Managing Complex Systems: Performance Management in Public Health

Public-private partnerships have emerged as a new paradigm in health policy as a focus on the entire health system has supplanted the previous focus on solely governmental sectors. The Robert Wood Johnson Foundation (RWJF) has worked to support these partnerships through an initiative called "Turning Point: Collaborating for a New Century in Public Health." The Turning Point initiative invested in the Performance Management National Excellence Collaborative (PMC), a four year effort to develop useful performance management models for states, stimulate national dialogue on performance management in public health and support the application of performance management as a core discipline. This article provides a summary of the PMC's model for performance management and the evidence used to refine it, along with examples that illustrate the model in practice. The model includes elements of performance standards, measures, reporting of progress and quality improvement. One application of the PMC model is in the field of bioterrorism preparedness. Though only a theoretical example, this complex, multiprogram set of concurrent activities provides a scenario in which a management practice model focused on performance can be effective. The authors conclude that continuous application of performance management to public health practice can be a foundation of both the new paradigm of public-private partnerships and a new paradigm of improving population health.