creative healthcare strategies august 9, 2004
TRANSCRIPT
Creative Healthcare Strategies August 9, 2004
August 9, 2004
Learning ObjectivesLearning Objectives
nn Participants will have an understanding Participants will have an understanding of the basic elements of the Balanced of the basic elements of the Balanced Scorecard.Scorecard.
nn Participants will be able to define four Participants will be able to define four perspectives as they relate to the perspectives as they relate to the organization.organization.
nn Participants will be able to assess their Participants will be able to assess their organization’s readiness to build a organization’s readiness to build a Balanced ScorecardBalanced Scorecard
August 9, 2004
What is the Balanced Scorecard?What is the Balanced Scorecard?
nn Performance Measurement SystemPerformance Measurement System
nn Mechanism for CommunicationMechanism for Communication
nn Strategic Management ToolStrategic Management Tool
August 9, 2004
What is the Balanced Scorecard?What is the Balanced Scorecard?
nn A performance management framework and A performance management framework and methodologymethodology
nn Research of Dr. Robert Kaplan and Dr. David Research of Dr. Robert Kaplan and Dr. David Norton in 1990Norton in 1990
nn Belief that traditional performance Belief that traditional performance measurement systems (relying on financial measurement systems (relying on financial measures) hinder organizational growth and measures) hinder organizational growth and progressprogress
nn Translating Strategy into Action, The Translating Strategy into Action, The Balanced ScorecardBalanced Scorecard
August 9, 2004
Framework and MethodologyFramework and Methodologynn Includes strategy and performance Includes strategy and performance
measures through the use of a set of measures through the use of a set of perspectives to gain a balanced perspectives to gain a balanced evaluation of your organization’s evaluation of your organization’s performance.performance.
August 9, 2004
Indicators of SuccessIndicators of Success
nn Historically fiscal measures have been Historically fiscal measures have been the barometer of an organization’s the barometer of an organization’s performanceperformance
nn The drive for balance between fiscal The drive for balance between fiscal and nonand non--fiscal indicatorsfiscal indicators
nn Requires a balance of internal and Requires a balance of internal and external measuresexternal measures
nn Use a combination of Use a combination of laglag and and leadleadindicatorsindicators
August 9, 2004
Lag and Lead IndicatorsLag and Lead Indicators
Lag Indicators Lag Indicators -- Measures outcomes of Measures outcomes of past actions. For example: Income & past actions. For example: Income & Expense ReportExpense Report
Lead Indicators Lead Indicators –– Process measures that Process measures that drive future performancedrive future performance
August 9, 2004
Driving ForcesDriving ForcesCenter for Medicare & Medicaid Services RequirementsCenter for Medicare & Medicaid Services Requirements
nn People have “freedom of choice” providersPeople have “freedom of choice” providersnn Providers must be qualifiedProviders must be qualifiednn Health and safety must be assuredHealth and safety must be assurednn Services must be monitoredServices must be monitorednn Account for expenditures and demonstrate Account for expenditures and demonstrate
cost effectivenesscost effectivenessnn Quality Management ProgramQuality Management Programnn Standardized business practicesStandardized business practices
August 9, 2004
Cause and Effect RelationshipsCause and Effect Relationships
nn Separates the scorecard from other Separates the scorecard from other performance management systemsperformance management systems
nn The BSC describes your strategy through the The BSC describes your strategy through the objectives & measures you chooseobjectives & measures you choose
nn The measures on the scorecard should link The measures on the scorecard should link together in a series of cause and effect together in a series of cause and effect relationships to tell the organization’s relationships to tell the organization’s strategic storystrategic story
August 9, 2004
Cause and Effect MapCause and Effect Map
FISCAL
The budget supportsthe necessary
training &development
activities to ensurethat consumers aresafe in their homes
& communities
LEARNING &GROWTH
Staff have thecompetencies to
ensure thatconsumers are safe
in their homes &communities
INTERNAL
There are processesin place to ensure
that consumers aresafe in their homes
& communities
CUSTOMER
Consumers are safein their homes &
communities
August 9, 2004
The Four PerspectivesThe Four Perspectives
nnCustomerCustomernnFiscalFiscalnn InternalInternalnn Learning & GrowthLearning & Growth
August 9, 2004
INTERNAL
To satisfy customers whilemeeting budgetary
constraints, at whichbusiness process must we
excel?
MISSION
EMPLOYEELEARNING &
GROWTH
How do we enable ourselvesto grow and change, meeting
ongoing demands?
FISCAL
How do we add value to ourcustomers while controlling
costs?
CUSTOMER
Whom do we define as ourcustomers? How do we
create value for ourcustomers?
STRATEGY
P. Niven, Balanced Scorecard Step by Step for Government and Non-profit Agencies
August 9, 2004
Customer PerspectiveCustomer Perspectivenn Whom do we define as our customer? How Whom do we define as our customer? How
do we create value for our customer?do we create value for our customer?nn Focuses on…Focuses on…
–– Health and SafetyHealth and Safety–– Quality of LifeQuality of Life–– ChoiceChoice–– ServiceService–– SatisfactionSatisfaction
nn Measures…Measures…–– Customer SatisfactionCustomer Satisfaction–– Customer OutcomesCustomer Outcomes
August 9, 2004
Fiscal PerspectiveFiscal Perspective
nn How do we add value for customers How do we add value for customers while controlling costs?while controlling costs?
nn Focuses on…Focuses on…–– Past performance ( Lag indicators)Past performance ( Lag indicators)
nn Measures…Measures…–– On budgetOn budget–– Authorizations compared to invoicesAuthorizations compared to invoices
August 9, 2004
Internal PerspectiveInternal Perspectivenn Which business processes must we excel at in Which business processes must we excel at in
order to satisfy customers?order to satisfy customers?nn Focuses on…Focuses on…
–– Process and EfficienciesProcess and Efficiencies–– Continuous ImprovementContinuous Improvement–– Response TimeResponse Time
nn Measures…Measures…–– Timely Service/Plans and Timely Service/Plans and MonitoringsMonitorings–– Waiting List ReductionWaiting List Reduction–– UpUp--toto--date Documentationdate Documentation
August 9, 2004
Learning and Growth PerspectiveLearning and Growth Perspective
nn How do we enable ourselves to grow & How do we enable ourselves to grow & change, meeting ongoing demands?change, meeting ongoing demands?
nn Focuses on…Focuses on…–– Employee and organization developmentEmployee and organization development
nn Measures…Measures…–– Employee RetentionEmployee Retention–– Employee SatisfactionEmployee Satisfaction–– Employee ProductivityEmployee Productivity–– Employee CompetencyEmployee Competency
August 9, 2004
.
Performance Areas
Core Functions
#3: SUPPORT COORDINATION & SERVICE MANAGEMENT
Legend
#4:PLAN & DEVELOP SERVICES
#1: HEALTH, SAFETY & HUMAN RIGHTS
#2: QUALITY OVERSIGHT
The MHMR Quality Management Plan framework identifies 4 Core Functions that MHMR performs to
fulfill the MH/MR Act of 1966 .
Core Function #1:HEALTH, SAFETY, &
HUMAN RIGHTS
Core Function #2:QUALITY
OVERSIGHT
Core Function #3: SUPPORT COORDINATION & SERVICE
MANAGEMENT
Core Function #4:PLAN & DEVELOP
SERVICES
Assure Health, Safety and Human
RightsContract Management
Unified Intake, Information & Referral Plan and Develop
Services System
Program Monitoring & Compliance
Plan and Develop Individual Services System Advocacy
and EducationHuman Resource Management
Service Delivery
Assure Health, Safety and Human
Rights Advocacy & Education
Assure Health, Safety and Human Rights
CHESTER COUNTYMH/MR BALANCED SCORECARD
HOME PAGE
August 9, 2004
August 9, 2004
Legend
HOME PAGE
#1: HEALTH, SAFETY & HUMAN RIGHTS
Core Functions
#2: QUALITY OVERSIGHT
#4: PLAN & DEVELOP SERVICES
#3: SUPPORT COORDINATION & SERVICE MANAGEMENT
CORE FUNCTION #1Health, Safety, and
Human RightsDepartment Scorecard
Chester County MH/MR DEPARTMENT Scorecard
CORE FUNCTION #2Quality
OversightDepartment Scorecard
CORE FUNCTION #3Support Coordination and
Service ManagementDepartment Scorecard
CORE FUNCTION #4Plan & Develop
ServicesDepartment Scorecard
DATABASESfor Performance Measures
ACTION PLAN
CHESTER COUNTYMH/MR BALANCED SCORECARD
DATA FLOWCHART
Key Performance Indicator Report for each
CRITICAL SUCCESS FACTOR by PERSPECTIVE
CORE FUNCTIONHealth and Safety
by Unit
August 9, 2004
CORE FUNCTION: Health, Safety, Human Rights SCORE 86%
Target Actual Variance Target Actual Variance Target Actual Variance Target Actual Variance
Target Actual Variance Target Actual Variance Target Actual Variance Target Actual Variance
Target Actual Variance Target Actual Variance Target Actual Variance Target Actual Variance
CC DEPT MHMR SCORECARD MENTAL RETARDATION BSC
SUMMARY
Core Function #1: Health, Safety, Human Rights
Single click on the Critical Success Factor for the Cause & Effect Map (summary of perspectives) for that CSF
BALANCED SCORECARD
CRITICAL SUCCESS FACTOR
CUSTOMER FISCAL INTERNAL LEARNING & GROWTH
AVG SCORE
Consumers are safe in their homes and communities 100% 28% -72% 100% 86% -14% 100% 92% -8% 100% 88% -12% 74%
Consumer human rights are protected 100% 89% -11% 100% 86% -14% 100% 91% -10% 100% 95% -5%
79%
90%
Consumers enjoy optimal health 100% 100% 0% 100% 95% -5% 100%
87% 94% 86%
0%-21% 100% 100% 94%
HOME PAGE
Perspective TOTAL 72% 89%
MENTAL HEALTH BSC
August 9, 2004
Budget supports training to ensure that consumers are safe in their home & community FISCAL 78%
Staff have competencies to ensure that consumers are safe in their home & community LEARNING & GROWTH 96%
Processes are in place to ensure that consumers are safe in their home & community INTERNAL 95%
Consumers are safe in their home & community CUSTOMER 98%
SCORE 92%
CSF #1: CONSUMERS ARE SAFE IN THEIR HOME AND COMMUNITY
Back to Core Function #1 BSC
CAUSE AND EFFECT MAP for
FISCAL
The budget supports necessary staff training
and development activities to ensure that consumers are safe in
their homes and communities.
LEARNING & GROWTH
Staff have the competencies to
ensure that consumers are safe in their homes
and communities.
INTERNAL
Processes are in place to ensure that
consumers are safe in their homes and
communities.
CUSTOMER
Consumers are safe in their homes and
communities.
August 9, 2004
August 9, 2004
Assessing Organizational Needs Assessing Organizational Needs & Fit& Fit
August 9, 2004
Seven Criteria for Choosing Where to Begin the Seven Criteria for Choosing Where to Begin the BSC in Your OrganizationBSC in Your Organization
StakeholderSupport
Supportof Participants
Data Resources
Commitment to Measurement
Need
Mission &
Strategy
Balanced Scorecard
August 9, 2004
Requirements for SuccessRequirements for Success
nn Know your MissionKnow your Missionnn Clear Strategic VisionClear Strategic Visionnn Executive SponsorshipExecutive Sponsorshipnn Assess IT Capacity, Skill & SupportAssess IT Capacity, Skill & Supportnn Staff TrainingStaff Trainingnn Have Common QI VocabularyHave Common QI Vocabularynn Wide buyWide buy--in for changein for change
August 9, 2004
Team RolesTeam Roles
nn BSC ChampionBSC Championnn BSC AdministratorBSC Administratornn Communications Team LeaderCommunications Team Leadernn DirectorsDirectorsnn Agency StaffAgency Staffnn Quality Improvement Core Committee Quality Improvement Core Committee
(QICC)(QICC)
August 9, 2004
BSC ChampionBSC Champion
nn Oversee implementation of BSCOversee implementation of BSCnn Offer technical expertiseOffer technical expertisenn Be the resource person for all staffBe the resource person for all staffnn Summarize results from databases and analysesSummarize results from databases and analysesnn Provide overall cause/effect analysis at regular intervalsProvide overall cause/effect analysis at regular intervalsnn Train staff on the use of QI toolsTrain staff on the use of QI toolsnn Troubleshoot problemsTroubleshoot problemsnn Actively participate in design, facilitation, and Actively participate in design, facilitation, and
implementation of BSC Communication Planimplementation of BSC Communication Plannn Champion performance improvement initiativesChampion performance improvement initiatives
August 9, 2004
BSC AdministratorBSC Administratornn Oversee the technical (automated) aspects of the cardOversee the technical (automated) aspects of the cardnn Provide technical to staff when neededProvide technical to staff when needednn Oversee database assistance/support design and developmentOversee database assistance/support design and developmentnn Provide technical assistance to the QI Director in the Provide technical assistance to the QI Director in the
automation of survey design and implementationautomation of survey design and implementationnn Provide ongoing evaluation of both hardware and software Provide ongoing evaluation of both hardware and software
requirements for cardrequirements for cardnn Communicate regularly with the BSC Champion regarding the Communicate regularly with the BSC Champion regarding the
effectiveness of cardeffectiveness of card
August 9, 2004
DirectorsDirectorsnn Ensure staff comfort level with BSCEnsure staff comfort level with BSCnn Ensure programmatic aspects of the data are current and accurateEnsure programmatic aspects of the data are current and accuratenn Ensure that data is submitted in a timely fashion and provide Ensure that data is submitted in a timely fashion and provide
followfollow--up when neededup when needednn Do firstDo first--level analysis and forward to BSC Champion for level analysis and forward to BSC Champion for
summarizingsummarizingnn Use data in the decisionUse data in the decision--making processmaking processnn Communicate regularly with BSC ChampionCommunicate regularly with BSC Championnn Participate in QIAParticipate in QIAnn Reward staff in using data to make thoughtful decisionsReward staff in using data to make thoughtful decisionsnn Make QI a standing agenda item on Unit Staff meetingsMake QI a standing agenda item on Unit Staff meetings
August 9, 2004
Agency StaffAgency Staff
nn Actively participate in the processActively participate in the processnn Be a knowledgeBe a knowledge--seekerseekernn Give feedback Give feedback nn Look for opportunitiesLook for opportunitiesnn Complete BSC assignments on timeComplete BSC assignments on timenn Use BSC results in making thoughtful decisionsUse BSC results in making thoughtful decisionsnn Hold each other accountableHold each other accountable
August 9, 2004
Quality Improvement Core Quality Improvement Core Committee (QICC)Committee (QICC)
nn Review overall effectiveness of BSCReview overall effectiveness of BSCnn Partner with BSC Champion and Directors in QIAPartner with BSC Champion and Directors in QIAnn Give input into the QI Quarterly ReportGive input into the QI Quarterly Reportnn Serve as a resource to Senior Management and Serve as a resource to Senior Management and
individual unitsindividual unitsnn Assess and modify the BSC as necessaryAssess and modify the BSC as necessarynn Serve as QI “Think Tank” regarding QI work planServe as QI “Think Tank” regarding QI work plannn Conduct annual evaluation Conduct annual evaluation nn Serve as change agentsServe as change agents
August 9, 2004
How Government Agencies Use How Government Agencies Use The Balanced ScorecardThe Balanced Scorecard
nn Fulfill Government Performance Results Fulfill Government Performance Results Act (GPRA 1993) requirements for Act (GPRA 1993) requirements for strategic planningstrategic planning
nn City of Charlotte, Southeastern New City of Charlotte, Southeastern New England United WayEngland United Way
nn Department of Defense Department of Defense –– The President’s The President’s AwardAward
nn Local Local gov’tsgov’ts: link performance to budgets, : link performance to budgets, effectively manage organizationseffectively manage organizations
August 9, 2004
Benefits of the Balanced Benefits of the Balanced ScorecardScorecard
nn Performance Measurement FrameworkPerformance Measurement Frameworknn Provides multiProvides multi--dimensional perspectivesdimensional perspectivesnn Assists in evaluating key system Assists in evaluating key system
processes/outcomesprocesses/outcomesnn Reveals critical cause and effect Reveals critical cause and effect
relationships required to promote relationships required to promote optimal performance of the Human optimal performance of the Human Services System.Services System.
August 9, 2004
Creative Healthcare StrategiesCreative Healthcare Strategies
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