About the Balanced Scorecard, Essay Example

St. Michael’s Strategic Plan

St. Michael’s approach towards strategic framework is currently focused on determining how to best understand the diversity of the patients that visit the healthcare center and to use this knowledge to provide them with the best care possible. Quality improvement is of major concern, which will be facilitated by improving communication with patients and their families to gain a greater understanding of their health situation so that relevant treatments can be issued (Washington State Department of Health, 2011). As a whole, the strategic plan is referred to as SOAPEE, which is an acronym that stands for safety, outcomes, access, patient-centredness, equity, and efficiency (St. Michael’s, n.d.). The health care organization plans to accomplish these goals through implementation of leadership, infrastructure, and engagement.

The first step of the strategic plan involves conducting a comprehensive and internal scan to determine the quality improvement policies that are currently being implemented in addition to their consequences in the hospital. Although these initiatives had already been put in place in the past, there is concern because they are disparate and therefore not sustainable. It is therefore necessary to determine how the organization could implement these programs across the board so that all patients can acquire equitable benefit. The scans were conducted through use of external review and interviews, internal interviews, and committee consultations. After this preliminary data was retrieved, this information was validated and discussed in a manner that would allow the management team to recognize new directions that should be taken. Last, all available information was synthesized and the Quality Strategy Framework (QSF) was drafted.

Thus, all information contained within the QSF was evidence based in a manner that allowed researchers to gain a greater understanding of baseline performance to best determine how the selected intervention would achieve quality improvement. This study found that the primary goal of the organization should be to establish a governance structure for the framework development that reflects the organizational strategy. As a consequence, several new committees and subcommittees were established and placed in a manner that reflected the desired organizational hierarchy. After the establishment of this new hierarchy, it was decided that the organization’s vision should be defined as providing the best patient experience. This endeavor is to be based on principles stating that an academic lens should be placed on quality improvement that the available support system can be transformed through these means, and a change management approach can be utilized to support goals. Ultimately, it is expected that quality improvement will enhance the patient experience.

The specific principles that will be implemented to increase performance quality reflect St. Michael’s standing as a research institution. As a consequence, focus will be on developing rigorous training programs to ensure that all employees are provided with the tools they need to be successful, research related to quality improvement will be prioritized, and partnerships will be established to confirm the safety and efficacy of established practices. To change aspects regarding practice in the hospital, the organization will follow the “Making the Case, Get Going, Make it Stick” model, which states that to initiate change, an individual must first establish a sense of urgency and develop a change vision. Next, the vision must be communicated and short-term goals should be established. Last, gains should be consolidated to promote more change and the change should be implemented in future practices.

Efforts will be made to ensure that quality improvement changes occur at the unit, department, and organizational levels. Furthermore, the organization will work to determine how to best establish patients, families, staff, and physicians as partners in care. Last, work will be done to best determine how to test, learn, and evaluate new models of patient-centered care.

St. Michael’s Accrediting Body and Associated Standards

Recognizing that standards for a quality management program are constantly changing, the Joint Commission is constantly engaged in determining how to promote change in its institutions in order to facilitate quality improvement. Broadly, Joint Commission standards are ideals that help health care facilities measure and analyze their performance in a manner that is conducive to improvement. These standards focus “on important patient, individual, or resident care and organization functions that are essential to providing safe, high quality care” (Joint Commission, n.d.). To ensure that all standards can be accomplished, the Joint Commission ensures that they are simple and measurable.

The Joint Commission uses evidence-based practice and thus requirements identified by the scientific literature as a basis for its standards. Currently, the organization is highly concerned with the need for health care workers to communicate effectively both verbally and in on paper. The first several standards involve the hospital and ambulatory sites and their need to identify whether or not the institution follows an integrated care program, whether the facility can support the delivery of integrated care, and whether relevant resources and procedures and being evaluated and new strategies are being produced accordingly (Joint Commission, 2014).

Next, each member of the organization who has specific responsibilities in the integrated care program must be identified. In addition, leaders must delegate job duties to these individuals and ensure that they are being performed. The hospitals and ambulatory sites must put down in writing their mission, vision, and goals for their integrated care programs. These should include ensuring that they are comprehensive and focus on patient-centered care. Clinical, operational, and financial goals should be clearly defined. Furthermore, patients should be provided information concerning the mission and goals of the integrated care program.

The Joint Commission also states that it is necessary to consider the patient population it is treating in addition to the needs of its staff. Health disparities and priorities for the patient population must be determined. In addition, the results of performance improvement project should be reflected in future practice. Training of employees needs to be improved in a manner that includes the resolution of conflicting recommendations of care. All employees should only provide care that is within the scope of their training. Information about a patient’s care should be provided to them whenever possible.

The standards are also very specific about the sharing of patient information with outside institutions, stating when this is and when this is not necessary. Ultimately, all actions should be performed while considering what the best interest of the patient is. All health care institutions are urged to track safety data, including satisfaction with care, medication, errors, falls, etc. so the organization has a means by which to track quality improvement in terms of measurable metrics.

Balanced Scorecard for Quality Measurement

Evaluation of Scorecard

This scorecard is beneficial because it provides St. Michael’s with a means to assess the interventions it will implement according to its quality improvement goals. Since the health care institution wishes to focus on accomplishing its aims through by building upon leadership, infrastructure, and engagement, these are the broad categories through which sub aims will be created. The most important skills that can be facilitated through strengthened leadership is communication and the effective evaluation of new models. Likewise, the infrastructure of the institution can be utilized to establish a more meaningful hierarchy and to determine how to best incorporate patient voice into practice. Last, engagement can help facilitate employee motivation to increase efficacy of practice and the establishment of training programs are expected to support this goal as well.

As a consequence, the proposed scorecard is expected to assist St. Michael’s with its quality improvement goals. Most importantly, it will help improve safety and outcomes by providing the hospital with a means to establish accountability, which ties into the hierarchy reorganization. Evaluating new models will assist with this practice as well, as it will provide the health care team an effective manner in comparing hospital practices both prior to and following the implementation of an intervention. Access and patient-centeredness will be accomplished by gaining an increased understanding of patient voice and implementing this information into the development of new procedures. Equity and efficiency will be enhanced by the focus on increasing employee motivation and education in a manner that will lead to their increased ability to make evidence-based decisions (Muecke et al., 2013).

Definition of the Value of a Balanced Scorecard

It is beneficial to utilize a balanced scorecard as a tool in the health care setting because they help predict future performance in terms of changes that will be established. While balanced scorecards are typically utilized in the financial sector, they are useful as components of strategic management systems of all kinds. In the health care setting, this tool allows the organization to focus on developing an understanding of the needs of their patient population, enhancing internal organizational practices, and determine how to further learning and growth. According to the Balanced Scorecard Institute, balance scorecards can be utilized to achieve a variety of means that focus on the development and implementation of the strategic plan (Balanced Scorecard Institute, 2014).

It is possible that my organization would be able to improve its balanced scorecard by increasing the level of detail that it contains. While it is important to have a basic understanding of the institution’s broader goals, it is also necessary for them to detail the specifics that will allow them to accomplish these aims. As a whole, the strategic plan was made to be very broad so that it would be able to accommodate new plans as they arise. However, the balanced scorecard should be adapted in a manner that reflects the current and existing needs of the organization so that they are able to accomplish goals in a measureable and evaluable manner (U.S. Department of Health and Human Services, 2010).

Explanation of Each Scorecard Measure

An increase in communication can be determined by tracking the quality of communication over time. Data could be tracked by use of electronic health record systems, and correspondence detailing patient status should be coded according to its qualitative value on a scale of insufficient, poor, adequate, and complete (Franklin, 2012). The quality of recording for each member of the health care staff in addition to the institution as a whole will be tracked over time. Next, the evaluation of new models will take place by establishing a baseline statistics including records of practice errors including failure to provide adequate medication or to ensure patient safety. A student’s t-test will be used to compare the amount of errors made prior to and following a new intervention. An assessment of the hierarchy change will be made using similar variables.

An incorporation of patient voice will be accomplished by issuing patient surveys. Quantitative responses will be compiled and qualitative responses will be coded to determine the most popular patient feedback messages and requests (Babbie, 2010). This data will be utilized in the development of new models, the analysis of which was discussed above. Employee motivation will be measured quantitatively by determining the amount of patients that each employee sees in a given amount of time, which qualitative measures will come into play to determine how effective their work was within this duration. Employee training programs will be assessed quantitatively by tracking employee progress on required evaluative assessments over time.

Evaluation of External Benchmarks

To determine the efficacy of these benchmark goals, it will be necessary to compare the safety data of St. Michaels with the safety data with the remainder of the population on the regional and national level. It is necessary to determine how the individual institution compares to others, which will allow the organization to gain a greater understanding of its progress towards its goals. Over the next three years, it will be necessary to increase hand safety by ensuring that hands are adequately washed before seeing patients. It is expected that this will occur at least 75% of the time in three years. In addition, medication errors will be prevented 80% of the time, which is up from an expectation of 65% in 2014-2015. The readmission rate is currently 18.8% and it is expected that this will drop to 15% in three years after retraining staff (St. Michaels, 2014).

A Reflection of the Strategic Plan

The balanced scorecard reflects the strategic plan for St. Michael’s because it provides an outline of institutional goals and a means by which they can be accomplished. It explains these aims in a manner that allows everyone to recognize their unique responsibility in ensuring that they will be accomplished. The nurse’s role is to engage in the programs that were outlined and to ensure that they are doing their best job to ensure that these goals are accomplished on the individual level. In this specific situation, this will involve ensuring that all medical records are detailed and written clearly and concisely. It will also include participating in all required training programs and committed the required information to memory. Last, it will require working closely with managers and supervisors to determine if they are being any additional responsibilities regarding data collection and other aspects of the research process.

References

Babbie ER. (2010). The Practice of Social Research. 12th ed. Belmont, CA: Wadsworth Cengage.

Balanced Scorecard Institute. (2014). About the Balanced Scorecard. Retrieved from  https://balancedscorecard.org/Resources/About-the-Balanced-Scorecard/Definitions

Franklin MI. (2012). Understanding Research: Coping with the Quantitative-Qualitative Divide.

Muecke S, Curac S, Binks D. (2013). Informing clinical policy decision-making practices in ambulance services. International Journal of Evidence-Based Healthcare, 11(4): 299-304.

St. Michael’s. (n.d.). Quality Strategic Framework. Retrieved from http://www.stmichaelshospital.com/quality-new/quality-strategic-framework.pdf

St. Michael’s. (2014). Quality Improvement Plan (QIP) Narrative for Healthcare Organizations in Ontario. Retrieved from http://www.stmichaelshospital.com/quality-new/qip_part_a.pdf

The Joint Commission. (n.d.). Facts about Joint Commission standards. Retrieved from http://www.jointcommission.org/facts_about_joint_commission_accreditation_standards/

The Joint Commission. (2014). Requirements for Integrated Care Certification. Retrieved from https://jointcommission.az1.qualtrics.com/CP/File.php?F=F_0dpOs5UEeAjSfiJ

U.S. Department of Health and Human Services. (2010). Balanced scorecards for small rural hospitals: Concept Overview & Implementation Guidance. Retrieved from https://www.ruralcenter.org/sites/default/files/Final%20BSC%20Manual%2010.18F.pdf

Washington State Department of Health. (2011). Quality Improvement Program. Retrieved from http://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/PublicHealthSystemRes ourcesandServices/QualityImprovement