Standards-Based Management and Recognition (SBM-R)

In many developing countries, health systems are so weak that meaningful change may only be possible from the ground up. To improve health and save lives in the communities they serve, service providers working on the frontlines need tools and methods that will enable them to make decisions, solve problems and innovate at the local level. Standards-Based Management and Recognition® (SBM-R)—a performance and quality improvement approach—is designed to empower these frontline workers to work together to achieve meaningful improvements in the of the services they provide. Developed in the field by Jhpiego, SBM-R is a proactive, practical management methodology that focuses not on lengthy examination of the problems, but on the streamlined standardization and implementation of best practices.                                                          

A hallmark of the approach, SBM-R participants are encouraged to focus on simple interventions at first (“low-hanging fruit”) in order to achieve some results quickly. This practice creates momentum for change and provides the team an opportunity to develop the change-management skills needed to address more complex problems.

In brief, the four steps of the SBM-R process are as follows:

  • Setting objective performance standards for a defined service delivery process or specific content area—clear, simply worded standards with observable criteria are key to the success of SBM-R
  • Implementing the standards in a streamlined, systematic way—which involves identifying gaps between actual and desired performance and devising detailed action plans to address the gaps
  • Measuring progress to guide the improvement process toward these standards—such ongoing measurements can serve to motivate the group or help inform improved action plans
  • Rewarding achievement of standards through social/peer recognition mechanisms—this may be a public event or ceremony including symbolic rewards (e.g., certificates, plaques)

Experience has shown that results are best when SBM-R is coupled with creative management of the change process, as well as active involvement of providers, clients and communities.