The balanced scorecard at Duke Children's Hospital

internal business process perspective balanced scorecard turns attention aspects organization's operations possibility direct control managers employees. Here a summary approach: Niven, P. (N.D.) Internal Process perspective.

The balanced scorecard at the Duke Children's Hospital

The change process at Duke Children's Hospital was decided upon as the healthcare institution faced severe challenges. Its operational costs were increasing while its revenues were decreasing. Issues had been raised about eliminating specific programs and reducing the palette of services offered. The levels of productivity on the part of the staff members were decreased, as was their satisfaction and the satisfaction of the patients.

In addressing these issues, the managerial team at the hospital focused on the integration of the clinicians and administrators in a strategic manner, with the aid of the balanced scorecard. As a result, the revenues increased and the net margin of the hospital increased by $15 million. Employee satisfaction also increased to now reveal unprecedented levels.

2. Analysis

The tool used by the Duke Children's Hospital, the balanced scorecard, is a "strategic planning and management system that is used extensively in business and industry, government, and nonprofit organizations worldwide to align business activities to the vision and strategy of the organization, improve internal and external communications, and monitor organization performance against strategic goals" (The Balanced Scorecard Institute).

The balanced scorecard is as such an integrated effort to improve the overall organization and it is integrated at various levels of the entity. In the case of the Duke Children's Hospital, emphasis was placed on the integration of the data available so that it is easily accessible, reliable and efficiently portrays a picture of the reality. Then, emphasis was also placed on the generation of performance and the organization of the operational process in terms of financial results. The concepts at the basis of the balanced scorecard implementation referred to the following: financial, customer, learning and growth, and finally, internal business (Meliones, Ballard, Liekweg and Burton, 2001).

In order to attain the objectives initially set, the Duke Children's Hospital focused on the following measures:

The establishment of the key linkages to ensure the necessary connections within the hospital

The analysis of the performances

The gaining of knowledge and strategic control over the organization (Meliones, Ballard, Liekweg and Burton, 2001).

4. Evaluation

The implementation of the balanced scorecard has helped the Duke Children's Hospital attain its objectives and has allowed them to increase performance, net margin as well as patient and employee satisfaction.

"By integrating the clinical and business aspects of health care at Duke Children's Hospital, we achieved a significant improvement in all perspectives -- financial, customer, learning and growth, and internal business" (Meliones, Ballard, Liekweg and Burton, 2001).

References:

Meliones, J.N., Ballard, R., Liekweg, R., Burton, W., 2001, No mission No margin: It's that simple, Journal of Health Care Finance, Vol. 27, No. 3

Balanced scorecard basics, The Balanced Scorecard Institute, http://www.balancedscorecard.org/BSCResources/AbouttheBalancedScorecard/tabid/55/Default.aspx last accessed on August 4, 2011