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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.

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balanced scorecard
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 scorecard2

Balanced Scorecard

Principles & Methods

must do s 2 3 job 2 better system performance job 3 better professional development
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

slide4

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 scorecard5
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
Balanced Scorecard: 4 Points of Success

Strategic Learning and Innovation

Core Processes

Customers’ View of Goodness

Financial Results

balanced scorecard7
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
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?

slide9

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
Example of Balanced Scorecard

Providence Health NICU: Alaska

balanced scorecard note this
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

Measure What Matters

A Worksheet for Making Your

Value Compass & Balanced Scorecard

slide18

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

slide19

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

slide20

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

slide21

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