CIMS refers to whether the provider’s care conformed to best clinical practice. Managerial quality refers to the degree to which administrative systems such as procurement, human resources, data management, etc. support the delivery of high-quality clinical care. Efficiency – Ability to produce a given quality of service for a lesser price or a greater quality of service for the same price. Sustainability – The organization’s ability to continue delivering needed and valued services. Dimensions of sustainability include sustained political support from government officials, sustained community and patient support, and predictable access to needed inputs.