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“Balanced Scorecard –Regulatory Style”
Jan Robinson, RegistrarCollege of Physiotherapists of
Ontario
2006 Annual Conference
Alexandria, Virginia
Council on Licensure, Enforcement and Regulation
Expect the Unexpected: Are We Clearly Prepared?
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
2
Objectives
• Reasons for initiative• Vision for Accountability• Building the Scorecard• Success and learning
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Impetus
• Culture change• External environment• High performing organization
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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• Regulatory organizations are public organizations entrusted to professions
• Trust is earned
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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One of Four Strategic Objectives
• To demonstrate public accountability through performance measurement.
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Value for Public Accountability
• By 2007Effective measurement system
indicates College performance meets, exceeds or is “best practice”
Staff & Council quickly identify and resolve areas of concern
Evaluate & CQI embedded in culture
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Vision for Public Accountability
• By 2007,Stakeholders know performance
versus targetsHigh level of accountability + higher
trust relationshipsNew projects screened for
performance impactThe College is in a leadership role
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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To demonstrate public accountability through
performance measurement
• IndicatorsKey measures are identified and
monitored regularlyPrograms set in an evaluation
frameworkAccountability results reported
externally
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Project
Define what, why and how College will evaluate its performance.
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Tactics
• Select evaluation framework and adapt it to regulatory environment
• Define and select “programs”
• Identify measures that demonstrate public accountability
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Performance Measurement
Balanced Scorecard selected 2004
•Type:Navigational – monthly, forward
facing, internal focus
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Quadrants of Balanced Scorecard
Stakeholder Finance
Process Learning & Growth
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Corporate Balanced Scorecard
Governance Scorecard
Operations Scorecard- Program Scorecard
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Indicator Development
• Layers relevant to the role & function
– Council - critical few for governance– CEO - higher level / global operations– Manager / Director – program details
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Program Definition and Selection
Entry to PracticeQuality ManagementProfessional PracticeProfessional Conduct
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Rapid Scorecard Development
• Strategy Map & Definitions
• Core processes and current projects
• Indicator selection & collection process
• Templates for Reporting
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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To protect and serve the public interest by ensuring that physiotherapists provide high quality, competent and ethical services
Register Competent Practitioners Assure Quality PT Practice
v1
Use Resources Effectively
Enforce Practice Standards
Deliver Effective Registrant Resources
Demonstrate Public Accountability
Sustain a High Performance Standard
Maximize Business Partnerships
Ensure High Staff & Board Competence Leverage TechnologyCelebrate Collaboration &
Innovation
2020
1010
4545
2525
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Core Processes
• Process that is ongoing and relates to input, output and outcomes.
• 15 Core processes identified.
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Projects & Activities
• Undertaken to close a performance gap
• Line up to domains on the strategy map
• Weighting and ranking process
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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CEO monitors themes monthly
• Customer service• Case management• Systems improvement• Fiscal effectiveness• Stakeholder engagement• Program implementation • Staff performance
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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CEO monitors monthly
• Volumes
• Workload trends
• Outcomes
• Variance
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Examples of CEO Indicators
Case managementinitiation to disposition meets timelinenotice time met# appeals College decision upheld on appeal timely posting on public register remediation outcomes
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Examples of CEO Indicators
Stakeholder engagement practice advice volume and quality response to registrant material
validation (#, satisfaction) % electorate voting # presentations requested /
delivered
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Staff report to CEO
• Monthly / quarterly
• Performance in identified areas
• Analysis & recommendation
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Staff report to CEO
• What
• So What
• Now What
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Table Format for Scorecard
Indicator Title
Definition
Target Rationale
Score
Analysis
3 word title
What is in / out
Performance standard
Rationale for standard
How we did
What
So What
Now What
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Operations ScorecardIndicator Title
Definition Target Rationale Score
Analysis
Case Disposition
# of cases
closed within
established standard for case type / all casesclosed in quarter
(aggregate view of Exec. Registration, QM, Complaints)
Green- all compliant
Yellow – 1 area not at standard
Red- 2areas not at standard and / or 1 area not at standard2nd consecutive quarter or more
Complaint with statutory requirement & high performance
What:
So What:
Now What:
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Rationale for Setting the Target
Statutory requirement
Council direction
Industry benchmark
Standard that reflects a high performance organization
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Color Coding
Green – fully compliant with target
Yellow – 1 area not compliant with target; some concern
Red – 2 areas not compliant; or 1 area not compliant for second quarter; recovery plan required.
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Operations DashboardStakeholder
INDICATOR Q2 Q3 Q4 Q1 Q2
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Corporate Balanced Scorecard
Operations Scorecard
Focused on operational activities
Monthly to CEO & quarterly to Council
Council receives compiled CEO & staff indicators
Governance Scorecard
Focused on governance activities
Quarterly to Exec Com & Council
Council receives all indicators
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Accountabilities
Operations Scorecard
• Council
• CEO
• CEO & staff
Governance Scorecard
• Council
• President & Exec Committee
• CEO
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Evolution• Commitment to quality improvement
• Indicators can change
• Targets can change
• Active role working in partnership
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Key Success Factors
• Key participants must understand performance measurement
• Critical few indicators• Right discussion at right level• Tools • Integrate into day to day work life• Buy in
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Definition of Success
The College of Physiotherapists is an The College of Physiotherapists is an organization publicly known for its organization publicly known for its strategic leadership in professional self-strategic leadership in professional self-regulation. It is governed and staffed by regulation. It is governed and staffed by a competent and capable team that a competent and capable team that thrives in best practice and thrives in best practice and accountability environment. The College accountability environment. The College is a model for others and partners are is a model for others and partners are satisfied with its current performance satisfied with its current performance and future vision.and future vision.
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Definition of Success (cont’d)
The College is viewed as fair and cost effective within its mandate. Physiotherapists actively use the College resources in practice; the public consistently recognizes the College as advocating and investing in safe, quality physiotherapy practice.
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Next Steps
• Complete one full year cycle
• Stakeholder consultation on reporting
• Full public reporting
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Learnings
• Keep it simple consider key areas already reviewed.
• Be flexible• “red is not “bad”• Just get started
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Resources Kaplan, Robert S. and Norton, David – Having Trouble with
your Strategy? Then Map it Harvard Business Review September – October 2000
Niven, Paul R. - Balanced ScorecardStep-By-Step for Government and Nonprofit Agencies (2003)
CCAF Reporting Principles: Taking public Reporting to a New Level (2002)
Institute on Governance – www.iog.ca
Ontario Hospital Association – Guide to Good Governance
Canadian Policy Research Network (CPRN)- Series of papers on Accountability in Health Care Website: http//www.cprn.org
pm2 Performance Measurement and Management
Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia
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Speaker Contact Information
Speaker Name: Jan Robinson, RegistrarOrganization: College of Physiotherapists
of OntarioAddress: 375 University Ave. Suite 901Toronto, Ontario, M5G 2J5, CanadaPhone, Fax : 416-591-3828 / 416-591-3834 (fax)E-mail: [email protected]: www.collegept.org