A site is a facility or organizational entity (e.g. health district, hospital, laboratory, community, and teaching institute) or any contiguous area where health actions and resources are coordinated to achieve specific health objectives.

There are a wide variety of classifications for different institutions or facilities such as hospitals and health centers. The emphasis has traditionally been on improving the organization and administration of health facilities and institutions around a recognized area of expertise or specialty. In the MEP, the focus is not on the level or nature of the medical or health specialty being offered but rather on how organizational arrangements, leadership and team competence can be developed to improve performance in relation to the attainment of health objectives in a specific context. This implies not only internal change at the Site but also changes in how the particular Site relates with clients, the community it serves and other stakeholders.

It is at the Site where the management capacity is developed and where the enhanced performance will be monitored. The key individuals at the site include the Site Leader, the Process Improvement Coordinator (PIC) and the Site Team.

The Site Leader and Site Team are supported by the tutor-mentors. The information generated as result of the improvements is referred back to the highest levels of the health systems through feedback mechanisms, from the Site through the learning centre to the Hub.

How is a site selected?

The single most important criterion for the selection of a site is the interest and willingness of the manager or potential Site Leader to participate in the implementation of the approach, with his or her team by providing valuable feedback. Other criteria for selection of sites include:

• Accessibility to the Learning Centre;

• Minimum requirement of resources;

• Commitment to improvements in organization and management;

• Motivated staff;

• Opportunities for partnership between health, community and other sectors;

• Adequate authority to affect change;

• Desire to improve client satisfaction.

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