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IntroductionPerformance 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…
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