ASHONPLAFA, a network of health care providers in Honduras, recognized that it had to raise quality and client satisfaction in order to meet its goal of financial sustainability. M&L’s Performance Improvement Methodology provided a systematic approach to raising quality. Staff training was designed and delivered by M&L facilitators in collaboration with the organization’s managers.

ASHONPLAFA managers worked together with M&L facilitators to identify the main and common problems, set priorities, and design the program to improve practices and behaviors. Using the Performance Improvement (PI) methodology, they developed 12 training modules, one for each month. Managers from the central office trained regional managers and regional facilitators to conduct the training. The modules introduced new behaviors and procedures at the service delivery point.

A self-assessment instrument is built into each module to test how well participants in the training understand the concepts. In addition, each module is tied to specific quality improvements, with performance indicators matched to questions in the annual client satisfaction survey. For example, the annual survey asks clients, "Were you greeted warmly?" and "Were you treated with kindness?" to test the effectiveness of the module that covered communication with clients. The centers will compete for an annual award based on the highest grades in test knowledge and client satisfaction.

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