Table 3.

Summary of elements of high performance

Structure	Processes	Attitudes/behaviours	Outcomes
SMT has the ability and authority to move financial resources within and across silos	PSRA at the organization-wide level is based on economic and ethical principles and involves:  • Well-defined, weighted criteria which reflect the organization’s values and strategic priorities  • Use of a scoring tool to operationalize criteria in ranking individual proposals  • Mechanisms for incorporating best available evidence  • A decision review mechanism	Fit of priority setting decisions with social and community values is sought:  • Public participation and input is valued; it is integrated into decisions in meaningful ways.  • Consideration is given to how decisions align with external partners and the larger health system.	Actual reallocation of financial resources is achieved
Mechanisms are established for engagement of staff (clinical and non-clinical) in PSRA decisions, with particular though not exclusive attention to physicians  • May include the use of incentives to encourage participation	SMT ensures effective communication (both internally and externally) around its priority setting and resource allocation—leading to transparency	SMT displays strong leadership for PSRA–SMT is aware of and manages the external environment and other constraining factors, and is willing to take and stand behind tough decisions.	Resource allocation decisions are justified in light of the organization’s established and agreed upon core values.

SMT senior management team, PSRA priority setting and resource allocation