How a Balanced Scorecard Approach Can Help Provide a Snapshot of Your Organization’s Health

Disclosures

• We have no conflicts of interest to disclose

Objectives for this Presentation

• Demonstrate the value of developing meaningful metrics that can be measured and reviewed consistently

• Introduce concept of Balanced Scorecards and the four perspectives

• Detail the process of selecting Key Performance Indicators (KPIs) and establishing a dashboard utilizing the Balanced Scorecard approach

• Consider how you can apply the Balanced Scorecard to your organization

Rationale behind Meaningful Metrics

• Small wins that add up to major accomplishments

• Boosts motivation, productivity and creativity• Dashboards are one suggested way for

employees to visually mark their progress toward organizational goals

• Well-defined, accurate and relevant metrics are the first step toward achieving goals

Adapted from Why Small Wins Matter article

Meaningful Metric Definition• Metrics

– standard of measurement by which the performance, progress or quality is assessed

– objective measure of the quality or effectiveness– accelerate performance when senior

management and staff are engaged in monitoring and taking action

– allows informed decisions (allocation of resources, capital investment, budgets)

– provides the data to drive improvement, identify issues, and serve as motivators

ABCs of Identifying Meaningful Metrics

• The hard work of paring down your data is easier if the focus is on the ABCs:– Actionable track only data you can change or

can routinely act on– Balanced means collecting a diversity of

data points– Culture means the culture of performance

improvement, not the actual data • (don’t worry about imperfect data)

Adapted from How to Improve Mission-Related Outcomes article

Sharing a Meaningful Metric

• Find a partner to chat with• Think of a meaningful metric in your

organization• Describe for your partner what the metric

measures– What is the numerator and denominator?– How is the data tracked and reported?– Why is it relevant for what you want to track?– Is it actionable?

Defining Balanced Scorecard• A strategic planning and management system

that organizations can use to– Communicate what they are trying to accomplish– Align the day-to-day work with strategy– Prioritize projects and services– Measure and monitor progress towards strategic

targets• A system that connects the dots between big

picture strategy elements (Mission; values) and more operational elements (measures; initiatives)

Adapted from Balanced Scorecard Institute website

Four Perspectives of BSC

Application of the Scorecard Approach to Create a Dashboard

Steps to Identifying KPIs1. North Country asked for actionable

metrics from all over the organization (A KPI is a measurable and actionable metric that demonstrates how effectively you are achieving your department’s objectives) - 118

Proposed KPI Department/Program

Press Ganey Recommend Provider Office Marketing

Linkage of care within 30 days for HIV and Hep C reactive Enabling Services

Days in AR Financial

Number of health professions student training hours in rural or underserved area

NAHEC

Number of INR visits in person Clinical Pharmacy

Percent of SOGI data gathered on patients Front Office

Percentage of Colorectal Cancer Screening Clinical

Clarifying KPIs2. Defining the metric

• Reviewing to ensure it was measuring what it was supposed to measure & actionable

• Defining numerator and denominator• Identifying where the data comes from• Ensuring data validity

3. Ensuring four perspectives were met

Prioritizing KPIs

4. Once compiled, a team scored each metric for impact

ScoringDept 1 6S.I. 0 10External 0 6Community 0 10Finance 0 10

Range 1 42

Balanced ScorecardF: Financial - financial performance and resourcesC: Customer - effects customersIP: Internal Process - workflow outcome successO: Organization: workflows effectiveness

DepartmentsC: ClinicalO: OperationsF: FinancialE: Enabling (BH, CH, NAHEC)P: PharmacyA: Admin (IT, HR, MKT)Scoring: 1 point each

ExternalRequirementsYes = 6Yes/No = 3No = 0

Strategic Initiative (SI)A - Family Medicine Residency ProgramB - Development and FundraisingC - Integrated Care TeamsD - Leverage Resources - Serve the PatientE - Leverage Resources - Bill and Collect SmartN - None SI Scoring

None = 0One = 6Two = 8Three or more = 10

Community1 Community cannot receive elsewhere2 Alignment with CHC3 Fulfill mission4 Increases pipeline5 Promotes individual ability to thriveScoring: 2 point each

Financial impact0 to 10

Selecting & Grounding KPIs• North Country selected 14 organization wide

KPIs on a dashboard with rationale• Established metric goals and ranges to

ground it in progression toward the goal• Use images of gauges/colors to illustrate

performance

Utility of Dashboard• Optimally, at least one KPI will be

measured over time

• Strategic KPIs monitor – the implementation and effectiveness of an

organization's strategies– determine the gap between actual and

targeted performance

0

200

400

600

800

1000

1200

Oct Nov Dec Jan Feb MarBH CPH CM

Adapted from Balanced Scorecard Institute website

Utility of Dashboard• Cascading means translating the scorecard down

from leadership, to support departments and then teams or individuals

• The end result should be clearly visible organization alignment – through strategy, performance measures and targets,

and initiatives• Scorecards should be used to improve

accountability – objective and performance measure ownership– desired employee behaviors should be incentivized – cascading focuses the entire organization on strategy

Adapted from Balanced Scorecard Institute website

Share Perspectives

• Team back up with your partner and share your perspectives

• Ideas you can share:– How might your organization benefit from a

Balanced Scorecard approach?– What was a takeaway?– Was there a novel

approach that spoke to you?

Final Takeaways

– Balanced Scorecards development is a process that can be used to align & visualize their process

– Consider revisiting scorecard/dashboard data every year

– If you rush it, or just bring in a consultant to do the work for you, you may miss the value of the process

– Celebrate & acknowledge small wins

Adapted from How to Improve Mission-Related Outcomes article

Questions?