The Organisational Strategy for Improvement Matrix (OSIM), previously called the Health Improvement Capability Quotient (Health ICQ), is a capability measurement tool and process that health services can use to identify, measure and monitor organisational accelerators and barriers to improvement. In other words, it can help health services determine how supportive of improvement or ‘change friendly’ their organisation is at a point in time.

To create an organisational environment and culture that delivers outstanding care, health services need to have a clear understanding of where they are in their improvement journey and where they want to be.

OSIM is designed to help health services in this journey, and can help to:

  • prompt discussion about organisational strengths and areas of potential development
  • reflect on ways to improve capability
  • inform strategic goals.

Completing OSIM will put health services in a better position to determine ways to close the gap between where their organisation is and where they want it to be. It will also shine a light on capability for improvement at all levels of the organisation, helping to identify potential areas to strengthen.

It is a learning opportunity and gives health services a target to aim for.

What is OSIM?

OSIM is a tool health services can use to self-assess their organisation's level of improvement capability.

It is structured around four key areas, known as 'domains', referred to in literature as common to high-performing organisations, and framed in the context of improvement include:

OSIM Domain Definition

Each domain comprises a set of criteria - the levers in an organisation that impact on or promote improvement capability.

Evolution of OSIM

The first edition of OSIM, originally referred to as the Health Improvement Capability Quotient (Health ICQ), was developed in 2012 by Victoria's (former) Department of Health. The second edition of Health ICQ was developed in 2014 following an independent review and feedback received from Victorian health services that had completed the Health ICQ.

The management of the Health ICQ shifted from the Department of Health and Human Services to Better Care Victoria (BCV) in 2016. BCV secretariat integrated into SCV in mid-2017, which included integrating the management of Health ICQ. This provided an opportunity to broaden the scope of BCV to work with SCV to drive further integration of the improvement and quality agenda across Victoria.

The NSW Clinical Excellence Commission (CEC) adopted the Health ICQ in 2016 as a tool for measuring and monitoring the organisational capability for quality improvement of each local health district across their state's jurisdiction. Through a collaborative working relationship, CEC, SCV and selected Victorian health services formed a working group in 2017 to review the Health ICQ and develop the third edition.

The name change from Health ICQ to OSIM reflects the renewed focus of this tool in helping health services understand their organisation's accelerators and barriers to improvement and develop informed strategic goals and priorities to target improvement efforts

How is OSIM used?

Health services use the provided workbook to self-assess against each criterion. This involves asking the question, 'How well does our health service meet this criterion?' and then assigning a maturity level (from Level 1 - Foundational to Level 5 - Advanced).

Completing OSIM produces a score indicative of the health service's overall maturity level for improvement capability, providing a picture of organisational strengths and areas of potential development.

OSIM maturity levels

What are the benefits of using OSIM?

Improvement is most successful where health services have well-developed organisational capability. OSIM provides a structured and guided way to consider a broad range of organisational levers of improvement capability.

By understanding and developing the elements that contribute to organisational capability for improvement, health services are better placed to make sustainable improvements. OSIM has been designed to enable health services to assess and monitor their organisational capability for improvement over time, and set capability targets for the future.

Who gets involved with OSIM?

It is recommended that health services invite a broad representation of the organisation, from executives through to frontline, to be involved in the OSIM self-assessment, so that there is:

  • a deep, diverse and informed assessment
  • an organisation-wide view, rather than making assumptions about the whole organisation
  • credibility in the OSIM self-assessment process to support seeking executive buy-in and ownership of post-OSIM priorities and action plans.

OSIM toolkit

OSIM fact sheet

The OSIM fact sheet provides a brief overview of the OSIM tool and process, including what OSIM is, how OSIM is used and the benefits of using OSIM.


OSIM administration guide

The OSIM administration guide has been developed to guide health services through implementing the OSIM tool and process and interpreting the outcomes.


OSIM workbook

The OSIM workbook is the tool for health services to capture the OSIM self-assessment, interpret outcomes, develop reports and record actions.


OSIM slide presentation template

The OSIM slide presentation template has been developed to help health services prepare slide presentations about the OSIM tool and process, including what OSIM is, how OSIM is used and the benefits of using OSIM.


Improvement and innovation plan template

The improvement and innovation plan template has been developed to help health services document and track the status of the organisation's improvement and innovation activities. It can be a useful resource to communicate the organisation's improvement and innovation agenda, and monitor and report progress to leadership.

Need more information?

Email bcv@safercare.vic.gov.au or call 03 9096 2761.