Designing a Framework for “Iranian Pay for Performance” Program for Non-Medical Workforce in Hospitals

Abstract

Background: Various pay for performance (PFP) models have been used for different purposes in many countries. The present study aimed to investigate the general framework and feasibility of the PFP program that was implemented in Iran (IR-PFP). Methods: In 2016, a document analysis was performed to achieve the original framework, and to evaluate its validity with the help of 2 expert panels, and both phases were managed using a four-stage Hermeneutic cycle. Results: The results of reviewing the documentation revealed that the framework required some prerequisites and determining the PFP of the department and individuals. The expert panels confirmed these 3 components, however, a fourth component namely determining the payment time was added to the model. In addition, the status of the key factors in the design and implementation of the program was reported. Conclusions: The model prerequisites proved helpful in considering the work diversity in hospitals. Furthermore, determining the PFP in 2 stages allowed the inclusion of more indicators in the structure of the program, however, it seems that determining the payment time in 3 months has not been practical for the Iranian health system. The framework has some instruments to strengthen teamwork and decentralize the human resources control and performance measurement in hospitals, however, hospital managers should always be careful about the unwanted side effects.