The Balanced Scorecard (BSc) is a corporate strategic control tool that has been developed by Robert S. KAPLAN et David P. NORTON in the early nineties. It is based on measures of performance used by various multinationals. This tool underlines the key factors for success of an organisation based on “perspectives”. For each perspective ,key factors for success are identified and followed up through the regular measurement of indicators. The BSc was initially developed for commercial companies and proposed four perspectives: financial perspective, customers’perspective, internal business perspective, innovation and learning perspective.
The definition of these four perspectives and the identification of the key factors result from the following logical process: to reach the shareholders’financial objectives, it is imperative to consolidate one’s position on the market while meeting the customers’ needs, which requires the definition and the development of efficient internal processes. To guarantee the viability of the company beyond the short-term period, it is important for the company’s intangible assets (competence, degree of innovation, flexibility) to be maintained and developed.It is therefore indispensable to take steps to guarantee innovation and learning.
We have applied the above explained concept of Balanced Scorecard to a Hospital by analyzing the above four indicators from a hospital’s perspective. Clinical Quality ( Internal Business Perspective) It describes the clinical performance of hospitals and refers to such things as access to hospital services, clinical efficiency, and quality of care. Financial Performance and Condition It describes how hospitals manage their financial and human resources. It refers to a hospital’s financial health, efficiency, management practices, and human resource allocations.
Patient Satisfaction (Customer’s Perspective) Examines patients’ perceptions of their hospital experience including their perceptions of overall quality of care, outcomes of care, and unit-based care. System and process alignment and innovation (Innovation and learning perspective) Describes a hospital’s ability to adapt to its changing health care environment. More specifically, it examines how clinical information technologies, work processes, and hospital-community relationships function within the hospital system.
The qualitative or quantitative measures used under each of the above indicators or perspectives are: Clinical Quality and Internal Business Length of Stay Length of stay (LOS) is a common way to measure clinical efficiency. The LOS in a hospital is measured in days, and is the number of days from admission to when the patient is discharged or when he/she is determined to be appropriate for an alternate level of care (i.e. no longer in need of acute care hospital services). The standard under this measure would vary across medical unit to unit
Complications A case will be defined as having a complication if the patient’s diagnosis changes after admission ie the condition worsened or not, develops further or the patient had a length of stay that was longer than the provincial median for that patient group, or the patient died. Access to technology Whether the procedures, equipment, qualifications of physicians and staff is in line with certain standards and what is the access the hospital has to latest technology and processes.