The Balanced Scorecard:
Measuring Healthcare Performance
A Powerful Management System  Translating strategy into action…now that's what we all want to improve performance in Oklahoma healthcare. In a recent book by Kaplan and Norton, The Balanced Scorecard, the authors describe a new management system that provides performance measures across four balanced perspectives:

The authors began by looking for performance measures. They concluded a balanced set of measures, not just financial measures, lead to higher performance. And, as organizations began implementing the Balanced Scorecard they saw it was an effective way to communicate strategy to everyone.

The Four Perspectives Certainly you must maintain the financial perspective to ensure your healthcare organization remains viable. However, you must effectively listen to patients and measure core outcomes which are critical for patient satisfaction. Your internal business processes are those critical processes where you deliver value, from triage on incoming telephone calls to direct patient care. The learning and growth perspective defines organization skills needed for long-term growth.

Where do you start? The scorecard process starts with your senior management team defining goals, objectives and strategies for your practice. Then you set targets and measures for each strategic initiative. The Balanced Scorecard helps you identify those processes which are most critical in meeting the performance level you want. Here is a major benefit. With the Balanced Scorecard, you can give very specific targets and measures to your staff, so they can see what their contribution must be to reach the strategic goals of your practice.

A Healthcare Example A patient goal may be "Reduce patient waiting time on all contacts with our practice." That is, reduce waiting time in the office, on the telephone and for prescriptions. One objective associated with this goal might be " By January 31, 2000, ensure prescriptions are called in within three hours from the time the patient calls." Now, what targets and measures should we use? Certainly, the target would be prescriptions called in within three hours. The measure would be the average time it takes from receiving the patient request until the prescription is called in to the pharmacy. Now, everyone knows what is expected, with targets and measures set to track performance.