HALABA KULITO GENERAL HOSPITAL
Self-Assessment Checklist for Hospital Senior Management
Team
S/N Self- Methods of Evaluation Yes or No Comments
performance
parameters
1 Establishment Are the number and composition of elected/appointed SMT
of SMT, members are based on their respective FMOH Directive
selection and (EHSTG)?
composition of SMT has been established and Members of the SMT has been
members approved by the Governing Board.
2 Functionality of Did the SMT members define Terms of Reference /Mandate?
SMT Does the SMT have an annual plan and approves it?
Does the SMT orientate Hospital staff on Hospital statement of
Vision, Mission, and Values?
Did the SMT hold regular meetings bi-weekly based on their
respective RHB or FMOH Directive?
Does the SMT keep minutes of meetings properly?
Is there an orientation programme on hospitals functions and
reforms for the all members and updates whenever new SMT
members assigned?
Does the SMT review quarterly and annual hospital performance
based on selected indicators and give written feedback?
Does the SMT conduct meetings with all hospital staff?
3 Responsive and Does the SMT make timely decisions to correct issues that arise
Accountable from CLIENTS/STAFF by designing action plan and bring
SMT improvements?
Does the SMT evaluate the performance of individual members
and the SMT as a team according to the standard procedures?
Did the SMT submit regular performance reports to Regional
Health Bureau/FMOH?
Do the SMT members bring the clients’ complaints on service
delivery to the meeting?
Did the SMT get an external /internal audit report?
Has the CEO been evaluated every 6 months whether s/he
performed outlined duties and responsibilities to lead hospital?
Does SMT ensure that activities of the hospital are carried out
with transparency and accountability and that all required reports
are submitted to higher authorities (e.g. RHB, BOFED, FMOH
Does the SMT ensure functionality of Hospital case teams by
tracking the regular activities and issues in the case team?
Does SMT Resolve departmental or case team problems or
disputes when these are beyond the ability of the department head
or case team director.
Does SMT prepare hospital strategic and annual plans for
submission to the Governing Board?