Implementation of the Change Management Approach for Ideal Clinic Realisation and Maintenance

Name of the Project:

The implementation of the Change Management Approach for Ideal Clinic Realisation and Maintenance

Description of the Project:

In July 2013, the ideal clinic realisation initiative was launched as a way of systematically improving the deficiencies in PHC clinics in the public sector. The ideal clinic is envisaged to offer a comprehensive range of integrated diagnostics, curative, rehabilitative and palliative services.  Using existing clinic functions and staff duties in a different and systematic manner, the goal of this initiative is to ensure universally available high quality PHC services. To transition clinics from current state to ‘ideal’ state, a set of almost 200 items needed to be given attention and improved to an acceptable level. Progress within these 200 items is monitored through the Ideal Clinic Dashboard which scores the item as either Green (achieved), Amber (partially achieved) or Red (not achieved). Having identified the standards and indicators helps convey a sense of what is required, but does little to support and catalyse the change necessary to transition clinics from their current state to the envisaged, ideal state. Various change and/or lean models are currently implemented within the public health sector. Some health facilities are additionally supported by development partners that use different change and/or lean models. Ensuring that there is health system wide understanding of the National Department of Health (NDoH) standards to health service delivery and compliance to protocol is critical.

Health Systems Trust (HST) serves as the coordinating body for the development and implementation of the change management model that would facilitate successful Ideal Clinics Realisation and Maintenance (ICRM).

Objectives of the Project:

The development of the change management approach (CMA) is informed by prior experience in implementing evidence based approaches to change and lean strategies in primary health care facilities, engagements with development partners, other key stakeholders and change management experts. The overarching objectives of the change management approach are to:

  • Co-ordinate inputs towards the conceptualisation and development of an appropriate change management model
  • Provide a structured process for the implementation of the change management model
  • Monitor and provide implementation feedback
  • Provide recommendations for scale-up

Progress to Date:

  • The pilots in Tshwane and Thabo Mofutsanyana Districts were completed between September 2014 and February 2015. Based on the findings of these pilots, the CMA was review and adapted. 
  • The pilots in UMgungundlovu and Frances Baard Districts were completed between May and October 2015. Based on the findings of these pilots, the CMA was review and adapted.
  • The implementation method of the CMA was reviewed and adapted to utilize the skills and experience of the SA SURE staff. Staff were selected and completed the Train-the-Trainer sessions in September and October 2015.
  • Training material was finalized. The pilots in Chris Hani and uThukela Districts were completed between June and September 2016. The final project report is currently being finalized.





Project Director:                                               Dr René English

Project Manager and Senior Researcher: Dr Nazia Peer

Researcher:                                                       Michael Burnett

Status:                                                                 Current


For further information contact the Project Manager, Dr Nazia Peer at