nursing healthcare balanced scorecard

Introduction Performance scorecards provide a straightforward means of integrating metrics into a healthcare organization’s strategic planning. Scorecards are most effective when they have a clear purpose, identifying specific patient populations and outcome measures. According to Baker (2015), “savvy organizations select the best metrics to track that are appropriate to what the organizational staff members wish to measure,” which could include specific issues like patient vital signs or patient satisfaction survey outcomes (p. 224).

Moreover, performance scorecards need to be simple, kept on a manageable scale so that the data gleaned can be readily communicated to inform organizational practices, policies, and procedures (Hansel, n.d.). The following performance scorecard includes three core categories including performance, quality, patient safety, and employee engagement, all while focusing on addressing the needs of a specific patient population: adults over the age of 65 who have been diagnosed with Type II Diabetes.

GOAL TARGET KEY STAFF REVIEW FREQUENCY JAN 2018 FEB 2018 MAR 2018 APRIL 2018 Performance Readmission 15% Monthly 25% 22% 23% 27% Mortality 10% Monthly 15% 10% 5% 10% Quality Lifestyle counseling 99% Monthly 80% 82% 79% 82% Complications 15% Monthly 18% 22% 23% 19% At-Home Testing 99% Monthly 85% 89% 90% 92% Patient Perceptions 90% Every three months 90% 85% 89% 90% Patient Safety Equipment Failure 5% Monthly 2% 5% 8% 10% Voluntary Error Reports 10% Monthly 5% 2% 6% 10% Patient Error Reports 5% Every three months 3% 8% 12% 8% Employee Engagement Survey data 90% Every three months 85% 80% 82% 80% Outcome Measures Performance The outcome measures for performance will include mortality rates within the patient population and readmission rates.

Quality Performance outcomes for quality include number of patients receiving at-home testing equipment for self-monitoring, number of patients receiving lifestyle counseling and preventative care, complications related to Type II Diabetes, and patient perception of care. Patient Safety Patient safety outcomes include number of equipment and/or test failures, voluntary error reporting from staff, and patient-reported errors in care. Employee Engagement Employee engagement outcomes include surveys that can be quantified. Driving Outcomes Measures Driving outcomes measures requires a combination of leadership best practices and evidence-based practice with the patient population.

Performance To drive outcomes measures in performance, nurses need to monitor several factors at once, including patient readmission rates and mortality rates within the patient population. An additional indicator that would be important would be one derived from Medicare, such as total cost expenditures per patient. To drive outcome measures, it would be important to pay attention to the other performance metrics including those that address quality of care such as lifestyle counseling and preventative interventions for at-risk patients.

The workplace environment, job characteristics, and institutional supports all contribute to measurable performance outcomes. Quality Driving outcomes measures to improve quality of care requires a dependence on evidence-based practice, a reinvigoration of nurse training, and additional indicators to monitor outcomes such as patient family surveys to evaluate their perceptions of care quality. Quality of life factors including mental health and social functioning would also be additional indicators nurses could use on a qualitative level, with quantitative indicators including vital signs measurements including BMI/weight-related issues and heart health measures.

Another additional indicator would be to quantify numbers of direct patient referrals: the critical word-of-mouth marketing the healthcare organization depends on for its long term success and financial performance. Driving quality of care, nurse leaders can make changes to institutional policies, technologies, and job characteristics. Patient Safety Patient safety remains one of the easier outcomes measures to quantify.

In addition to core indicators like equipment efficacy and error reporting, nurses can also drive outcomes through the implementation of a no-fault error reporting system, The no-fault error reporting system would encourage nurses to report errors immediately without fear of reprimand, allowing appropriate corrections to be made in a timely and honest fashion. Technology, organizational supports, and leadership drive patient safety outcomes. Employee Engagement Employee engagement is known to be a “prerequisite for high performance,” (Lowe, 2012, p. 29).

Engaged employees increase overall job satisfaction rates, which means higher morale, commitment, camaraderie, reduced absenteeism, and reduced turnover rates. Therefore, to properly measure employee engagement, it is critical to operationalize the definition and construct different survey instruments and means of measuring engagement outcomes. Having individual interviews with employees is helpful, but primarily yields case-by-case qualitative data that is difficult to input into the balanced scorecard. Preferable for snapshots of performance data and for communicating to hospital administrators would be simpler, more straightforward metrics of assessing employee engagement.

Exit interviews, surveys, and online questionnaires that are shorter and which encourage employee responses to be honest and forthcoming would all help administrators measure employee engagement systematically over time. Scorecard Advantages Although it includes several more performance outcomes than would be required, this scorecard nevertheless does focus on only four main areas including employee engagement, patient safety, quality of care, and performance measures. Each of these is then broken down into sub-categories with clearly defined measurable outcomes. The benefits of using this particular balanced scorecard include the following. 1. Data-Driven.

This scorecard depends on measurable, quantitative outcomes. Even the surveys with patients and employees require measurable data outcomes that can be used to inform company policies and practices. In the evidence-based practice landscape, having data-driven performance outcomes is crucial. 2. Consistent. This scorecard includes multiple elements that all tie together to describe one single patient population: seniors who have been diagnosed with Type II Diabetes.

Within this patient population, nurse administrators can then examine specific ways of improving performance outcomes in order to meet the self-defined objectives and goals of the organization. 3. Clear. This scorecard includes several metrics that clearly and accurately encapsulate what they intend to measure. For example, the equipment failures can be tabulated over the course of each month, as can mortality rates. These clearly defined performance indicators are measured using means that have strong internal validity, regardless of whether they can be applied to other patient populations.

Employee Engagement Employee engagement, while not necessarily linked only to the target population, is nevertheless critical for enhancing performance outcomes. Some of the core elements of employee engagement include allowing pathways for active, earnest, and even anonymous employee feedback, and offering employees the opportunity to receive accurate and supportive feedback in return, overall happiness measures such as workplace satisfaction, relationships with colleagues and managers, and opportunities for personal and professional development.

Alignment of professional goals with individual values, mental health and physical wellness, and ambassadorship are also employee engagement practices that can be used to directly improve performance outcomes (Shirar, 2017). Current trends in employee engagement include the standardization and operationalization of terms, altering organizational culture to stimulate employee engagement, and using a variety of tools and surveys for assessing whether employee engagement tactics and techniques are working. Employee engagement is directly linked to healthcare quality for a number of reasons.

First, engaged employees have a personal stake in performance outcomes, taking greater pride in their own performance not just because it reflects well on them but because they genuinely care about both individual patients and the organization as a whole. Second, healthcare quality depends on an engaged employee population because of factors like job satisfaction and low burnout rates.

Employees that are working to the point of burnout will not only be less engaged psychologically and physically with their patients, but also more prone to errors, and less willing to communicate their concerns with an unsupportive team. Receiving recognition for good work, maintaining work-life balance, opportunities for job advancements and professional development, and other key trends will help to ultimately drive up patient care outcomes, quality of care, and perceptions of care quality. Current tools in my organization adequately provide nurse leadership with data regarding employee engagement.

For example, my organization uses established digital pulse surveys, which are “a great way to maintain a consistent pulse on the vibe in your office,” (Shirar, 2017, p. 1). Pulse surveys offer nurse managers a distinct advantage over longer format surveys, particularly in that nurses do not need to take much time out of their schedule to perform the pulse survey, and may be far more willing to answer a quick question or two instead of devoting much more time to a more involved instrument.

Also, pulse surveys can potentially be more honest because they offer the chance for nurses to give off-the-cuff, instantaneous responses to questions related to leadership, patient safety, performance, and any other meaningful metric. Another tool my organization uses to assess employee engagement is the scheduled interview and the scheduled performance review. One-on-one interviews provide the opportunity to create dialogue, and should ideally be a bilateral conversation rather than an asymmetrical conversation.

Finally, my organization has a policy of providing exit interviews to discover what the organization can do differently to improve retention and to create a more harmonious work environment conducive to employee engagement and job satisfaction. Plan to Improve Employee Engagement Goals The goals of an employee engagement improvement plan include reducing turnover and absenteeism rates, improving all measurable performance outcome goals including those related to readmission rates, cost of.