Balanced Scorecard • Review these slides and also review the “Measure What Matters” worksheet • Print out FULL SIZE Slides for slides 10, 11, 12, 13 to use as worksheets. • Watch the Measurement Videos with Eugene Nelson posted under MATERIALS, CLICK VIDEOS
Balanced Scorecard Principles & Methods
Must Do’s 2 & 3Job 2: Better system performanceJob 3: Better professional development Balanced Scorecard After Kaplan & Norton, Balanced Scorecard approach A measurement model for assessing & executing on must do jobs 2 & 3
Balanced scorecard answers the question …Is the microsystem performing in a way that will enable it to grow and survive given available resources?Note: Unit of analysis is the microsystem i.e., a clinical program providing care to a population(s) of patients
Balanced Scorecard Way to link strategy and vision with objectives for business performance & strategic progress measures of each objective target values for measures specific initiatives to improve and innovate
Balanced Scorecard: 4 Points of Success Strategic Learning and Innovation Core Processes Customers’ View of Goodness Financial Results
Balanced Scorecard Are we learning and innovating in business critical areas? How are core processes performing? How do we look in eyes of our customers? How are we doing at managing costs and making margins?
4 Points of Success Learning and Growth To achieve our vision, how will we sustain our ability to change and improve as fast as times require? Key Processes To satisfy customers, what key processes must we perfect? Customers ** To achieve our vision, how should we appear to our customers? ** Note: This is good place for Job #3: Professional Development Financial To succeed financially, how should we appear to our shareholders/board?
3- © 1996 Dartmouth Medical School and Lahey Hitchcock Clinic 3. Customer Satisfaction Balanced Scorecard 2. Core Processes 1. Innovation & Learning 4. Financial
Example of Balanced Scorecard Providence Health NICU: Alaska
Balanced Scorecard: Note This Answers a big question: How is your system performing as a business enterprise? Unit of analysis is system (not patient) Reflects current strategy and operations and hot issues Offers way to specify your current strategy & operating plan and to track progress & to promote accountability “We measure what matters.”
Measure What Matters A Worksheet for Making Your Value Compass & Balanced Scorecard
Measure What Matters • Clinical Value Compass • Balanced Scorecards • Microsystem Dashboards • Unit NameDate: • Organization Name: • Aim: Provide a clear path forward to identify key measures to track unit performance in real time and over time: • Patient Outcomes (Clinical Value Compass) • Microsystem Performance (Balanced Scorecard) • Microsystem Dashboard/Instrument Panel ( and ) • Linkage to Organization Strategy (Cascading Measures) • Background: • Organized data displays provide feedback on system performance. Key measures which reflect the purpose and goals of the microsystem include measures regarding population and/or subpopulation outcomes (e.g. clinical value compass), and system performance measures (e.g. balanced scorecard) both of which reflect microsystem results toward desired outcomes. The unit dashboard/instrument panel provides a method to monitor a blend of current indicators (clinical value compass and balanced scorecard) of a microsystem to provide real time indications over time on how the unit is performing. It is important to remember that the microsystem level dashboard/instrument panel variables can change as improvements, priorities and process measures change. • Path Forward: • Create Clinical Value Compass • Create Balanced Scorecard • Determine Organization’s Strategic Measures Create Microsystem Dashboard/Instrument Panel • Cascading Measures © 2007 Trustees of Dartmouth College, Godfrey, Nelson, Batalden Adapted July 2007 Vermont Oxford Network Page 1
Create clinical value compass (unit of analysis if patients) • Whole population • Subpopulation • Disease specific subpopulation • Individual patient Functional Biological/Clinical Patient/Family Satisfaction • Cost • • • • Your microsystem dashboard/instrument panel Use Key Value Compass and Key Balanced Scorecard Measures to create your dashboard * Recommend to track data over time (run charts, control charts, p-charts) © 2007 Trustees of Dartmouth College, Godfrey, Nelson, Batalden/ Adapted July 2007 Vermont Oxford Network Page 2
Core Processes Innovation and Learning Customer Satisfaction Financial Create your balanced scorecard (unit of analysis is microsystem) Determine where the 7 NIC/Q Themes Fit: Safe Timely Effective Efficient Equitable Patient Centered Socially Responsible Determine macrosystem and mesosystem strategic goals Use Key Value Compass and Key Balanced Scorecard Measures to create your dashboard © 2007 Trustees of Dartmouth College, Godfrey, Nelson, Batalden/ Adapted July 2007 Vermont Oxford Network Page 3
Microsystem Mesosystem Macrosystem Cascading Measures * Consider annual reports, organization’s strategic plan, senior leadership and Board of Trustee driven measures Microsystem Mesosystem Macrosystem References • Kaplan, RS, Norton, DP. The Strategy-Focused Organization: How Balanced Scorecard Companies Thrive in the New Business Environment (Hardcover - Sep 2000). • Nelson, Batalden, Ryer. “Measuring Outcomes and Costs: “The Clinical Value Compass” Chapter Three, Clinical Improvement Action Guide, Joint Commission Resources 2001. • Kaplan, RS, Norton, DP. “Putting the Balanced Scorecard to Work” Harvard Business Review, September 1, 1993. • Kaplan, RS, Norton, DP. “The Balanced Scorecard: Translating Strategy into Action”, Sep 1996 • www.clinicalmicrosystem.org • Click on “tools” on left hand menu, then streaming videos. • Measuring & Monitoring Video #2- Value Compass Thinking • Measuring & Monitoring Video #3 - Balanced Scorecard Approach • Both require Real Player © 2007 Trustees of Dartmouth College, Godfrey, Nelson, Batalden/ Adapted July 2007 Vermont Oxford Network Page 4