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¶ … Internal Business Process Perspective balanced scorecard turns attention aspects organization's operations possibility direct control managers employees.
The balanced scorecard at Duke's Children Hospital Analysis
In the context of a rapidly evolving society, the health care sector must also develop new mechanisms by which to keep up with the emergent changes and challenges. One example in this sense is represented by the implementation of business tools and techniques within the act of health care provision.
One relevant example in this sense is offered by Duke Children's Hospital in Durham, North Carolina, which implemented the balanced scorecard to address some critical problems with costs of health care provision and nurse dissatisfaction.
"Between 1993 and 1996 DCH's cost per case increased $4,389, while reimbursement declined, leading to a negative net margin in 1996 of $11 million dollars. During this same period, nurse productivity declined from 80th percentile to the 80th percentile, while patient and staff satisfaction declined to record lows" (Dunham-Taylor and Inczuk, 2006).
The balanced scorecard seemed the most adequate solution to addressing these problems and the method selected by the managerial team at the health care institution was represented by the integration of the business processes and the health care processes into a single unified effort (Meliones, Ballard, Liekweg and Burton, 2001). This approach was due to the belief that no process should take priority over the other (Dunham-Taylor and Pinczuk, 2006).
The implementation of the balanced scorecard at the Duke Children's Hospital was based on the need to promote the business sustainability of the entity, without compromising the quality of the medical act. In their implementation of the balanced scorecard, distinctive emphasis came to be placed on three specific commitments, namely those of communicating, carting the path and never stopping.
At the level of communication, the managerial team focused on the communication of the problem that existed within the hospital; it listed to what the employees had to say; it improved the organizational culture and it changed the role of people. At the level of the path, the DCH's managers focused on a pilot project, developing and realistic goals, focus on information and the inclusion of the employees and their support in performance generation. Finally, at the level of the continuance, emphasis came to be placed on mapping the business to the balanced scorecard and remaining consistent to this mapping; continually experimenting and learning from failures and encouraging strategic thinking at all of the organizational levels (Meliones, 2000).
Aside from the actual balanced scorecard, the managers at the Duke Children's Hospital were also faced with the challenge of integrating the balanced scorecard within the overall context of the institution, in order to support the full attainment of the pre-established objectives. In this order of ideas, the balanced scorecard was in charge of ensuring an organization wide strategic alignment, while it also interacted…
References:
Dunham-Taylor, J., Pinczuk, J.Z. (2006) Health care financial management for nurse managers: merging the heart with the dollar. Jones & Bartlett Learning
Meliones, J. (2000).Saving money, saving lives. Harvard Business Review. http://www.csus.edu/indiv/l/lundbladg/1_ACCY122_Fa08/ACCT122_Exams/SavingMoney+_SavingLives_Duke.pdf accessed on August 17, 2012
Meliones, J.N., Alton, M., Mericle, J., Ballard, R., Cesari, J., Frush, K.S., Mistry, K. 10-year experience integrating strategic performance improvement initiatives: can the balanced scorecard, Six Sigma and team training all thrive in a single hospital? Agency for Healthcare Research and Quality http://www.ahrq.gov/downloads/pub/advances2/vol3/advances-meliones_40.pdf accessed on August 17, 2012
Meliones, J., Ballard, R., Burton, W., (2001). No mission, no margin: it's that simple. J Health Care Finance. Vol. 27. No 3
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