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Maximazing Access and Quality Website

Lamia Jaroudi for JHU/CCP

Table of Contents

• Summary
• Credits

1. Understanding the Concept
2. Evidence-Based Practices
3. Adaptability
4. Links with Other Services
5. Minimizing Paperwork
6. Physical Factors
7. Service Hours and Scheduling
8. Client Flow
9. Division of Labor and Job Design
10. Social Factors
11. Implementing the Concept
12. Bibliography

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This issue was prepared in collaboration with the Maximizing Access and Quality (MAQ) Initiative of the United States Agency for International Development's Office of Population and Reproductive Health. The MAQ Initiative supports research and evidence-based interventions to promote access to and quality of reproductive health and family planning services.

Published by the INFO Project, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA.

Organizing Work Better

Family planning and other health care organizations in developing countries increasingly must do more with the same resources, and sometimes with fewer. Reorganizing work processes offers one common-sense way to help staff members at all levels cope with growing demands.

Whether you are a clinic manager, front-line provider, program supervisor, or district-level manager, you can improve how work is organized and performed. Often, simple changes enable organizations to serve clients better, offer more satisfying work to the staff, operate more effectively, cut waste, and even reduce or recover costs.

Decentralization, integration of services, the AIDS epidemic, and the increasing push to reach the poorest and most remote communities challenge health care organizations everywhere. To cope, organizations need to operate more effectively, become more efficient, and meet evolving client needs.

The organization of work approach can help. It encourages managers and service providers to see their organization as a collection of resources and processes and to ask: Do the resources and processes work together? Do they meet clients’ and providers’ needs? How can they work more productively? By addressing these questions, staff often can devise ways to work more efficiently and effectively. Improving the organization of work need not be time-consuming, complicated, or expensive.

In health care a focus on meeting patients’ needs increasingly guides service delivery. Now, the Maximizing Access and Quality Initiative has identified nine key elements of service delivery in which the organization of work approach can be applied to better meet clients’ reproductive health care needs:

Use of evidence-based practices. Organizations that base clinical practices on the best available evidence can remove needless barriers to care and deliver better quality services.

Adaptability. Foresight and flexibility enable managers to deal with the fluctuations common to health care service delivery.

Links with other services and sites. Good referral systems help organizations provide access to a complete range of services.

Minimizing paperwork, maximizing information use. Collecting and using only those data necessary to make decisions reduces time-consuming paperwork.

Physical factors. Service providers can make better use of space and resources to ensure well-organized, well-stocked, and comfortable facilities.

Service hours and scheduling. Both clients and providers benefit when scheduling takes their needs into consideration.

Client flow. Improving how clients move through the clinic can shorten waits and provide more time for clients and providers to interact.

Division of labor and job design. Service providers and managers can be more productive—and satisfied—when all know their responsibilities and have authority to carry them out.

Social factors. Leadership, staff development, and open lines of communication motivate and support the staff—a health care organization’s key resource.

Improving organization of work requires that people look at their programs and jobs with fresh eyes, learn, and agree to work together in better ways. Good work organization results when all nine elements of service delivery are addressed, integrated, and managed as a whole. Basic principles provide practical guidance, including:

• Remove unnecessary barriers that limit care,
• Balance both clients’ and providers’ needs,
• Promote teamwork, not hierarchical thinking,
• Plan for common fluctuations in health care delivery,
• Deliver each service at the lowest-level facility practical,
• Empower staff to both collect and use data, and
• Use the most up-to-date interventions and approaches.

When programs apply the principles of good organization of work, they serve clients better, providers are more productive and satisfied, and resources are used more efficiently.

Disclaimer: The information provided on this web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government.