. Diagnostic tests increased by 24%. (b) Improvement in number of doctors who had achieved benchmarks. In 2004-1198 doctors had not achieved the benchmarks whereas in 2005 it was only 327 doctors.

Cost Involvement of the cost element is nil because it needs only issue of the Government order.
Place One hundred and fifty four hospitals in Punjab, including Community Health Centres, Sub divisional hospitals and District hospitals.
Time Frame Approximate time from planning to implement the reform is one year.
Advantages

Accountability of specialists: Doctors are encouraged to perform according to set norms. Increased utilisation of the health facilities: Utilisation of the diagnostic and curative services available in the health facilities increases. Availability of the services to the patients: Availability of the services increases due to decrease in absenteeism of health professionals.

Challanges

None perceived.

Prerequisites

Government Order.

Who needs to be consulted

State government.

Risks

Sustainability

Sustainable, as implementation of the scheme involves only the issue of a Government Order.

Chances of Replication

Good.

Comments

Giving health facilities a facelift by restoring the infrastructure and necessary equipment is not sufficient to improve service delivery if the health professionals are absent. Setting benchmarks and encouraging them to attain them is one of the ways to motivate health professionals to deliver services.

Contact

Submitted By

Dr. Anuradha Davey, Research Consultant, NIMS, September, 2005.

Status Active
Reference Files
PHSCHS20002112-2147.doc GO: PHSC/HS/2000/2112-2147.
Benchmarks for specialist doctors.doc Benchmarks for the specialist doctors.
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