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A framework to help you improve performance
We created this framework to support your performance improvement.
It aligns with our mission: To improve health outcomes through access to quality services, a skilled health workforce, and innovative, high-value programs.
How we organized the framework
There are seven domains:
- Governance, leadership, and management
- Workforce
- Financial sustainability
- Community health and health-related needs
- Quality, patient care, and safety
- Patient experience
- Access and affordability
Each domain has example suggested activities for improvement that can be found in the self-assessment tools. Work with your technical assistance (TA) organizations to develop specific activities for your health center.
Health Center Performance Improvement Framework

How you should use the framework
Use it to identify:
- How you’re performing in each domain
- How you’d like to perform in the future
- The path toward improvement
Review our quick reference to the framework (PDF - 1 MB) that provides an overview of the framework domains.
Review our guide to self-assessment that further explains how to use the framework.
A guide for self-assessment
Who should use the guide
- Health center leaders at the executive level responsible for improving performance and driving innovation
- Other staff or board members who inform your strategies
- Primary Care Associations (PCAs), Health Center Controlled Networks (HCCNs), and National Technical Assistance Program (NTAPs) can inform and organize the TA they provide
Why you should use the guide and tools
The guide and tools can:
- Help you see where you are in each domain
- Interpret the results
- Identify areas for improvement that you can focus on
The results of a self-assessment can:
- Guide your strategic planning process
- Enhance your quality improvement efforts
- Inform how you apply for grants
- Inspire your board to innovate
Using the guide will help to:
- Improve program performance
- Prioritize areas for improvement
- Promote innovation
Review our self-assessment tools to help you see where you are in each domain, interpret the results, and identify areas for improvement that your health center can focus on.
How to assess
Use the domain checklists in the self-assessment tool
You will work with your health center staff and TA organizations to identify activities for each domain. You will assess the status of domain-specific activities to see your performance level. You can complete them alone or in teams. You can tailor the process to meet your needs.
You choose:
- Which and how many domains
- Which and how many activities within each domain
- How much time to devote to the process
- How often to assess
- How to use the results
How you should use the results
The checklist results provide a “one time” snapshot of performance.
The results allow you to:
- Identify gaps to help you improve performance and mature through the performance levels
- Set your goals and priorities
- Prioritize, plan, and complete activities
- Advance toward leadership

Assessment aids
- Guide to Self-Assessment (PDF - 5 MB) includes an overview of the framework, steps in the process, examples, and resources.
- Self-Assessment Tools (PDF - 4 MB) include the fillable tool, progress snapshots, and example activities per domain.
- Quick Reference to the Framework (PDF - 1 MB), provides an overview of the framework domains
Contact us
If you have a question about: | You can reach us at: |
---|---|
The framework or guide |
Call 877-464-4772 (select option 1), 8 a.m. – 8 p.m. ET, Monday – Friday (except federal holidays) |