Julie Sharp is a Performance Improvement Specialist at the Public Health Foundation (PHF). At the Kane County Health Department in Aurora, IL, she led the development and operation of performance management and quality improvement programs and systems, and was Accreditation Coordinator for the department’s successful Public Health Accreditation Board accreditation application in 2013.

Many health departments create their performance management system based on the requirements for public health department accreditation. However, that is just a start. Health departments often want a performance management plan to guide and support their work moving forward. Others want to know what defines the work of their performance management team and what moves performance management practices from good to great.

I have several suggestions health departments may wish to consider as they develop and implement a performance management system.

1. Consider developing a performance management plan that includes quality improvement (QI) as a component of performance management. You can build the performance management plan using the Public Health Performance Management System Framework (Framework), integrating Public Health Accreditation Board (PHAB) expectations.
• Include sections for each of the four major Framework components (Standards, Measures, Reporting and QI). This could include a narrative on how to fulfill the components (tasks, roles, timelines), as well as graphics and visuals of the performance management system (dashboard). 
• Include a section for Visible Leadership that addresses each of the areas within it (customer-focus, culture of quality, strategic alignment, and transparency) and the various strategies you would employ for each. Provide descriptions are how these are developed, implemented, measured, and evaluated. 
2. Consider using the Framework as a big picture Plan-Do-Check-Act (PDCA) model for the organization. This aligns well with the PHAB requirements, and integrates not only the work done in “little qi”, but also helps you think about how performance management (and QI) cut across the organization.
3. Try to use QI tools to develop a performance management plan, particularly regarding decision-making, setting goals and objectives, and determining timelines.
4. You may want to look at the Performance and Quality Improvement Plan from Lake County (IL) Health Department. Its use of a Modified Balanced Scorecard is a different take on performance management.
5. Instead of developing a performance management plan, consider creating a Performance Improvement Plan. This would include both performance management and QI as described above, but would also reference the role of a performance improvement professional (e.g., a public health professional who works to develop or implement plans and activities in the areas of quality improvement, performance management, accreditation readiness, and/or community health assessment and improvement planning). While a Performance Improvement Plan could be more complex, as it requires more integration with other plans (e.g., Community Health Improvement Plan/State Health Improvement Plan, strategic plan), it can help keep plans from just sitting on the shelf. PHF's tool A Crosswalk for Aligning Accreditation Plans and on-site workshop Aligning Accreditation Plans can also help support these efforts.
6. To create an actionable performance management plan, consider developing an implementation plan as an appendix. This implementation plan can include tasks (e.g., setting measures, training staff), timeframes, roles, and responsible individuals/teams for meeting the goals and objectives of the performance management plan. QI tools, such as a Gantt Chart, may be helpful here.

Regardless of the direction you take, the most useful way to think about a performance management system is as a tool to help monitor progress and inform decision-making. For customized technical assistance on creating and implementing a performance management plan, submit your information online.

I also invite you to share your experiences with performance management plans in the comments section below.​