Achieving excellence in veterans healthcare--a balanced scorecard approach.

PubMed

Biro, Lawrence A; Moreland, Michael E; Cowgill, David E

2003-01-01

This article provides healthcare administrators and managers with a framework and model for developing a balanced scorecard and demonstrates the remarkable success of this process, which brings focus to leadership decisions about the allocation of resources. This scorecard was developed as a top management tool designed to structure multiple priorities of a large, complex, integrated healthcare system and to establish benchmarks to measure success in achieving targets for performance in identified areas. Significant benefits and positive results were derived from the implementation of the balanced scorecard, based upon benchmarks considered to be critical success factors. The network's chief executive officer and top leadership team set and articulated the network's primary operating principles: quality and efficiency in the provision of comprehensive healthcare and support services. Under the weighted benchmarks of the balanced scorecard, the facilities in the network were mandated to adhere to one non-negotiable tenet: providing care that is second to none. The balanced scorecard approach to leadership continuously ensures that this is the primary goal and focal point for all activity within the network. To that end, systems are always in place to ensure that the network is fully successful on all performance measures relating to quality.

The Strategic Evaluation of Regional Development in Higher Education

ERIC Educational Resources Information Center

Kettunen, Juha

2004-01-01

The study analyses the role of regional development in higher education using the approach of the balanced scorecard, which provides a framework for organizations to describe and communicate their strategy. It turns out that the balanced scorecard is not only an approach for implementing the strategy, but it also provides a general framework for…

Design Principles for the Development of the Balanced Scorecard

ERIC Educational Resources Information Center

Keser Ozmantar, Zehra; Gedikoglu, Tokay

2016-01-01

Purpose: The purpose of this paper is to investigate the development and implementation process of the balanced scorecard (BSC) approach in an educational institution in the context of the Turkish educational system. It also aims, on the basis of the results of the applications in a particular school, to define principles through which the…

Improving health services to displaced persons in Aceh, Indonesia: a balanced scorecard.

PubMed

Chan, Grace J; Parco, Kristin B; Sihombing, Melva E; Tredwell, Susan P; O'Rourke, Edward J

2010-09-01

After the Indian Ocean tsunami in December 2004, the International Organization for Migration constructed temporary health clinics to provide medical services to survivors living in temporary accommodation centres throughout Aceh, Indonesia. Limited resources, inadequate supervision, staff turnover and lack of a health information system made it challenging to provide quality primary health services. A balanced scorecard was developed and implemented in collaboration with local health clinic staff and district health officials. Performance targets were identified. Staff collected data from clinics and accommodation centres to develop 30 simple performance measures. These measures were monitored periodically and discussed at meetings with stakeholders to guide the development of health interventions. Two years after the tsunami, 34 000 displaced persons continued to receive services from temporary health clinics in two districts of Aceh province. From March to December 2007, the scorecard was implemented in seven temporary health clinics. Interventions stimulated and tracked by the scorecard showed measurable improvements in preventive medicine, child health, capacity building of clinic staff and availability of essential drugs. By enhancing communication, the scorecard also led to qualitative benefits. The balanced scorecard is a practical tool to focus attention and resources to facilitate improvement in disaster rehabilitation settings where health information infrastructure is poor. Introducing a mechanism for rapid improvement fostered communication between nongovernmental organizations, district health officials, clinic health workers and displaced persons.

Applicability of Balanced Scorecard System in Primary Schools According to Opinions of Education Inspectors, Managers and Teachers

ERIC Educational Resources Information Center

Gündüzalp, Seda; Arabaci, Imam Bakir

2017-01-01

This study was carried out in order to specify the opinions of the staff working as manager, teacher and educational inspectors at primary schools about the implementation of balanced scorecard in education institutions. To perform that aim the staffs serving as manager, teacher and inspector at the primary Schools nearby center of Elazig Province…

Implement balanced scorecard to translate strategic plan into actionable objectives.

PubMed

2004-09-01

Faced with challenges ranging from declining reimbursement to staff shortages, health care organizations--integrated delivery systems, physician group practices, disease management providers, and others--increasingly are turning to general business models to map out step-by-step action plans for performance measurement and process improvement. Creating a "balanced scorecard" is an obvious starting point for assessing and improving clinical and financial performance.

[Balanced Scorecard--a business tool for profit calculations--usable in gynecology and obstetrics?].

PubMed

Goerke, K

2001-08-01

The balanced scorecard (BSC) is an instrument of business administration using score numbers, that not only includes financial aspects but also levels of communication, motivation and customer relations. Thus it seems usable in service oriented companies including hospitals. The next years will have to show, whether the results rectify the immense expenses necessary with the implementation of the BSC.

Balanced scorecard application in the health care industry: a case study.

PubMed

Kocakülâh, Mehmet C; Austill, A David

2007-01-01

Balanced scorecards became a popular strategic performance measurement and management tool in the 1990s by Robert Kaplan and David Norton. Mainline companies accepted balanced scorecards quickly, but health care organizations were slow to adopt them for use. A number of problems face the health care industry, including cost structure, payor limitations and constraints, and performance and quality issues that require changes in how health care organizations, both profit and nonprofit, manage operations. This article discusses balanced scorecards generally from theoretical and technical views, and why they should be used by health care organizations. The authors argue that balanced scorecards are particularly applicable to hospitals, clinics, and other health care companies. Finally, the authors perform a case study of the development, implementation, and use of balance scorecards by a regional Midwestern health care system. The positive and negative aspects of the subject's balanced scorecard are discussed. Leaders in today's health care industry are under great pressure to meet their financial goals. The industry is faced with financial pressures from consumers, insurers, and governments. Inflation in the industry is much higher than it is within the overall economy. Employers can no longer bear the burden of rising group health insurance costs for its employees. Too many large companies have used bankruptcy law as a shield to reduce or shift some of their legal obligations to provide health insurance coverage to present or retired employees. Stakeholders of health care providers are demanding greater control over costs. As the segment of un- or underinsured within the United States becomes larger as a percentage of the population, voters are seriously beginning to demand some form of national health insurance, which will drastically change the health care industry.

Improving health services to displaced persons in Aceh, Indonesia: a balanced scorecard

PubMed Central

Parco, Kristin B; Sihombing, Melva E; Tredwell, Susan P; O'Rourke, Edward J

2010-01-01

Abstract Problem After the Indian Ocean tsunami in December 2004, the International Organization for Migration constructed temporary health clinics to provide medical services to survivors living in temporary accommodation centres throughout Aceh, Indonesia. Limited resources, inadequate supervision, staff turnover and lack of a health information system made it challenging to provide quality primary health services. Approach A balanced scorecard was developed and implemented in collaboration with local health clinic staff and district health officials. Performance targets were identified. Staff collected data from clinics and accommodation centres to develop 30 simple performance measures. These measures were monitored periodically and discussed at meetings with stakeholders to guide the development of health interventions. Local setting Two years after the tsunami, 34 000 displaced persons continued to receive services from temporary health clinics in two districts of Aceh province. From March to December 2007, the scorecard was implemented in seven temporary health clinics. Relevant changes Interventions stimulated and tracked by the scorecard showed measurable improvements in preventive medicine, child health, capacity building of clinic staff and availability of essential drugs. By enhancing communication, the scorecard also led to qualitative benefits. Lessons learnt The balanced scorecard is a practical tool to focus attention and resources to facilitate improvement in disaster rehabilitation settings where health information infrastructure is poor. Introducing a mechanism for rapid improvement fostered communication between nongovernmental organizations, district health officials, clinic health workers and displaced persons. PMID:20865077

Department of Defense Civilian Human Resources Strategic Plan

DTIC Science & Technology

2005-04-01

the strategic plan. A balanced scorecard approach was used to build the strategic plan. The balanced scorecard is a strategic management tool that...in the balanced scorecard format. Details of how the balanced scorecard addresses the DoD Human Capital Initiative are outlined in the Office of...mission- ready civilian workforce 8 GOALS AND OBJECTIVES The balanced scorecard approach reflects the changes the Department is undergoing and

Estimating the ROI on Implementation of RFID at the Ammunition Storage Warehouse and the 40th Supply Depot: KVA as a Methodology

DTIC Science & Technology

2009-12-01

Balanced Scorecard CAPM Capital Asset Pricing Model DIS Defense Information System DoD Department of...Measurement Tool (PMT) is the Balanced Scorecard (BSC) based on critical success factors and key performance indicators. The MND has referred to Jung’s...authors can replicate the methodology for multiple projects to generate a portfolio of projects. Similar to the Capital Asset Pricing Model ( CAPM ) or

Performance Management in Healthcare Organizations: Concept and Practicum.

PubMed

Dimitropoulos, Panagiotis E

2017-01-01

Organizational performance can create and sustain competitive advantages for corporations and even improve their sustainability and future prospects. Health care organizations present a sector where performance management is structured by multiple dimensions. The scope of this study is to analyze the issue of performance management in healthcare organizations and specifically the implementation of the Balanced Scorecard (BSC) methodology on organizations providing health services. The study provides a discussion on the BSC development process, the steps that management has to take in order to prepare the implementation of the BSC and finally discusses a practical example of a scorecard with specific strategic goals and performance indicators. Managers of healthcare organizations and specifically those providing services to the elderly and the general population could use the propositions of the study as a roadmap for processing, analyzing, evaluating and implementing the balanced scorecard approach in their organizations' daily operations. BSC methodology can give an advantage in terms of enhanced stakeholder management and preservation within a highly volatile and competitive economic environment.

76 FR 13353 - Department of Commerce FY 2011-2016 Strategic Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

... scorecard. A balanced scorecard ``balances'' or equally emphasizes programmatic and management objectives... senior leadership to develop a balanced scorecard to deploy and execute this Strategic Plan. The Secretary directed a balanced scorecard approach to establish and maintain focus on the Department's top...

Measurement in Service Businesses: Challenges and Future Directions

NASA Astrophysics Data System (ADS)

Tyagi, Rajesh Kumar

This chapter presents challenges faced by service businesses while implementing a measurement system. A review of existing frameworks is presented and a new framework, the Service Scorecard, is introduced. The Service Scorecard is an adaptation of the Six Sigma Business Scorecard for the service sector. The framework has also been influenced by existing frameworks such as the Malcom Baldrige award criteria, the Balanced Scorecard, the European Quality award and the Service Profit Chain model. The seven elements of the Service Scorecard are Growth, Leadership, Acceleration, Collaboration, Innovation, Execution, and Retention. The examples of measurement systems are presented with concrete real-world case examples. Final thoughts and the challenges faced are also presented.

Balanced Scorecard--A Strategic Management System of the Higher Education Institution

ERIC Educational Resources Information Center

Hladchenko, Myroslava

2015-01-01

Purpose: The purpose of this paper is to focus on the comparative analysis of the Balanced Scorecards of four higher education institutions and aims to define the general framework of the Balanced Scorecard for the higher education institution which concerns: the structure and elements of the Balanced Scorecard; development of the Balanced…

Success factors for implementation of the balanced scorecard in a NHS multi-agency setting.

PubMed

Radnor, Zoe; Lovell, Bill

2003-01-01

Even though the balanced scorecard (BSC) has become a highly popular performance management tool, usage in local public sector National Health Service (NHS) organisations is still rare. This paper conditionally outlines some grounds in supporting such usage. In particular underlying conceptual concerns with the BSC system and its implementation pitfalls require full consideration. This paper then outlines some factors to be taken into account for "successful" BSC implementation in a NHS multi-agency setting. These findings emerged from a series of focus groups that took place with contributors drawn from all the key organisations within the Bradford Health Action Zone. Finally, this paper argues that if key criteria are met, successful implementation of the BSC may then proceed. However, "blind" BSC implementation without consideration of these factors may result in potential "failure".

Application of Balanced Scorecard in the Evaluation of a Complex Health System Intervention: 12 Months Post Intervention Findings from the BHOMA Intervention: A Cluster Randomised Trial in Zambia

PubMed Central

Mutale, Wilbroad; Stringer, Jeffrey; Chintu, Namwinga; Chilengi, Roma; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Balabanova, Dina; Spicer, Neil; Lewis, James; Ayles, Helen

2014-01-01

Introduction In many low income countries, the delivery of quality health services is hampered by health system-wide barriers which are often interlinked, however empirical evidence on how to assess the level and scope of these barriers is scarce. A balanced scorecard is a tool that allows for wider analysis of domains that are deemed important in achieving the overall vision of the health system. We present the quantitative results of the 12 months follow-up study applying the balanced scorecard approach in the BHOMA intervention with the aim of demonstrating the utility of the balanced scorecard in evaluating multiple building blocks in a trial setting. Methods The BHOMA is a cluster randomised trial that aims to strengthen the health system in three rural districts in Zambia. The intervention aims to improve clinical care quality by implementing practical tools that establish clear clinical care standards through intensive clinic implementations. This paper reports the findings of the follow-up health facility survey that was conducted after 12 months of intervention implementation. Comparisons were made between those facilities in the intervention and control sites. STATA version 12 was used for analysis. Results The study found significant mean differences between intervention(I) and control (C) sites in the following domains: Training domain (Mean I:C; 87.5.vs 61.1, mean difference 23.3, p = 0.031), adult clinical observation domain (mean I:C; 73.3 vs.58.0, mean difference 10.9, p = 0.02 ) and health information domain (mean I:C; 63.6 vs.56.1, mean difference 6.8, p = 0.01. There was no gender differences in adult service satisfaction. Governance and motivation scores did not differ between control and intervention sites. Conclusion This study demonstrates the utility of the balanced scorecard in assessing multiple elements of the health system. Using system wide approaches and triangulating data collection methods seems to be key to successful evaluation of such complex health intervention. Trial number ClinicalTrials.gov NCT01942278 PMID:24751780

Application of balanced scorecard in the evaluation of a complex health system intervention: 12 months post intervention findings from the BHOMA intervention: a cluster randomised trial in Zambia.

PubMed

Mutale, Wilbroad; Stringer, Jeffrey; Chintu, Namwinga; Chilengi, Roma; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Balabanova, Dina; Spicer, Neil; Lewis, James; Ayles, Helen

2014-01-01

In many low income countries, the delivery of quality health services is hampered by health system-wide barriers which are often interlinked, however empirical evidence on how to assess the level and scope of these barriers is scarce. A balanced scorecard is a tool that allows for wider analysis of domains that are deemed important in achieving the overall vision of the health system. We present the quantitative results of the 12 months follow-up study applying the balanced scorecard approach in the BHOMA intervention with the aim of demonstrating the utility of the balanced scorecard in evaluating multiple building blocks in a trial setting. The BHOMA is a cluster randomised trial that aims to strengthen the health system in three rural districts in Zambia. The intervention aims to improve clinical care quality by implementing practical tools that establish clear clinical care standards through intensive clinic implementations. This paper reports the findings of the follow-up health facility survey that was conducted after 12 months of intervention implementation. Comparisons were made between those facilities in the intervention and control sites. STATA version 12 was used for analysis. The study found significant mean differences between intervention(I) and control (C) sites in the following domains: Training domain (Mean I:C; 87.5.vs 61.1, mean difference 23.3, p = 0.031), adult clinical observation domain (mean I:C; 73.3 vs.58.0, mean difference 10.9, p = 0.02 ) and health information domain (mean I:C; 63.6 vs.56.1, mean difference 6.8, p = 0.01. There was no gender differences in adult service satisfaction. Governance and motivation scores did not differ between control and intervention sites. This study demonstrates the utility of the balanced scorecard in assessing multiple elements of the health system. Using system wide approaches and triangulating data collection methods seems to be key to successful evaluation of such complex health intervention. ClinicalTrials.gov NCT01942278.

A Balanced Scorecard Approach to Public Relations Management Assessment.

ERIC Educational Resources Information Center

Fleisher, Craig S.; Mahaffy, Darren

1997-01-01

Describes a new managerial approach to assessing public relations/communications (PR/C) performance using a "balanced scorecard." Reviews the current state of PR/C management assessment; illustrates the balanced scorecard framework; highlights its strengths and weaknesses; describes the process of applying the scorecard to PR/C units;…

A comparison of systemwide and hospital-specific performance measurement tools.

PubMed

Yap, Clarence; Siu, Emily; Baker, G Ross; Brown, Adalsteinn D

2005-01-01

Balanced scorecards are being implemented at the system and organizational levels to help managers link their organizational strategies with performance data to better manage their healthcare systems. Prior to this study, hospitals in Ontario, Canada, received two editions of the system-level scorecard (SLS)--a framework, based on the original balanced scorecard, that includes four quadrants: system integration and management innovation (learning and growth), clinical utilization and outcomes (internal processes), patient satisfaction (customer), and financial performance and condition (financial). This study examines the uptake of the SLS framework and indicators into institution-specific scorecards for 22 acute care institutions and 2 non-acute-care institutions. This study found that larger (teaching and community) hospitals were significantly more likely to use the SLS framework to report performance data than did small hospitals (p < 0.0049 and 0.0507) and that teaching hospitals used the framework significantly more than community hospitals did (p < 0.0529). The majority of hospitals in this study used at least one indicator from the SLS in their own scorecards. However, all hospitals in the study incorporated indicators that required data collection and analysis beyond the SLS framework. The study findings suggest that SLS may assist hospitals in developing institution-specific scorecards for hospital management and that the balanced scorecard model can be modified to meet the needs of a variety of hospitals. Based on the insight from this study and other activities that explore top priorities for hospital management, the issues related to efficiency and human resources should be further examined using SLSs.

Strategic performance in hospitals: the use of the balanced scorecard by nurse managers.

PubMed

Naranjo-Gil, David

2009-01-01

The competitive and dynamic health care sector has spurred hospitals into delivering greater flexibility and quality of services while cutting the hospital cost at the same time. However, hospitals differ in the extent to which they achieve these strategic goals. This article explores the use of a new management tool-the balanced scorecard-which facilitates managers to meet multiple strategic goals. It also analyzes how nurse managers use the balanced scorecard in an interactive or diagnostic way and its subsequent effect on strategic goal achievement (cost reduction and flexibility). It also examines how "balanced" is the balanced scorecard in terms of financial versus nonfinancial measures. Data were collected from a mail survey sent to 218 nurse managers in Spanish public hospitals. A satisfactory response rate was achieved, with 114 (52.29%) useful answered questionnaires. The results show that younger, more tenured, and clinically trained nurse managers would be more likely to use the balanced scorecard in an interactive way. Conversely, older, less tenured, and administratively trained managers would use it diagnostically. The results also indicate that the balanced scorecard facilitates the cost reduction and flexibility in hospitals only when it is used interactively. This article provides evidence that not only the technical design of the balanced scorecard matters, but also an appropriate use of the balanced scorecard is paramount for achievement of multiple strategic goals. An effective use of the balanced scorecard requires managers to actively stimulate dialogue and agreement among hospital's staff about desirable financial and nonfinancial performance measures in alignment with multiple strategic goals.

The balanced scorecard: sustainable performance assessment for forensic laboratories.

PubMed

Houck, Max; Speaker, Paul J; Fleming, Arron Scott; Riley, Richard A

2012-12-01

The purpose of this article is to introduce the concept of the balanced scorecard into the laboratory management environment. The balanced scorecard is a performance measurement matrix designed to capture financial and non-financial metrics that provide insight into the critical success factors for an organization, effectively aligning organization strategy to key performance objectives. The scorecard helps organizational leaders by providing balance from two perspectives. First, it ensures an appropriate mix of performance metrics from across the organization to achieve operational excellence; thereby the balanced scorecard ensures that no single or limited group of metrics dominates the assessment process, possibly leading to long-term inferior performance. Second, the balanced scorecard helps leaders offset short term performance pressures by giving recognition and weight to long-term laboratory needs that, if not properly addressed, might jeopardize future laboratory performance. Copyright © 2012 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

Balanced scorecards for performance management.

PubMed

Park, Eun-Jun; Huber, Diane L

2007-01-01

Nurse administrators who manage nursing case management programs are challenged to demonstrate the improved quality of patient care and financial outcomes to their organization that result from such programs. This article introduces the balanced scorecard and discusses its benefits and practical concerns for adopting the scorecard. The balanced scorecard is a useful performance management tool used to both evaluate and direct case management performance in meeting organizational missions and strategies.

[The Balanced Scorecard as a management tool in a public health organization].

PubMed

Villalbí, Joan R; Villalbí, Joan; Guix, Joan; Casas, Conrad; Borrell, Carme; Duran, Júlia; Artazcoz, Lucía; Camprubí, Esteve; Cusí, Meritxell; Rodríguez-Montuquín, Pau; Armengol, Josep M; Jiménez, Guy

2007-01-01

The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board.

Implementation of Strategies in Continuing Education

ERIC Educational Resources Information Center

Kettunen, Juha

2005-01-01

Purpose--The purpose of this paper is to provide higher education institutions with strategies of continuing education and methods to communicate and implement these strategies. Design/methodology/approach--The balanced scorecard approach is used to implement the strategy. It translates the strategy into tangible objectives, measures and targets…

Tallying the U.S.-China Military Scorecard: Relative Capabilities and the Balance of Power, 1996-2017

DTIC Science & Technology

2015-01-01

C O R P O R A T I O N RESE ARCH BR IEF Tallying the U.S.-China Military Scorecard Relative Capabilities and the Balance of Power, 1996–2017 Over the...sources, the scorecards provide a basis for deeper public discussion of how the balance of power in Asia has evolved and the challenges the United...SUBTITLE Tallying the U.S.-China Military Scorecard : Relative Capabilities and the Balance of Power, 1996-2017 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

The balanced scorecard: an integrative approach to performance evaluation.

PubMed

Oliveira, J

2001-05-01

In addition to strict financial outcomes, healthcare financial managers should assess intangible assets that affect the organization's bottom line, such as clinical processes, staff skills, and patient satisfaction and loyalty. The balanced scorecard, coupled with data-warehousing capabilities, offers a way to measure an organization's performance against its strategic objectives while focusing on building capabilities to achieve these objectives. The balanced scorecard examines performance related to finance, human resources, internal processes, and customers. Because the balanced scorecard requires substantial amounts of data, it is a necessity to establish an organizational data warehouse of clinical, operational, and financial data that can be used in decision support. Because it presents indicators that managers and staff can influence directly by their actions, the balanced-scorecard approach to performance measurement encourages behavioral changes aimed at achieving corporate strategies.

Driving Improvement with a Balanced Scorecard

ERIC Educational Resources Information Center

Cowart, Scott K.

2010-01-01

This article describes how a school district's use of a transparent tool coalesced support for systemic improvement. The author was looking for a way to push improvement in his 4,000-student school system when he discovered the balanced scorecard, a strategic tool for performance management. The author details how the balanced scorecard helped him…

Balanced Scorecard in Higher Education Institutions: Congruence and Roles to Quality Assurance Practices

ERIC Educational Resources Information Center

Reda, Nigusse W.

2017-01-01

Purpose: The purpose of this paper is twofold: first, to highlight the congruence and roles of the balanced scorecard in the quality assurance practices in higher education institutions, and second, to propose a balanced scorecard model for higher education institutions. Design/methodology/approach: A descriptive literature review was used to…

The Implementation of the Bologna Process

ERIC Educational Resources Information Center

Kettunen, Juha; Kantola, Mauri

2006-01-01

This study identifies the responsibilities of the bodies and institutions involved in the implementation of the Bologna Process. They include the levels of Europe, nations, higher education institutions, departments, degree programmes, teachers and students. The future planning is analysed using the Balanced Scorecard approach designed for the…

Balanced Scorecards in Managing Higher Education Institutions: An Indian Perspective

ERIC Educational Resources Information Center

Umashankar, Venkatesh; Dutta, Kirti

2007-01-01

Purpose: The paper aims to look at the balanced scorecard (BSC) concept and discuss in what way it should be applied to higher education programs/institutions in the Indian context. Design/methodology/approach: The paper is based on extant literature on the balanced scorecard concept per se, as well as applications of BSC in higher education as…

Introducing the Balanced Scorecard: Creating Metrics to Measure Performance

ERIC Educational Resources Information Center

Gumbus, Andra

2005-01-01

This experiential exercise presents the concept of the Balanced Scorecard (BSC) and applies it in a university setting. The Balanced Scorecard was developed 12 years ago and has grown in popularity and is used by more than 50% of the Fortune 500 companies as a performance measurement and strategic management tool. The BSC expands the traditional…

A study of a nursing department performance measurement system: using the Balanced Scorecard and the Analytic Hierarchy Process.

PubMed

Chu, Hsuan-Lien; Wang, Chen-Chin; Dai, Yu-Tzu

2009-01-01

The health care industry is under pressure from government and private entities as well as from market conditions to contain costs. In an effort to respond to these pressures, the case hospital in this study implemented a Balanced Scorecard (BSC) in January 2003 and integrated it with the hospital's formal incentive plan for non-physicians in January 2005. The nursing department's performance improved in the 2 years following the introduction of the plan. This study contributes to the literature by demonstrating the performance improvement that results from integrating the BSC with an incentive plan in the nursing field. The results provide insight into the current BSC performance metrics applied by the case nursing department, and could be used as guidelines by other health care organizations that wish to implement BSC-based incentive plans.

Now's the Time: Implementing Performance Management

ERIC Educational Resources Information Center

Legutko, Lee V.

2012-01-01

During the past several years, school systems have implemented a variety of organizational improvement initiatives, such as Six Sigma, Balanced Scorecards, Baldrige Criteria, activity-based costing, and managing for results. Unfortunately, evidence of sustained success is fleeting as school districts remain trapped in a time warp of command,…

[Application of the balanced scorecard in nursing practice].

PubMed

Huang, Tsai-Yu; Chwo, Miao-Ju

2004-02-01

Kaplan and Norton's balanced scorecard (BSC) was developed in 1992. It was designed to be both a performance framework and a management methodology. The BSC enables an organization to convert its mission and vision into specific strategic objectives across four perspectives: (1) the financial perspective, (2) the customer perspective, (3) the internal business process perspective, and (4) the learning and growth perspective. Emphasis is focused on the balance of internal and external, outcome and future, and subjective and objective measures. Currently, some health care organizations have implemented the concept of the BSC as a performance measurement tool and are convinced that the BSC can be of great value to an organization. This paper provides development of the BSC and its application in the health care system and nursing practice.

[Development and evolution of a balanced scorecard in primary health care: Lessons learned].

PubMed

Bartolomé-Benito, E; Jiménez-Carramiñana, J; Sánchez-Perruca, L; Bartolomé-Casado, M S; Dominguez-Mandueño, A B; Marti-Argandoña, M; Hernández-Pascual, M; Miquel-Gómez, A

To describe the design, implementation, and monitoring of eSOAP (Primary Health Care Balanced Scorecard) and its role in the deployment of strategic objectives and clinical management, as well as to show the lessons learned during six years of follow-up. Descriptive study areas: methodology (conceptual framework, strategic matrix, strategic map, and processes map), technology and standardisation. As of December 2014, 9,046 (78%) professionals are registered in eSOAP. A total of 381 indicators were measured from 16 data sources, of which 36% were of results (EFQM model), 39.1% of clinical management, and 20% were included in the Program Centre Contract. The Balanced Scorecard has enabled to deploy all strategic lines of Primary Health Care, and has enabled the healthcare professionals to evaluate the evolution of results over time, and at patient level (e.g. 16% increase in control of diabetic patients). A total of 295,779 reports were generated and 13,080 professionals were evaluated by goals. There was an increased use of the eSOAP application by the professionals. The Balanced Scorecard was the key in deploying Primary Health Care strategies. It has helped clinical management and improved relevant indicators (health, patient experience, and costs), such as the management models that we used as references (EFQM Kaplan and Norton), and new emerging scenarios (Triple aim). Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Quantitative performance targets by using balanced scorecard system: application to waste management and public administration.

PubMed

Mendes, Paula; Nunes, Luis Miguel; Teixeira, Margarida Ribau

2014-09-01

This article demonstrates how decision-makers can be guided in the process of defining performance target values in the balanced scorecard system. We apply a method based on sensitivity analysis with Monte Carlo simulation to the municipal solid waste management system in Loulé Municipality (Portugal). The method includes two steps: sensitivity analysis of performance indicators to identify those performance indicators with the highest impact on the balanced scorecard model outcomes; and sensitivity analysis of the target values for the previously identified performance indicators. Sensitivity analysis shows that four strategic objectives (IPP1: Comply with the national waste strategy; IPP4: Reduce nonrenewable resources and greenhouse gases; IPP5: Optimize the life-cycle of waste; and FP1: Meet and optimize the budget) alone contribute 99.7% of the variability in overall balanced scorecard value. Thus, these strategic objectives had a much stronger impact on the estimated balanced scorecard outcome than did others, with the IPP1 and the IPP4 accounting for over 55% and 22% of the variance in overall balanced scorecard value, respectively. The remaining performance indicators contribute only marginally. In addition, a change in the value of a single indicator's target value made the overall balanced scorecard value change by as much as 18%. This may lead to involuntarily biased decisions by organizations regarding performance target-setting, if not prevented with the help of methods such as that proposed and applied in this study. © The Author(s) 2014.

Procurement performance measurement system in the health care industry.

PubMed

Kumar, Arun; Ozdamar, Linet; Ng, Chai Peng

2005-01-01

The rising operating cost of providing healthcare is of concern to health care providers. As such, measurement of procurement performance will enable competitive advantage and provide a framework for continuous improvement. The objective of this paper is to develop a procurement performance measurement system. The paper reviews the existing literature in procurement performance measurement to identify the key areas of purchasing performance. By studying the three components in the supply chain collectively with the resources, procedures and output, a model is been developed. Additionally, a balanced scorecard is proposed by establishing a set of generic measures and six perspectives. A case study conducted at the Singapore Hospital applies the conceptual model to describe the purchasing department and the activities within and outside the department. The results indicate that the material management department has already made a good start in measuring the procurement process through the implementation of the balanced scorecard. There are many data that are collected but not properly collated and utilized. Areas lacking measurement include cycle time of delivery, order processing time, effectiveness, efficiency and reliability. Though a lot of hard work was involved, the advantages of establishing a measurement system outweigh the costs and efforts involved in its implementation. Results of balanced scorecard measurements provide decision-makers with critical information on efficiency and effectiveness of the purchasing department's work. The measurement model developed could be used for any hospital procurement system.

Meeting the challenge in performance management: the diffusion and implementation of the balanced scorecard in Chinese hospitals.

PubMed

Gao, Tian; Gurd, Bruce

2015-03-01

The bonus system used in Chinese hospitals has been criticized for eroding doctors' professional ethics and aggravating patient expense. This research article focuses on one system to improve hospital performance, the balanced scorecard (BSC). We use three data sources to examine the diffusion and implementation of the BSC in China: a questionnaire survey in Shandong Province, a print-media indicators and content analysis of the published BSC papers and semi-structured interviews with managers of Chinese hospitals that use the BSC. The research evidence shows that bonus systems are important, partially because of the poor pay of hospital professionals, and the BSC is perceived as providing a fair system to award such bonuses. This helps explain the relative endurance of the BSC in Chinese hospitals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Measuring and monitoring IT using a balanced scorecard approach.

PubMed

Gash, Deborah J; Hatton, Todd

2007-01-01

Ensuring that the information technology department is aligned with the overall health system strategy and is performing at a consistently high level is a priority at Saint Luke's Health System in Kansas City, Mo. The information technology department of Saint Luke's Health System has been using the balanced scorecard approach described in this article to measure and monitor its performance for four years. This article will review the structure of the IT department's scorecard; the categories and measures used; how benchmarks are determined; how linkage to the organizational scorecard is made; how results are reported; how changes are made to the scorecard; and tips for using a scorecard in other IT departments.

Dueling Scorecards: How Two Colleges Utilize the Popular Planning Method

ERIC Educational Resources Information Center

Ballentine, Howard; Eckles, Jay

2009-01-01

The Balanced Scorecard is a planning model used extensively in business to provide direction and accountability to an organization. Despite the demonstrated success of the model, it has not been widely used in higher education. This article compares and contrasts the use of the Balanced Scorecard by two small, private colleges. The article…

Keeping Score for Organizational Performance.

ERIC Educational Resources Information Center

Prewitt, Vana

2001-01-01

Discussion of the balanced scorecard (BSC) as a performance management tool focuses on common mistakes and problems with implementing it. Topics include the need for intraorganizational communication and collaboration; strategic thinking; organizational goals; purposes of measurements; individual accountability; and setting priorities. (LRW)

[Balanced scorecard in health].

PubMed

Leyton-Pavez, Carolina Elena; Huerta-Riveros, Patricia Carolina; Paúl-Espinoza, Iván Renato

2015-01-01

To evaluate the installation of strategies in the higher complexity hospitals (HMC, in Spanish) of public health in Chile starting from the results of the Balanced Scorecard (BSC), during the years 2011-2012. The implementation of the BSC is described, the strategies and indicators identified, and the results of the 57 HMC compared and analyzed. Starting from the comparison of the results it is discovered that the BSC allows to evaluate the installation of the strategies. Differences are identified in the installation of the strategies by geographical area, with North presenting a higher score (20.21), followed by Center (10.41) and South (19.50), which can be explained by the size and complexity of this establishments, variables that should be incorporated in the evaluation of the results of the BSC.

Balanced scorecard-based performance evaluation of Chinese county hospitals in underdeveloped areas.

PubMed

Gao, Hongda; Chen, He; Feng, Jun; Qin, Xianjing; Wang, Xuan; Liang, Shenglin; Zhao, Jinmin; Feng, Qiming

2018-05-01

Objective Since the Guangxi government implemented public county hospital reform in 2009, there have been no studies of county hospitals in this underdeveloped area of China. This study aimed to establish an evaluation indicator system for Guangxi county hospitals and to generate recommendations for hospital development and policymaking. Methods A performance evaluation indicator system was developed based on balanced scorecard theory. Opinions were elicited from 25 experts from administrative units, universities and hospitals and the Delphi method was used to modify the performance indicators. The indicator system and the Topsis method were used to evaluate the performance of five county hospitals randomly selected from the same batch of 2015 Guangxi reform pilots. Results There were 4 first-level indicators, 9 second-level indicators and 36 third-level indicators in the final performance evaluation indicator system that showed good consistency, validity and reliability. The performance rank of the hospitals was B > E > A > C > D. Conclusions The performance evaluation indicator system established using the balanced scorecard is practical and scientific. Analysis of the results based on this indicator system identified several factors affecting hospital performance, such as resource utilisation efficiency, medical service price, personnel structure and doctor-patient relationships.

Revisit, revamp, and revitalize your business plan: part 3.

PubMed

Waldron, David

2011-01-01

Managing with financial statements is discussed, including fundamental definitions and conventions related to this process such as an income statement and a balance sheet. Balanced scorecards and dashboards can be used to measure progress and to communicate achievements. Steps taken to defining data using KPIs, sourcing data, and structuring the scorecard are outlined. A core part of managing with financial statements is understanding how to drive the business and engage the staff using balanced scorecards.

A Balanced Scorecard With Strategy Map: Measuring the Value of a Nursing Sabbatical.

PubMed

Embree, Jennifer L; Swenty, Constance F; Schaar, Gina

2015-01-01

Seasoned nurses frequently resign from their positions due to burnout. An innovative idea that could support nurse retention is nurse sabbaticals. Balanced scorecards with strategy maps can display financial benefit, positive customer experience, and operational and human capital development required to initiate and sustain a professional nurse sabbatical. A balanced scorecard with strategy map is an effective tool that demonstrates connection between the organizational mission and the outcomes of a nurse sabbatical program.

Umsetzung der Unternehmensstrategie mit der Balanced Scorecard

NASA Astrophysics Data System (ADS)

Crespo, Isabel; Bergmann, Lars; Portmann, Stefan; Lacker, Thomas; Lacker, Michael; Fleischmann, Jürgen; Kozó, Hans

Die Balanced Scorecard (BSC) ist ein Ansatz zum strategischen Management, der neben der Ausrichtung des Unternehmens auf finanzielle Zielwerte ebenso großes Gewicht auf so genannte weiche Faktoren legt, die den wirtschaftlichen Erfolg eines Unternehmens erst ermöglichen. Das entscheidende Merkmal der Balanced Scorecard ist dabei, dass sie ein ausgewogenes System strategischer Ziele herstellt, welches das Unternehmen hinsichtlich der vier Perspektiven Finanzen, Kunden, interne Prozesse und Mitarbeiter und Potenziale strategisch ausrichtet (Kaplan u. Norton 1997).

[BALANCED SCORECARD AS A MANAGEMENT TOOL IN CLINICAL NUTRITION].

PubMed

Gutiérrez López, Cristina; Mauriz, Jose L; Culebras, Jesús M

2015-07-01

Nowadays, balanced scorecards have updated traditional management systems in the business sector. In this way, Kaplan and Norton propose performance measurement through several perspectives with a logical sequence: internal processes and learning impact client services, so that financial performance is affected. The aim of the present paper is to analyze the main characteristics of balanced scorecard when it is applied to non-for-profit companies and, specifically to the health sector in the clinical nutrition field. This model improves the economic vision of management with clinical indicators that represent healthcare professional's perspective. The balanced scorecard would allow a proper monitoring and tracking system for the main healthcare indicators. This contributes to a better control in comparison with standards that are associated with adequate quality assistance. Owing to the role of management accounting and cost calculations, the definition of healthcare professionals as clients or users, and clinical results relevance, it is necessary to adapt the balanced scorecard to the specific characteristics of the clinical field, redefining both perspectives and indicators. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Designing a balanced scorecard for a tertiary care hospital in Pakistan: a modified Delphi group exercise.

PubMed

Rabbani, Fauziah; Jafri, Syed M Wasim; Abbas, Farhat; Shah, Mairaj; Azam, Syed Iqbal; Shaikh, Babar Tasneem; Brommels, Mats; Tomson, Goran

2010-01-01

Balanced Scorecards (BSC) are being implemented in high income health settings linking organizational strategies with performance data. At this private university hospital in Pakistan an elaborate information system exists. This study aimed to make best use of available data for better performance management. Applying the modified Delphi technique an expert panel of clinicians and hospital managers reduced a long list of indicators to a manageable size. Indicators from existing documents were evaluated for their importance, scientific soundness, appropriateness to hospital's strategic plan, feasibility and modifiability. Panel members individually rated each indicator on a scale of 1-9 for the above criteria. Median scores were assigned. Of an initial set of 50 indicators, 20 were finally selected to be assigned to the four BSC quadrants. These were financial (n = 4), customer or patient (n = 4), internal business or quality of care (n = 7) and innovation/learning or employee perspectives (n = 5). A need for stringent definitions, international benchmarking and standardized measurement methods was identified. BSC compels individual clinicians and managers to jointly work towards improving performance. This scorecard is now ready to be implemented by this hospital as a performance management tool for monitoring indicators, addressing measurement issues and enabling comparisons with hospitals in other settings. Copyright 2010 John Wiley & Sons, Ltd.

Building a balanced scorecard for a burn center.

PubMed

Wachtel, T L; Hartford, C E; Hughes, J A

1999-08-01

The Balanced Scorecard provides a model that can be adapted to the management of any burn center, burn service or burn program. This model enables an organization to translate its mission and vision into specific strategic objectives across the four perspective: (1) the financial perspective; (2) the customer service perspective; (3) the internal business perspective; and (4) the growth and learning perspective. Once the appropriate objectives are identified, the Balanced Scorecard guides the organization to develop reasonable performance measures and establishes targets, initiatives and alternatives to meet programmatic goals and pursue longer-term visionary improvements. We used the burn center at the University of Colorado Health Sciences Center to test whether the Balanced Scorecard methodology was appropriate for the core business plan of a healthcare strategic business unit (i.e. a burn center).

[Usefulness of the budget and the balanced scorecard in managing Primary Care Centres. Impact on staff motivation].

PubMed

Ramón-Jerónimo, Juan Manuel; Flórez-López, Raquel; Domínguez-Lario, Natalia

2018-03-01

To analyse the utility perceived by managers of centers of primary care about management tools (budget and balanced scorecard), together their impact on human resources motivation. Qualitative study (case study) based on grounded theory performed between January and June 2014. Units of Clinical Management of Primary Health (UGCAP) in Metropolitan Health Area of Seville, Spain. UGCAP managers and Health Area (CEO) managers. Data were collected through 8 semi-structured interviews using non-probabilistic intentional sampling with representation and sufficiency criteria of discourse. Interviews were recorded, literally transcripted and analysis through in-vivo codes. Both tools are fully implemented but differently used in primary care centers. Budget is perceived as a coercive management tool, which has been imposed for cost saving; however, it is scarcely adequate for day-by-day management. While balanced scorecard is a more flexible tool that allows identifying financial and welfare problems, budgeting limits heavily reduce the possibility of implementing adequate solutions. The policy of incentives is not adequate either, leading on de-motivation. This study shows that budgeting restrictions have led to a significant reduction in autonomy of Spanish Primary Care centers. Management decision making is much centralised, also focused on cost saving over quality of healthcare. As a result, two needs emerge for the future: increasing centers' autonomy and improving staff commitment through training and professional development programs. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Use of the balanced scorecard in health care.

PubMed

Zelman, William N; Pink, George H; Matthias, Catherine B

2003-01-01

Since Kaplan and Norton published their article proposing a balanced scorecard, the concept has been widely adopted by industry and health care provider organizations. This article reviews the use of the balanced scorecard in health care and concludes that the balanced scorecard: (1) is relevant to health care, but modification to reflect industry and organizational realities is necessary; (2) is used by a wide range of health care organizations; (3) has been extended to applications beyond that of strategic management; (4) has been modified to include perspectives, such as quality of care, outcomes, and access; (5) increases the need for valid, comprehensive, and timely information; and (6) has been used by two large-scale efforts across many health care organizations in a health care sector, which differ, namely in the units of analysis, purposes, audiences, methods, data, and results.

Performance Management in UK Universities: Implementing the Balanced Scorecard

ERIC Educational Resources Information Center

Taylor, John; Baines, Claire

2012-01-01

In recent years, UK universities have become increasingly concerned with performance management. This trend reflects both growing competition and marketisation within higher education, and the increasing requirements for accountability. In response, institutions have begun to explore the application of formal methodologies for performance…

Design, implementation and scaling up of the balanced scorecard for hospitals in Lebanon: policy coherence and application lessons for low and middle income countries.

PubMed

El-Jardali, Fadi; Saleh, Shadi; Ataya, Nour; Jamal, Diana

2011-12-01

This paper describes the development and implementation of the first national hospital performance indicators in Lebanon including its institutionalization within existing policy framework and the initiation of independent governance structure for sustainability. Guided by the Ontario Acute Care Balanced Scorecard framework, a step-wise approach was used. Guiding principles were non-punitive reporting, anonymity, voluntary participation, stakeholder involvement, consensus and feasibility. Modified Delphi technique was used, readiness assessment surveys in 52 hospitals were conducted, pilot testing and evaluation were completed in 14 hospitals. Initial balanced set of 21 indicators were selected. Findings showed wide variations in indicators' measurement in hospitals including formulas and tools. Barriers to measurement included lack of quality culture, physician resistance and resources. A gradual implementation strategy was developed and selected indicators were divided into two levels. Most piloted indicators proved to be valid, feasible and reliable. The initiative was linked to the national hospital accreditation system resulting in a balanced set of 40 indicators. An independent, not-for-profit, arm's-length organization was established. This is among the first attempts made in the East Mediterranean Region to adapt the BSC approach and translate the experience of its development to addresses local needs and contextual reality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Microworlds of the dynamic balanced scorecard for university (DBSC-UNI)

NASA Astrophysics Data System (ADS)

Hawari, Nurul Nazihah; Tahar, Razman Mat

2015-12-01

This research focuses on the development of a Microworlds of the dynamic balanced scorecard for university in order to enhance the university strategic planning process. To develop the model, we integrated both the balanced scorecard method and the system dynamics modelling method. Contrasting the traditional university planning tools, the developed model addresses university management problems holistically and dynamically. It is found that using system dynamics modelling method, the cause-and-effect relationships among variables related to the four conventional balanced scorecard perspectives are better understand. The dynamic processes that give rise to performance differences between targeted and actual performances also could be better understood. So, it is expected that the quality of the decisions taken are improved because of being better informed. The developed Microworlds can be exploited by university management to design policies that can positively influence the future in the direction of desired goals, and will have minimal side effects. This paper integrates balanced scorecard and system dynamics modelling methods in analyzing university performance. Therefore, this paper demonstrates the effectiveness and strength of system dynamics modelling method in solving problem in strategic planning area particularly in higher education sector.

Identifying Balance in a Balanced Scorecard System

ERIC Educational Resources Information Center

Aravamudhan, Suhanya; Kamalanabhan, T. J.

2007-01-01

In recent years, strategic management concepts seem to be gaining greater attention from the academicians and the practitioner's alike. Balanced Scorecard (BSC) concept is one such management concepts that has spread in worldwide business and consulting communities. The BSC translates mission and vision statements into a comprehensive set of…

Managing Service Quality with the Balanced Scorecard.

ERIC Educational Resources Information Center

Poll, Roswitha

In order to evaluate and utilize library data for the management process, a German project, sponsored by the German Research Council, uses the Balanced Scorecard as the concept for integrated quality management. Performance indicators across the following four perspectives are combined to produce a balanced evaluation of the library: (1) users,…

Using Balanced Scorecard (BSC) approach to improve ergonomics programs.

PubMed

Fernandes, Marcelo Vicente Forestieri

2012-01-01

The purpose of this paper is to propose foundations for a theory of using the Balanced Scorecard (BSC) methodology to improve the strategic view of ergonomics inside the organizations. This approach may help to promote a better understanding of investing on an ergonomic program to obtain good results in quality and production, as well as health maintenance. It is explained the basics of balanced scorecard, and how ergonomists could use this to work with strategic enterprises demand. Implications of this viewpoint for the development of a new methodology for ergonomics strategy views are offered.

An Examination of the Department of Defense Financial Improvement and Audit Readiness Plan Using a Balanced Scorecard

DTIC Science & Technology

2011-06-01

BEIS Business Enterprise Information Services BEP Business Enterprise Priorities BMMP Business Management Modernization Program BTA Business...Scorecard framework . Initially published in December 2005, the FIAR is the DoD’s strategy towards achieving audit readiness. The FIAR provides a timeline and...Secretary of Defense Comptroller, n.d.). The Balanced Scorecard, a strategic management framework developed in 1987 by Arthur Schneiderman and popularized

Balanced Scorecard Goal Four: Provide Policy Management, Advocacy and Problem Solving Measuring Achievement of Internal Customer Objectives

DTIC Science & Technology

2002-06-01

Achievement of Internal Customer Objectives A Graduate Management Project Submitted to The Residency Committee In Candidacy for the Degree of Masters in...internal customer relations, the GPRMC has incorporated use of a Balanced Scorecard within its management scheme. The scorecard serves as a strategy map...headquarters. The goal, "Provide Policy Management , Advocacy and Problem Solving", addresses the relationship between the headquarters and its internal

How to implement a new strategy without disrupting your organization.

PubMed

Kaplan, Robert S; Norton, David P

2006-03-01

Throughout most of modern busi ness history, corporations have attempted to unlock value by matching their structures to their strategies: Centralization by function. Decentralization by product category or geographic region. Matrix organizations that attempt both at once. Virtual organizations. Networked organizations. Velcro organizations. But none of these approaches has worked very well. Restructuring churn is expensive, and new structures often create new organizational problems that are as troublesome as the ones they try to solve. It takes time for employees to adapt to them, they create legacy systems that refuse to die, and a great deal of tacit knowledge gets lost in the process. Given the costs and difficulties involved in finding structural ways to unlock value, it's fair to raise the question: Is structural change the right tool for the job? The answer is usually no, Kaplan and Norton contend. It's far less disruptive to choose an organizational design that works without major conflicts and then design a customized strategic system to align that structure to the strategy. A management system based on the balanced scorecard framework is the best way to align strategy and structure, the authors suggest. Managers can use the tools of the framework to drive their unit's performance: strategy maps to define and communicate the company's value proposition and the scorecard to implement and monitor the strategy. In this article, the originators of the balanced scorecard describe how two hugely different organizations--DuPont and the Royal Canadian Mounted Police-used corporate scorecards and strategy maps organized around strategic themes to realize the enormous value that their portfolios of assets, people, and skills represented. As a result, they did not have to endure a painful series of changes that simply replaced one rigid structure with another.

Metrics help rural hospitals achieve world-class performance.

PubMed

Goodspeed, Scott W

2006-01-01

This article describes the emerging trend of using metrics in rural hospitals to achieve world-class performance. This trend is a response to the fact that rural hospitals have small patient volumes yet must maintain a profit margin in order to fulfill their mission to the community. The conceptual idea for this article is based largely on Robert Kaplan and David Norton's Balanced Scorecard articles in the Harvard Business Review. The ideas also come from the experiences of the 60-plus rural hospitals that are using the Balanced Scorecard and their implementation of metrics to influence performance and behavior. It is indeed possible for rural hospitals to meet and exceed the unique needs of patients and physicians (customers), to achieve healthy profit margins, and to be the rural hospital of choice that employees are proud to work for.

Management Information System Based on the Balanced Scorecard

ERIC Educational Resources Information Center

Kettunen, Juha; Kantola, Ismo

2005-01-01

Purpose: This study seeks to describe the planning and implementation in Finland of a campus-wide management information system using a rigorous planning methodology. Design/methodology/approach: The structure of the management information system is planned on the basis of the management process, where strategic management and the balanced…

Going International: The Balanced Scorecard.

ERIC Educational Resources Information Center

Rojas, Alicia M.

2001-01-01

Explains the balanced scorecard as a management system that provides a framework for strategic measurement which translates the vision and strategy of the organization in operational terms by four indicators: financial, process, employee and client satisfaction, and results. Also considers the importance of cultural differences in performance…

[The balanced scorecard used as a management tool in a clinical laboratory: internal business processes indicators].

PubMed

Salinas La Casta, Maria; Flores Pardo, Emilio; Uris Selles, Joaquín

2009-01-01

to propose a set of indicators as a management tool for a clinical laboratory, by using the balanced scorecard internal business processes perspective. indicators proposed are obtained from different sources; external proficiency testing of the Valencia Community Government, by means of internal surveys and laboratory information system registers. One year testing process proportion indicators results are showed. internal management indicators are proposed (process, appropriateness and proficiency testing). The process indicators results show gradual improvement since its establishment. after one years of using a conceptually solid Balanced Scorecard Internal business processes perspective indicators, the obtained results validate the usefulness as a laboratory management tool.

Balanced Scorecard: Evaluation of Air Force Materiel Command’s Implementation and Use

DTIC Science & Technology

2008-03-01

Department of Operational Sciences Graduate School of Engineering and Management Air Force Institute of Technology Air University Air Education...and Alignment (2006). Operational experience has also been accumulated through a number of BSC implementations. Together, organizations now have a...sustain operations . By 1994, it was the least profitable company in its sector. Executives knew things needed to change and decided to roll out

A Simulation-Based Approach for Teaching the Systems Perspective of Strategic Performance Management

ERIC Educational Resources Information Center

Capelo, Carlos; Lopes, Ana; Mata, Ana

2015-01-01

Kaplan and Norton introduced the balanced scorecard (BSC), which is based on a systems perspective of the business strategy and performance measurement. Many organisations around the world use the BSC to define, implement and manage strategy. Nevertheless, there are studies that identify problems and limitations associated with the implementation…

[Management and accounting solution required in clinical laboratory department in the hospital and the balanced scorecard (BSC)].

PubMed

Takahashi, Toshiro

2006-11-01

This is to describe required accounting knowledge and the techniques for the clinical laboratory department management level people to operate their division from the viewpoint of management. Especially, the necessity and the efficacy of the BSC implementation in the clinical laboratory department are being explained.

A Virtual Environment for Process Management. A Step by Step Implementation

ERIC Educational Resources Information Center

Mayer, Sergio Valenzuela

2003-01-01

In this paper it is presented a virtual organizational environment, conceived with the integration of three computer programs: a manufacturing simulation package, an automation of businesses processes (workflows), and business intelligence (Balanced Scorecard) software. It was created as a supporting tool for teaching IE, its purpose is to give…

Performance Management in Schools: Could the Balanced Scorecard Help?

ERIC Educational Resources Information Center

Storey, Anne

2002-01-01

Describes and examines the nature of the Balanced Scorecard as a conceptual framework and as a management information tool. Identifies and discusses the potential and the limitations of the approach in a school context. Outlines a research agenda. (Contains 3 figures and 33 references.) (AUTHOR/WFA)

The balanced scorecard--measures that drive performance.

PubMed

Kaplan, R S; Norton, D P

1992-01-01

Frustrated by the inadequacies of traditional performance measurement systems, some managers have abandoned financial measures like return on equity and earnings per share. "Make operational improvements and the numbers will follow," the argument goes. But managers do not want to choose between financial and operational measures. Executives want a balanced presentation of measures that allow them to view the company from several perspectives simultaneously. During a year-long research project with 12 companies at the leading edge of performance measurement, the authors developed a "balanced scorecard," a new performance measurement system that gives top managers a fast but comprehensive view of the business. The balanced scorecard includes financial measures that tell the results of actions already taken. And it complements those financial measures with three sets of operational measures having to do with customer satisfaction, internal processes, and the organization's ability to learn and improve--the activities that drive future financial performance. Managers can create a balanced scorecard by translating their company's strategy and mission statements into specific goals and measures. To create the part of the scorecard that focuses on the customer perspective, for example, executives at Electronic Circuits Inc. established general goals for customer performance: get standard products to market sooner, improve customers' time-to-market, become customers' supplier of choice through partnerships, and develop innovative products tailored to customer needs. Managers translated these elements of strategy into four specific goals and identified a measure for each.

Performance Evaluation of Extension Education Centers in Universities Based on the Balanced Scorecard

ERIC Educational Resources Information Center

Wu, Hung-Yi; Lin, Yi-Kuei; Chang, Chi-Hsiang

2011-01-01

This study aims at developing a set of appropriate performance evaluation indices mainly based on balanced scorecard (BSC) for extension education centers in universities by utilizing multiple criteria decision making (MCDM). Through literature reviews and experts who have real practical experiences in extension education, adequate performance…

Applying the Balanced Scorecard to Education

ERIC Educational Resources Information Center

Karathanos, Demetrius; Karathanos, Patricia

2005-01-01

Although the application of the balanced scorecard (BSC) in the business sector is well documented, very little research has been reported regarding the adaptation or application of the BSC in the education sector. In this article, the authors (a) describe how the Baldrige Education Criteria for Performance Excellence has adapted the concept of…

Strategic Reporting Tool: Balanced Scorecards in Higher Education

ERIC Educational Resources Information Center

Lyddon, Jan W.; McComb, Bruce E.

2008-01-01

In this toolbox article, the authors describe the recommended steps for creating a community college balanced scorecard that measures and reports on key performance indicators based on targets and signal values to end-users, college constituents and external stakeholders. Based on extensive experience in the field, the authors provide a…

Delivering Training Strategies: The Balanced Scorecard at Work

ERIC Educational Resources Information Center

Baraldi, Stefano; Cifalinò, Antonella

2015-01-01

Aligning the value of training to organizational goals is an emerging need in human resource management. This study, aiming at expanding the research on training evaluation from a strategic management perspective, examines whether the use of the Balanced Scorecard approach can enable an effective delivery of training strategies, thus strengthening…

Implementation of indicators through balanced scorecards in a nutritional therapy company.

PubMed

de Matos Nasser, Emanuele; Reis da Costa, Stella Regina

2013-01-01

The Balanced Scorecard (BSC) is a tool that helps in strategic management under the four following perspectives: the financial one, the client s, the internal processes of the company's, the growth and learning processes. In order to measure the performance of the entities, the BSC uses as a basis financial and non-financial indicators. To implement the BSC in a nutrional therapy company. This research deals with a case study that took place in a nutrional therapy company from January to November 2010. For analysis of the learning and growth perspective all 45 of the company's collaborators were considered and for client analysis 124 home-care clients were considered. The study sample consisted of 39 collaborators and 44 clients participating in the research. Material was elaborated for collection of data and verification of perspective tendencies through analysis of the main processes of the company, questionnaires of client's satisfaction, questionnaires of collaborator s satisfaction and spread sheets for the verification of net renvenue and percentage of disallowances. The data was launched in the spread sheet of the Excel Application Program. The indicators were chosen conforming to the strategic objectives and organizational profiles. Learning perspectives and personal growth: efficacy in capacitaion 94%, participation 77%, fidelity/retention 93%, satisfaction 75%, organizational environment 88%, well being 100%, process perspective: microbiological analysis 100%, internal auditing 100%, productivity 100%, nutritional evaluation 81%, nutritional support 100%, indication for domicile hospital care 94%, home-care visits 98%, client perspective: company perception 97%, prioritizating 94%, retention 59%, insatisfaction 24%, logistics 94%, customers ervice (SAC) 88%, motivation: trust, financial perspectives, disallowances 5% and positive company net revenue. The implementation of indicators under the four perspectives of the Balanced Scorecard were favourable in the organizational performance, in helping the decision making process. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Civilian and Contractor Workforces: Complete Information Needed to Assess DODs Progress for Reductions and Associated Savings

DTIC Science & Technology

2015-12-01

requirements to achieve the appropriate balance using all three components—military, civilian, and contractor—of its total workforce, and to prioritize the...of the report. As of October 2015, DOD has not taken action to fully implement the recommendation. In the context of DOD balancing its civilian and...reviewed DOD’s September 2014 report using a scorecard methodology and assigned a score as to whether the document (1) addresses, (2) partially

Using the balanced scorecard to align strategy and performance in long-term care.

PubMed

Macdonald, M

1998-01-01

The Sisters of Charity of Ottawa Health Service (SCOHS) is a Canadian health care corporation that has adapted Kaplan and Norton's balanced scorecard to enhance strategic management and measurement in a multisite health care facility comprising long term care, continuing complex care, rehabilitative services, palliative care and ambulatory care. This article discusses how the SCOHS has incorporated the following principles into the balanced scorecard: demonstration of cause and effect; inclusion of outcomes and performance drivers; linkage to fiscal and utilization indicators; and integration of the mission and values of the organization. Examples of corporate level outcomes and performance measures are provided in the form of lead and lag indicators.

Ratify, Reject or Revise: Balanced Scorecard and Universities

ERIC Educational Resources Information Center

Sayed, Naqi

2013-01-01

Purpose: The purpose of this paper is to examine the use of the Balanced Scorecard (BSC) in universities. Initially directed toward profit-oriented businesses, the BSC has since been adopted by many non-profit organisations with seemingly diverse objectives. A number of primarily publicly-funded universities and institutions, which are part of…

Successful Applications of the Balanced Scorecard in Higher Education

ERIC Educational Resources Information Center

Beard, Deborah F.

2009-01-01

Are there management tools that professionals use in business that academics have used successfully in higher education? The answer to that question is "yes", and the balanced scorecard (BSC) is one such tool. The author reports on measures that administrators chose for the BSCs of 2 educational institutions whose successes have been…

Strategic Control in the Real World: A Multidisciplinary Function

ERIC Educational Resources Information Center

McGinty, Robert L.; Regel, Roy

2004-01-01

This research paper was developed after completing and publishing articles using the Balanced Scorecard as a means of achieving strategic objectives of over twenty destination ski resorts. We believe the balanced scorecard idea is essentially a new model of the way the world works and should be conceptualized. Our research has helped answer a…

The E-Balanced Scorecard (e-BSC) for Measuring Academic Staff Performance Excellence

ERIC Educational Resources Information Center

Yu, May Leen; Hamid, Suraya; Ijab, Mohamad Taha; Soo, Hsaio Pei

2009-01-01

This research paper is a pilot study that investigated the suitability of adopting an automated balanced scorecard for managing and measuring the performance excellence of academic staffs in the higher education setting. A comprehensive study of related literature with requirements elicited from the target population in a selected premier…

The Balanced Scorecard: Beyond Reports and Rankings.

ERIC Educational Resources Information Center

Stewart, Alice C.; Carpenter-Hubin, Julie

2001-01-01

Discusses the use of performance indicators by higher education institutions for internal assessment as well as external reporting. Describes the balanced scorecard developed by Robert S. Kaplan and David P. Norton in 1992, a set of measures that allow for a holistic, integrated view of business performance. Explores how to create and use the…

The Design of Curriculum Development Based on Entrepreneurship through Balanced Scorecard Approach

ERIC Educational Resources Information Center

Hidayat, Muhammad; Musa, Chalid Imran; Haerani, Siti; Sudirman, Indrianti

2015-01-01

This research is intended to develop curriculum based on entrepreneurship through balanced scorecard approach at the School of Business or "Sekolah Tinggi Ilmu Ekonomi" (STIE) Nobel Indonesia. In order to develop the curriculum, a need analysis in terms of curriculum development that involves all stakeholders at STIE Nobel in Indonesia…

Performance, Process, and Costs: Managing Service Quality with the Balanced Scorecard.

ERIC Educational Resources Information Center

Poll, Roswitha

2001-01-01

Describes a cooperative project among three German libraries that used the Balanced Scorecard as a concept for an integrated quality management system. Considers performance indicators across four perspectives that will help academic libraries establish an integrated controlling system and to collect and evaluate performance as well as cost data…

Introducing a balanced scorecard management system in a university anesthesiology department.

PubMed

Zbinden, Alex M

2002-12-01

The study goal was to show how Balanced Scorecard, a modern management tool based on score numbers, can efficiently be applied to a university anesthesiology department. Nineteen score numbers were established in four perspectives. Meaningful results were obtained with limited resources to support a process of innovation and improvement.

Development and implementation of a balanced scorecard in an academic hospitalist group.

PubMed

Hwa, Michael; Sharpe, Bradley A; Wachter, Robert M

2013-03-01

Academic hospitalist groups (AHGs) are often expected to excel in multiple domains: quality improvement, patient safety, education, research, administration, and clinical care. To be successful, AHGs must develop strategies to balance their energies, resources, and performance. The balanced scorecard (BSC) is a strategic management system that enables organizations to translate their mission and vision into specific objectives and metrics across multiple domains. To date, no hospitalist group has reported on BSC implementation. We set out to develop a BSC as part of a strategic planning initiative. Based on a needs assessment of the University of California, San Francisco, Division of Hospital Medicine, mission and vision statements were developed. We engaged representative faculty to develop strategic objectives and determine performance metrics across 4 BSC perspectives. There were 41 metrics identified, and 16 were chosen for the initial BSC. It allowed us to achieve several goals: 1) present a broad view of performance, 2) create transparency and accountability, 3) communicate goals and engage faculty, and 4) ensure we use data to guide strategic decisions. Several lessons were learned, including the need to build faculty consensus, establish metrics with reliable measureable data, and the power of the BSC to drive goals across the division. We successfully developed and implemented a BSC in an AHG as part of a strategic planning initiative. The BSC has been instrumental in allowing us to achieve balanced success in multiple domains. Academic groups should consider employing the BSC as it allows for a data-driven strategic planning and assessment process. Copyright © 2013 Society of Hospital Medicine.

Determining the causal relationships among balanced scorecard perspectives on school safety performance: case of Saudi Arabia.

PubMed

Alolah, Turki; Stewart, Rodney A; Panuwatwanich, Kriengsak; Mohamed, Sherif

2014-07-01

In the public schools of many developing countries, numerous accidents and incidents occur because of poor safety regulations and management systems. To improve the educational environment in Saudi Arabia, the Ministry of Education seeks novel approaches to measure school safety performance in order to decrease incidents and accidents. The main objective of this research was to develop a systematic approach for measuring Saudi school safety performance using the balanced scorecard framework philosophy. The evolved third generation balanced scorecard framework is considered to be a suitable and robust framework that captures the system-wide leading and lagging indicators of business performance. The balanced scorecard architecture is ideal for adaptation to complex areas such as safety management where a holistic system evaluation is more effective than traditional compartmentalised approaches. In developing the safety performance balanced scorecard for Saudi schools, the conceptual framework was first developed and peer-reviewed by eighteen Saudi education experts. Next, 200 participants, including teachers, school executives, and Ministry of Education officers, were recruited to rate both the importance and the performance of 79 measurement items used in the framework. Exploratory factor analysis, followed by the confirmatory partial least squares method, was then conducted in order to operationalise the safety performance balanced scorecard, which encapsulates the following five salient perspectives: safety management and leadership; safety learning and training; safety policy, procedures and processes; workforce safety culture; and safety performance. Partial least squares based structural equation modelling was then conducted to reveal five significant relationships between perspectives, namely, safety management and leadership had a significant effect on safety learning and training and safety policy, procedures and processes, both safety learning and training and safety policy, procedures and processes had significant effects on workforce safety culture, and workforce safety culture had a significant effect on safety performance. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Balanced Scorecard for Open Innovation: Measuring the Impact of Industry-University Collaboration

NASA Astrophysics Data System (ADS)

Flores, Myrna; Al-Ashaab, Ahmed; Magyar, Andrea

The Balanced Scorecard (BSC) can be considered as a strategic measurement tool. Since its first publication by Norton and Kaplan in the early 1990’s, many companies have applied it to measure four key aspects of their organisations’ performance: Financial, Customer, Internal Business Process, Learning and Growth. Although it is widely used in the business arena, this original BSC was not developed to assess the impact of collaborative research projects under an open innovation strategy, where the outputs of research and development (R&D) developed by collaborative projects undertaken by industry and universities should be measured in a different way. In fact, many companies are losing important opportunities to spur their R&D results by not being able to quantify the results of such collaborations. Therefore, this paper will propose a Scorecard to measure the outcomes of collaborative research. It is important to recall that this scorecard has been developed during a collaborative research project by CEMEX Research Group AG (Switzerland) and Cranfield University (UK). During such project, a survey was developed to carry out eleven face-to-face interviews in a sample of ten companies in UK, which provided important inputs to design such strategic scorecard. It was confirmed that a collaborative balanced scorecard is a very useful tool to measure, track and improve the impact of conducting collaborative projects with universities.

Strategy Revitalization in Academe: A Balanced Scorecard Approach

ERIC Educational Resources Information Center

McDevitt, Roselie; Giapponi, Catherine; Solomon, Norman

2008-01-01

Purpose: The purpose of this paper is to present a unique version of the balanced scorecard developed and applied by the faculty of a university division. Design/methodology/approach: The paper uses a case study approach and uses the experiences of the faculty of a business school to describe the process and benefits of developing a custom…

A Commentary on "Rhetoric or Reality? Do Accounting Education and Experience Increase Weighting on Environmental Performance in a Balanced Scorecard?"

ERIC Educational Resources Information Center

Larrinaga, Carlos

2013-01-01

In the paper, "Rhetoric or Reality? Do Accounting Education and Experience Increase Weighting on Environmental Performance in a Balanced Scorecard?" (Wynder, Wellner, and Reinhard 2013), researchers test whether business education and (controller) experience influence decision-makers to consider a longer-term perspective and,…

Relationship between Balanced Scorecard and Professors' Job Characteristics at Ekiti State University, Nigeria

ERIC Educational Resources Information Center

Fatile, Mopelola

2017-01-01

The purpose of this quantitative, correlational study was to understand the relationship between a balanced scorecard, professors' job characteristics, and the leadership styles of higher education leaders at Ekiti State University, Ado-Ekiti State, Nigeria, which was the site of the study. The problem statement addressed whether or not a…

A Survey and Analysis of Aircraft Maintenance Metrics: A Balanced Scorecard Approach

DTIC Science & Technology

2014-03-27

Metrics Set Theory /Framework .................................................................................... 16 Balanced Scorecard overview...a useful form Figure 1: Metric Evaluation Criteria (Caplice & Sheffi, 1994, p. 14) Metrics Set Theory /Framework The researcher included an...examination of established theory and frameworks on how metrics sets are constructed in the literature review. The purpose of this examination was to

Using the balanced scorecard in the development of community partnerships.

PubMed

Tsasis, Peter; Owen, Susan M

2009-02-01

The benefits of community partnerships have been well established in the health service literature. However, measuring these benefits and associated outcomes is relatively new. This paper presents an innovative initiative in the application of a balanced scorecard framework for measuring and monitoring partnership activity at the community level, while adopting principles of evidence-based practice to the partnership process. In addition, it serves as an excellent example of how organizations can apply scorecard methodology to move away from relationship-based partnerships and into new collaborations of which they can select - using a formal skill and competency assessment for partnership success.

The occupational safety and health scorecard--a business case example for strategic management.

PubMed

Köper, Birgit; Möller, Klaus; Zwetsloot, Gerard

2009-12-01

Human resources and health issues are crucial in terms of corporate competitiveness. However, systematic, continuous and strategically aligned occupational safety and health (OSH) management is scarcely applied in companies. One major reason for this could be the lack of generally accepted and standardised OSH control methods. Our objective was thus to conceptualize a method by which qualitative factors such as human resources and OSH aspects contribute to the performance or value-added layer of an organization. We developed a business case based on the well-known and accepted Balanced Scorecard approach, which we adapted and applied to the management of OSH issues. The concept was implemented in the course of a comprehensive case study at a German automobile manufacturer. We gathered health as well as finance data in order to test which health-related indicators had an impact on financial performance. The demonstration of, and reporting on, how the promotion of workplace health contributes strategically to the organization is crucial for both health and human resource managers. Based on multivariate regression analyses, our main finding was that the Balanced Scorecard approach is an adequate means to control OSH issues in terms of strategic health management. Our analyses demonstrated that health-related interventions contribute significantly to performance aspects such as quality, productivity, absenteeism, and cost reduction. Therefore, the financial impact of health-related aspects / interventions could be demonstrated by means of the OSH scorecard. The availability and quality of health data within the context of overall corporate performance data needs to be improved in order to bridge OSH-related and performance issues of an organization.

Using the Balanced Scorecard to Enhance Undergraduate Education in a First Year Business Course: A Pilot Study

ERIC Educational Resources Information Center

Hunt, Irma; Taylor, Ronald K.; Winter, Anthony; Mackie, J. Jay; Fisher, Daniel

2016-01-01

Several research studies found that managers lacked a basic understanding of a balanced scorecard (BSC) approach to evaluate an organization. Because of this, the authors saw an opportunity to reorganize a course in order to provide students with an opportunity to address this issue. Therefore, a recent pilot study was conducted to ascertain…

Ubuntu-Praxis: Re-Modelling the Balanced Scorecard Model at a University, an Afrocentric Perspective

ERIC Educational Resources Information Center

Ndoda, Gladys Ruvimbo; Sikwila, Mike Nyamazana

2014-01-01

The authors design the innovation and learning perspective of the Balanced Scorecard (BSC) of "Ubuntu and client service charter nexus." This article borrows and advances the research carried out by Khomba, Vermaak and Gouws (2011). The point of departure is on praxis of ubuntu/unhu as a holistic approach in the re-modelling of the BSC…

Using the balanced scorecard to measure Chinese and Japanese hospital performance.

PubMed

Chen, Xiao-yun; Yamauchi, Kazunobu; Kato, Ken; Nishimura, Akio; Ito, Katuski

2006-01-01

The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries. One hospital from China and another from Japan were chosen and key indicators were selected according to the BSC framework. A comparative hospital performance measurement model was set up using the BSC framework to comprehensively compare hospital performance in two countries. The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the hospitals' contribution to performance improvement of each country's total health system. Hospital performance comparisons between countries using the BSC depend on the selection of feasible and appropriate key performance indicators, which is occasionally limited by data collection problems. The first use of the BSC to compare hospital performance between China and Japan shows benefits that not only suggests performance improvements in individual hospitals but also reveals effective health factors allowing implementation of valid national health policies.

Balancing the balanced scorecard for a New Zealand mental health service.

PubMed

Coop, Colleen F

2006-05-01

Given the high prevalence of mental disorders, there is a need to evaluate mental health services to ensure they are efficient, effective, responsive and accessible. One method that is being used is the "balanced scorecard" which uses performance indicators in four quadrants to assess various dimensions of service provision. This case study describes the steps taken by a New Zealand mental health service to improve service management through greater use of key performance indicators in relation to preset targets using this approach.

Poverty identification for a pro-poor health insurance scheme in Tanzania: reliability and multi-level stakeholder perceptions.

PubMed

Kuwawenaruwa, August; Baraka, Jitihada; Ramsey, Kate; Manzi, Fatuma; Bellows, Ben; Borghi, Josephine

2015-12-01

Many low income countries have policies to exempt the poor from user charges in public facilities. Reliably identifying the poor is a challenge when implementing such policies. In Tanzania, a scorecard system was established in 2011, within a programme providing free national health insurance fund (NHIF) cards, to identify poor pregnant women and their families, based on eight components. Using a series of reliability tests on a 2012 dataset of 2,621 households in two districts, this study compares household poverty levels using the scorecard, a wealth index, and monthly consumption expenditures. We compared the distributions of the three wealth measures, and the consistency of household poverty classification using cross-tabulations and the Kappa statistic. We measured errors of inclusion and exclusion of the scorecard relative to the other methods. We also gathered perceptions of the scorecard criteria through qualitative interviews with stakeholders at multiple levels of the health system. The distribution of the scorecard was less skewed than other wealth measures and not truncated, but demonstrated clumping. There was a higher level of agreement between the scorecard and the wealth index than consumption expenditure. The scorecard identified a similar number of poor households as the "basic needs" poverty line based on monthly consumption expenditure, with only 45 % errors of inclusion. However, it failed to pick up half of those living below the "basic needs" poverty line as being poor. Stakeholders supported the inclusion of water sources, income, food security and disability measures but had reservations about other items on the scorecard. In choosing poverty identification strategies for programmes seeking to enhance health equity it's necessary to balance between community acceptability, local relevance and the need for such a strategy. It is important to ensure the strategy is efficient and less costly than alternatives in order to effectively reduce health disparities.

Alignment of University Information Technology Resources with the Malcolm Baldrige Results Criteria for Performance Excellence in Education: A Balanced Scorecard Approach

ERIC Educational Resources Information Center

Beard, Deborah F.; Humphrey, Roberta L.

2014-01-01

The authors suggest using a balanced scorecard (BSC) approach to evaluate information technology (IT) resources in higher education institutions. The BSC approach illustrated is based on the performance criteria of the Malcolm Baldrige National Quality Award in Education. This article suggests areas of potential impact of IT on BSC measures in…

Assessment of Aberdeen Proving Ground - Army Contracting Command, Contract Management Processes

DTIC Science & Technology

2015-04-11

systems (2008). The Balance Scorecard approach is presented by Niven as “a carefully selected set of quantifiable measures derived from the ...areas of emphasis: the customer, internal processes, learning and growth and financial (Niven, 2003). Both public and private entities recognize the ...contract score card developed by Cullen looks further past the balance scorecard approach by assessing an organization’s contracted functions (2009

Governing patient safety: lessons learned from a mixed methods evaluation of implementing a ward-level medication safety scorecard in two English NHS hospitals.

PubMed

Ramsay, Angus I G; Turner, Simon; Cavell, Gillian; Oborne, C Alice; Thomas, Rebecca E; Cookson, Graham; Fulop, Naomi J

2014-02-01

Relatively little is known about how scorecards presenting performance indicators influence medication safety. We evaluated the effects of implementing a ward-level medication safety scorecard piloted in two English NHS hospitals and factors influencing these. We used a mixed methods, controlled before and after design. At baseline, wards were audited on medication safety indicators; during the 'feedback' phase scorecard results were presented to intervention wards on a weekly basis over 7 weeks. We interviewed 49 staff, including clinicians and managers, about scorecard implementation. At baseline, 18.7% of patients (total n=630) had incomplete allergy documentation; 53.4% of patients (n=574) experienced a drug omission in the preceding 24 h; 22.5% of omitted doses were classified as 'critical'; 22.1% of patients (n=482) either had ID wristbands not reflecting their allergy status or no ID wristband; and 45.3% of patients (n=237) had drugs that were either unlabelled or labelled for another patient in their drug lockers. The quantitative analysis found no significant improvement in intervention wards following scorecard feedback. Interviews suggested staff were interested in scorecard feedback and described process and culture changes. Factors influencing scorecard implementation included 'normalisation' of errors, study duration, ward leadership, capacity to engage and learning preferences. Presenting evidence-based performance indicators may potentially influence staff behaviour. Several practical and cultural factors may limit feedback effectiveness and should be considered when developing improvement interventions. Quality scorecards should be designed with care, attending to evidence of indicators' effectiveness and how indicators and overall scorecard composition fit the intended audience.

Governing patient safety: lessons learned from a mixed methods evaluation of implementing a ward-level medication safety scorecard in two English NHS hospitals

PubMed Central

Ramsay, Angus I G; Turner, Simon; Cavell, Gillian; Oborne, C Alice; Thomas, Rebecca E; Cookson, Graham; Fulop, Naomi J

2014-01-01

Background Relatively little is known about how scorecards presenting performance indicators influence medication safety. We evaluated the effects of implementing a ward-level medication safety scorecard piloted in two English NHS hospitals and factors influencing these. Methods We used a mixed methods, controlled before and after design. At baseline, wards were audited on medication safety indicators; during the ‘feedback’ phase scorecard results were presented to intervention wards on a weekly basis over 7 weeks. We interviewed 49 staff, including clinicians and managers, about scorecard implementation. Results At baseline, 18.7% of patients (total n=630) had incomplete allergy documentation; 53.4% of patients (n=574) experienced a drug omission in the preceding 24 h; 22.5% of omitted doses were classified as ‘critical’; 22.1% of patients (n=482) either had ID wristbands not reflecting their allergy status or no ID wristband; and 45.3% of patients (n=237) had drugs that were either unlabelled or labelled for another patient in their drug lockers. The quantitative analysis found no significant improvement in intervention wards following scorecard feedback. Interviews suggested staff were interested in scorecard feedback and described process and culture changes. Factors influencing scorecard implementation included ‘normalisation’ of errors, study duration, ward leadership, capacity to engage and learning preferences. Discussion Presenting evidence-based performance indicators may potentially influence staff behaviour. Several practical and cultural factors may limit feedback effectiveness and should be considered when developing improvement interventions. Quality scorecards should be designed with care, attending to evidence of indicators’ effectiveness and how indicators and overall scorecard composition fit the intended audience. PMID:24029440

Assessment of Aberdeen Proving Ground - Army Contracting Command, Contract Management Processes

DTIC Science & Technology

2014-12-01

order to enact improvement to public procurement systems (2008). The Balance Scorecard approach is presented by Niven as “a carefully selected set of...organizational performance. The framework analyzes four areas of emphasis: the customer, internal processes, learning and growth and financial (Niven, 2003...performance management (Cavanagh et al., 1999). The contract score card developed by Cullen looks further past the balance scorecard approach by

Accountability in public health units: using a modified nominal group technique to develop a balanced scorecard for performance measurement.

PubMed

Robinson, Victoria A; Hunter, Duncan; Shortt, Samuel E D

2003-01-01

Little attention has been paid to the need for accountability instruments applicable across all health units in the public health system. One tool, the balanced scorecard was created for industry and has been successfully adapted for use in Ontario hospitals. It consists of 4 quadrants: financial performance, outcomes, customer satisfaction and organizational development. The aim of the present study was to determine if a modified nominal group technique could be used to reach consensus among public health unit staff and public health specialists in Ontario about the components of a balanced scorecard for public health units. A modified nominal group technique consensus method was used with the public health unit staff in 6 Eastern Ontario health units (n=65) and public health specialists (n=18). 73.8% of the public health unit personnel from all six health units in the eastern Ontario region participated in the survey of potential indicators. A total of 74 indicators were identified in each of the 4 quadrants: program performance (n=44); financial performance (n=11); public perceptions (n=11); and organizational performance (n=8). The modified nominal group technique was a successful method of incorporating the views of public health personnel and specialists in the development of a balanced scorecard for public health.

Balanced scorecards for specialists: a tool for quality improvement.

PubMed

Marr, Thomas J; Mullen, Deborah M

2004-04-01

This article describes a program that HealthPartners uses to assess and compare the performance of specialists that serve its members. HealthPartners' Balanced Scorecards program focuses on cardiologist and orthopedist practices in the Minneapolis/St. Paul metro area and St. Cloud, Minnesota. The scorecards assess the clinical and business processes of specialist practices, their use of resources, the degree to which patients and referring physicians are satisfied with their performance, and their patient outcomes. Unblinded comparative data is made available to referring physicians, employers, and consumers only after each individual specialist group has had the opportunity to review its own data against blinded results, discuss the methodology, and comment on the results.

Innovation Process Design: A Change Management and Innovation Dimension Perspective

NASA Astrophysics Data System (ADS)

Peisl, Thomas; Reger, Veronika; Schmied, Juergen

The authors propose an innovative approach to the management of innovation integrating business, process, and maturity dimensions. Core element of the concept is the adaptation of ISO/IEC 15504 to the innovation process including 14 innovation drivers. Two managerial models are applied to conceptualize and visualize the respective innovation strategies, the Balanced Scorecard and a Barriers in Change Processes Model. An illustrative case study shows a practical implementation process.

Does performance evaluation help public managers? A Balanced Scorecard approach in urban waste services.

PubMed

Guimarães, Bernardo; Simões, Pedro; Marques, Rui Cunha

2010-12-01

The urban waste market has evolved significantly in the past decades, which among other changes, has led to the creation of new utilities and new business models. However, very few things have changed for the users. Urban waste collection remains mainly under the responsibility of local authorities and the charges paid by the users in most countries are very low compared to the provision costs. This situation forces the injection of public money into the system, encouraging the 'quiet-life' within the utilities and, therefore, inefficiency. The present study intends to analyze the potential for the application of the Balanced Scorecard (BSc) methodology into the waste utilities. After a comprehensive revision of the urban waste sector in Portugal, the methodology of BSc and its application in local public services is described and discussed. Focusing on implementation rather than on strategy, a set of performance indicators is proposed to be utilized in the different management models of waste utilities in Portugal: the municipalities, semi-autonomous utilities, municipal companies and mixed companies. This implementation is then exemplified through four case studies, one for each type of utility. This paper provides a flexible framework proposal to be applied to waste utilities operating both in Portugal and abroad. Copyright © 2010 Elsevier Ltd. All rights reserved.

Evaluating the balanced scorecard at the University Health Network: an impact assessment.

PubMed

Young, Justin; Bell, Robert; Khalfan, Adil; Lindquist, Evert

2008-01-01

The balanced scorecard (BSC) has become increasing popular in healthcare organizations. A recent study conducted at the University Health Network in Toronto explored the extent to which the BSC has focused and aligned various organizational units and departments around shared goals and objectives. The evaluation also assessed the BSC's impact on front-line staff and how the development and rollout of the BSC should be modified in the next planning iteration.

A critical review of financial measures as reported in the Ontario hospital balanced scorecard.

PubMed

Parkinson, John; Tsasis, Peter; Porporato, Marcela

2007-01-01

For Ontario hospitals in Canada, the Financial Performance and Condition measures in the Ontario hospital balanced scorecard are especially of interest since in the foreseeable future, they may be linked to provincial government funding decisions. However, we find that these measures lack valuable information on key attributes that affect organizational performance. We suggest changes that focus on key drivers of performance and reflect the operational realities of Ontario hospitals.

Designing and Using Projects with Real World Application in a MBA Managerial Accounting Class: The Case of The Balanced Scorecard

ERIC Educational Resources Information Center

Houke, Charlotte

2017-01-01

This paper explores the purpose of designing and using projects with real world application in a M.B.A. managerial accounting class. Included is a discussion of how and why the Balanced Scorecard (BSC) Project has been used in classes to link theory with practice by providing real world application of the BSC framework. M.B.A. students represent a…

Balanced scorecard as a framework for driving performance in managed care organizations.

PubMed

Sahney, V K

1998-01-01

Managed care organizations in a highly competitive environment constantly face the pressure of improving their financial performance. At the same time, customers of the organization expect the organization to deliver high-quality outcomes and improve customer service. Payers expect the organization to develop innovative new products to meet their needs. This article presents an approach called "Balanced Scorecard" for measurement, development of strategy, and performance improvement in a managed care organization.

Customising turnaround time indicators to requesting clinician: a 10-year study through balanced scorecard indicators.

PubMed

Salinas, Maria; López-Garrigós, Maite; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

2014-09-01

The purpose of this study is, first to present a 10-year monitoring of postanalytical turnaround time (TAT) adapted to different clinicians and patient situations, second to evaluate and analyse the indicators results during that period of time, and finally to show a synthetic appropriate indicator to be included in the balanced scorecard management system. TAT indicator for routine samples was devised as the percentage of certain key tests that were verified before a specific time on the phlebotomy day. A weighted mean synthetic indicator was also designed. They were calculated for inpatients at 15:00 and 12:00 and for primary care patients only at 15:00. The troponin TAT of emergency department patients, calculated as the difference between the troponin verification and registration time, was selected as the stat laboratory TAT indicator. The routine and stat TAT improved along the 10-year study period. The synthetic indicator showed the same trend. The implementation of systematic and continuous monitoring over years, promoted a continuous improvement in TAT which will probably benefit patient outcome and safety.

Using the balanced scorecard to mobilize human resources in organizational transformation.

PubMed

Tsasis, Peter; Harber, Bruce

2008-05-01

Traditionally, the balanced scorecard (BSC) has been an effective tool in linking measurement to strategy. However, what is least understood is how the BSC can be used to redefine organizational relationships, re-engineer fundamental processes and transform organizational culture, for superior performance in an organization with the same people, services and technology that previously delivered dismal performance. This paper highlights the process and uses York Central Hospital in Toronto, Ontario, Canada as an illustrative example.

Evaluating the Fraser Health Balanced Scorecard--a formative evaluation.

PubMed

Barnardo, Catherine; Jivanni, Amin

2009-01-01

Fraser Health (FH), a large, Canadian, integrated health care network, adopted the Balanced Scorecard (BSC) approach to monitor organizational performance in 2006. This paper reports on the results of a formative evaluation, conducted in April, 2008, to assess the usefulness of the BSC as a performance-reporting system and a performance management tool. Results indicated that the BSC has proven to be useful for reporting performance but is not currently used for performance management in a substantial way.

Scorecard implementation improves identification of postpartum patients at risk for venous thromboembolism.

PubMed

Berkin, Jill A; Lee, Colleen; Landsberger, Ellen; Chazotte, Cynthia; Bernstein, Peter S; Goffman, Dena

2016-07-01

To evaluate if an intensive educational intervention in the use of a standardized venous thromboembolism (VTE) risk assessment tool (scorecard) improves physicians' identification and chemoprophylaxis of postpartum patients at risk for VTE. After implementation of a VTE scorecard and prior to an intensive educational intervention, postpartum patients (n = 140) were evaluated to assess scorecard completion, risk factors, and chemoprophylaxis. A performance improvement campaign focusing on patient safety, VTE prevention, and scorecard utilization was then conducted. Evaluation of the same parameters was subsequently performed for a similar group of patients (n = 133). Differences in scorecard utilization and risk assessment were tested for statistical significance. Population-at-risk rates were similar in both assessment periods (31.4% vs 28.6%; p = NS). The greatest risk factors included cesarean delivery, body mass index (BMI) >30 and age >35. Scorecard completion rates for all patients increased in the postintervention period (15.7% vs 67.7%; p < .001). Postintervention scorecard completion rates for the at-risk population also improved (20% vs 79%; p < .001). In the postintervention group, those at risk with completed scorecards had higher prophylaxis rates than those at risk without scorecards (73% vs 25%; p = .03). At-risk patients with completed scorecards had 2.6 times more orders for chemoprophylaxis than at-risk patients without scorecards in both time periods (odds ratio [OR] = 8.4; 95% confidence interval [CI] 3.1-22.8). Utilization of a VTE scorecard coupled with an educational intervention for health care providers increases detection and chemoprophylaxis orders for at-risk patients. Encouraging universal scorecard assessment standardizes identification and chemoprophylaxis of at-risk patients who were otherwise not perceived to be at risk. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

Evaluation of the Vehicle Out-of-Commission Standard for Air Force Vehicle Maintenance Units.

DTIC Science & Technology

1995-09-01

been reduced, true performance of the unit has decreased. A study conducted by The Maryland Center for Productivity and Quality of Worklife in 1981...productivity indicators using criteria established by The Maryland Center for Productivity and Quality of Worklife study in 1981. The first conclusion was that...Results," Public Productivity and Management Review. 16: 395-402 (Summer 1993). Kaplan, Robert S. "Implementing the Balanced Scorecard at FMC

Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia

PubMed Central

Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

Introduction There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. Methodology The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Results Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff −0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). Conclusion The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could be valuable in monitoring and evaluation of health systems. PMID:23555590

Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

PubMed

Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could be valuable in monitoring and evaluation of health systems.

[The balanced scorecard. "Tool or toy" in hospitals].

PubMed

Brinkmann, A; Gebhard, F; Isenmann, R; Bothner, U; Mohl, U; Schwilk, B

2003-10-01

The change in hospital funding with diagnosis related groups (DRG), medical advances as well as demographic changes will call for new quantitative and qualitative standards imposed on German hospitals. Increasing costs and competition in the health care sector requires new and innovative strategies for resource management. Today's policy is mainly defined by rationing and intensified workload. The introduction of DRGs will presumably further constrict management perspectives on pure financial aspects. However, to ensure future development, compassionate services and continued existence of hospitals, a balance of seemingly conflicting perspectives, such as finance, customer, process, learning and growth are of utmost importance. Herein doctors and nurses in leading positions should play a key role in changing management practice. For several years the balanced scorecard has been successfully used as a strategic management concept in non-profit organizations, even in the health care sector. This concept complies with the multidimensional purposes of hospitals and focuses on policy deployment. Finally it gives the opportunity to involve all employees in the original development, communication and execution of a balanced scorecard approach.

Understanding the context of balanced scorecard implementation: a hospital-based case study in Pakistan.

PubMed

Rabbani, Fauziah; Lalji, Sabrina Nh; Abbas, Farhat; Jafri, Sm Wasim; Razzak, Junaid A; Nabi, Naheed; Jahan, Firdous; Ajmal, Agha; Petzold, Max; Brommels, Mats; Tomson, Goran

2011-03-31

As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation. Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data networks. Variable levels of the BSC implementation were observed in this study. Those intending to apply the BSC in other hospital settings need to ensure a participatory culture, clear institutional mandate, appropriate leadership support, proper reward and recognition system, and sensitization to BSC benefits.

EHR implementation in South Africa: how do we get it right?

PubMed

Yogeswaran, Parimalaranie; Wright, Graham

2010-01-01

In an environment of expanding demand on the health care system to provide equitable, accessible and safe health care, usage of information communication technology is one of the strategies identified to fulfil such expectations. Electronic Health Record (EHR) is an important tool towards achieving better health care using such technology, although, across the world EHR implementation has experienced a high failure rate. Nevertheless South Africa has made a strategic decision to implement EHR system in the public health sector. An evaluation toolkit was developed, to measure the state of readiness of health institutions in South Africa in implementing EHR based on Kaplan and Norton's work on Balanced Score Card (BSC), and the subsequent variant model developed by Protti. A Critical Success Factor (CSF) scorecard to assess the state of readiness and a Balanced Score Card matrix to be used as a strategic framework was developed. These tools were validated using critiques by a panel of experts. The toolkit developed has the potential to assist the organization towards a better EHR implementation path.

Adapting the balanced scorecard for mental health and addictions: an inpatient example.

PubMed

Lin, Elizabeth; Durbin, Janet

2008-05-01

The Balanced Scorecard (BSC) is a performance-monitoring framework that originated in the business sector but has more recently been applied to health services. The province of Ontario is using the BSC approach to monitor quality of inpatient care in five service areas. Feasibility of the scorecard framework for each area has been assessed using a standard approach. This paper reports results of the feasibility study for the mental health sector, focusing on three issues: framework relevance, underlying strategic goals and indicator selection. Based on a literature review and extensive stakeholder input, the BSC quadrant structure was recommended with some modifications, and indicators were selected that aligned with provincial mental health reform policy goals. The mental health report has completed two cycles of reporting, and has received good support from the field. Copyright © 2008 Longwoods Publishing.

Summarizing health inequalities in a Balanced Scorecard. Methodological considerations.

PubMed

Auger, Nathalie; Raynault, Marie-France

2006-01-01

The association between social determinants and health inequalities is well recognized. What are now needed are tools to assist in disseminating such information. This article describes how the Balanced Scorecard may be used for summarizing data on health inequalities. The process begins by selecting appropriate social groups and indicators, and is followed by the measurement of differences across person, place, or time. The next step is to decide whether to focus on absolute versus relative inequality. The last step is to determine the scoring method, including whether to address issues of depth of inequality.

A management approach that drives actions strategically: balanced scorecard in a mental health trust case study.

PubMed

Schmidt, Stefan; Bateman, Ian; Breinlinger-O'Reilly, Jochen; Smith, Peter

2006-01-01

Achieving excellence is a current preoccupation in U.K. public health organisations. This article aims to use a case study to explain how a mental health trust delivers excellent performance using a balanced scorecard (BSC) management approach. Reports a project to implement a BSC approach in the South West Yorkshire Mental Health NHS Trust to achieve its "excellence" objectives. The authors were participants in the project. The design of the pilot project was informed theoretically by the work of Kaplan and Norton and practically by in-house discussions on a strategy to achieve excellence. Explains the process of building a BSC strategy step-by-step. Discusses how the vision and strategies of a mental health trust can be translated into tangible measures, which are the basis for actions that are driven strategically. There are many possibilities for a BSC management approach and this case study is specific to mental health trusts in the UK, although it is believed that the case has a universally applicable modus operandi. This article will help healthcare managers to evaluate the benefits of a BSC management approach. This article explains how actions can be structured in connection with a BSC management approach.

The Integrated Scorecard in support of corporate sustainability strategies.

PubMed

Journeault, Marc

2016-11-01

Organizations have increasingly recognized the importance and benefits of developing a sustainability strategy that incorporates environmental and social responsibilities. However, the simultaneous integration of the economic, environmental and social aspects remains a major concern for organizations. The Sustainability Balanced Scorecard (SBSC) represents one of the most promising strategic tools to help organizations face these challenges and support their sustainability strategy. However, past research has provided unclear, incomplete and even contradictory SBSC frameworks while offering little knowledge about how to integrate stakeholder management as well as environmental and social performance within the balanced scorecard to successfully support a corporate sustainability strategy. The aim of this study is to address these issues and limitations by proposing the Integrated Scorecard, a specific SBSC that integrates the three pillars of sustainability performance within four different perspectives, namely environmental, social and economic performance, stakeholder management, internal business processes, and skills and capabilities. This study provides a conceptual approach to the Integrated Scorecard and illustrates, through the use of two practical illustrations, the ability of this framework to support the corporate sustainability strategy by identifying the core sustainability objectives that organizations should achieve when creating value, facilitating the understanding of the contribution of environmental and social initiatives on economic performance, allowing the monitoring and measurement of the strategy's level of achievement, and creating synergy between sustainability performance management and reporting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Balanced Scorecards As a Tool for Developing Patient-Centered Pharmacy Services

PubMed Central

Enwere, Emmanuel N.; Keating, Ellen A.; Weber, Robert J.

2014-01-01

Having accurate data is essential for the pharmacy director to manage the department and develop patient-centered pharmacy services. A balanced scorecard (BSC) of essential department data, which is a broad view of a department’s function beyond its financial performance, is an important part of any department’s strategic plan. This column describes how the pharmacy director builds and promotes a department’s BSC. Specifically, this article reviews how the BSC supports the department’s mission and vision, describes the metrics of the BSC and how they are collected, and recommends how the pharmacy director can effectively use the scorecard results in promoting the pharmacy. If designed properly and updated consistently, a BSC can present a broad view of the pharmacy’s performance, serve as a guide for strategic decision making, and improve on the quality of its services. PMID:24958976

Quality Measures for Dialysis: Time for a Balanced Scorecard

PubMed Central

2016-01-01

Recent federal legislation establishes a merit-based incentive payment system for physicians, with a scorecard for each professional. The Centers for Medicare and Medicaid Services evaluate quality of care with clinical performance measures and have used these metrics for public reporting and payment to dialysis facilities. Similar metrics may be used for the future merit-based incentive payment system. In nephrology, most clinical performance measures measure processes and intermediate outcomes of care. These metrics were developed from population studies of best practice and do not identify opportunities for individualizing care on the basis of patient characteristics and individual goals of treatment. The In-Center Hemodialysis (ICH) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey examines patients' perception of care and has entered the arena to evaluate quality of care. A balanced scorecard of quality performance should include three elements: population-based best clinical practice, patient perceptions, and individually crafted patient goals of care. PMID:26316622

Competing values in healthcare: balancing the (un)balanced scorecard.

PubMed

Wicks, Angela M; St Clair, Lynda

2007-01-01

Facing a complex environment driven by two decades of dramatic change, healthcare organizations are adopting new strategic frameworks such as the Balanced Scorecard (BSC) to evaluate performance (Kaplan and Norton 1992). The BSC was not originally developed as a performance management tool, however. Rather, it was designed as a tool to communicate strategy and, as such, provides little guidance when actual outcomes fall short of desired outcomes. In addition, although the BSC is an improvement over exclusively financial measures, it has three conceptual limitations that are especially problematic for evaluating healthcare organizations: (1) it underemphasizes the employee perspective, (2) it is founded on a control-based management philosophy, and (3) it emphasizes making trade-offs. To address these limitations, we propose using the Competing Values Framework (CVF), a theoretically grounded, comprehensive approach to understanding and improving organizational and managerial performance by focusing on four action imperatives: competing, controlling, collaborating, and creating. The CVF pays particular attention to the employee perspective, is consistent with a commitment-based management philosophy, and emphasizes transcending apparent paradoxes to identify win-win solutions. Rather than focusing on customer satisfaction or employee satisfaction, the CVF looks for ways to satisfy customers and employees while still addressing financial constraints and growth opportunities. The CVF also can be used to assess both the culture of the organization and the competencies of individual managers, thereby providing a clear link between strategy and implementation.

Supply chain value creation methodology under BSC approach

NASA Astrophysics Data System (ADS)

Golrizgashti, Seyedehfatemeh

2014-06-01

The objective of this paper is proposing a developed balanced scorecard approach to measure supply chain performance with the aim of creating more value in manufacturing and business operations. The most important metrics have been selected based on experts' opinion acquired by in-depth interviews focused on creating more value for stakeholders. Using factor analysis method, a survey research has been used to categorize selected metrics into balanced scorecard perspectives. The result identifies the intensity of correlation between perspectives and cause-and-effect chains among them using statistical method based on a real case study in home appliance manufacturing industries.

Monitoring intensive care unit performance—impact of a novel individualised performance scorecard in critical care medicine: a mixed-methods study protocol

PubMed Central

Neilipovitz, David; Sarti, Aimee J; Rosenberg, Erin; Ishaq, Rabia; Thornton, Mary; Kim, John

2018-01-01

Introduction Patients admitted to a critical care medicine (CCM) environment, including an intensive care unit (ICU), are susceptible to harm and significant resource utilisation. Therefore, a strategy to optimise provider performance is required. Performance scorecards are used by institutions for the purposes of driving quality improvement. There is no widely accepted or standardised scorecard that has been used for overall CCM performance. We aim to improve quality of care, patient safety and patient/family experience in CCM practice through the utilisation of a standardised, repeatable and multidimensional performance scorecard, designed to provide a continuous review of ICU physician and nurse practice, as well as departmental metrics. Methods and analysis This will be a mixed-methods, controlled before and after study to assess the impact of a CCM-specific quality scorecard. Scorecard metrics were developed through expert consensus and existing literature. The study will include 19 attending CCM physicians and approximately 300 CCM nurses. Patient data for scorecard compilation are collected daily from bedside flow sheets. Preintervention baseline data will be collected for 6 months for each participant. After this, each participant will receive their scorecard measures. Following a 3-month washout period, postintervention data will be collected for 6 months. The primary outcome will be change in performance metrics following the provision of scorecard feedback to subjects. A cost analysis will also be performed, with the purpose of comparing total ICU costs prior to implementation of the scorecard with total ICU costs following implementation of the scorecard. The qualitative portion will include interviews with participants following the intervention phase. Interviews will be analysed in order to identify recurrent themes and subthemes, for the purposes of driving scorecard improvement. Ethics and dissemination This protocol has been approved by the local research ethics board. Publication of results is anticipated in 2019. If this intervention is found to improve patient- and unit-directed outcomes, with evidence of cost-effectiveness, it would support the utilisation of such a scorecard as a quality standard in CCM. PMID:29358441

Understanding the context of balanced scorecard implementation: a hospital-based case study in pakistan

PubMed Central

2011-01-01

Background As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation. Results Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data networks. Conclusion Variable levels of the BSC implementation were observed in this study. Those intending to apply the BSC in other hospital settings need to ensure a participatory culture, clear institutional mandate, appropriate leadership support, proper reward and recognition system, and sensitization to BSC benefits. PMID:21453449

Configuring balanced scorecards for measuring health system performance: evidence from 5 years' evaluation in Afghanistan.

PubMed

Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H

2011-07-01

In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0-100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3-84.5, p<0.0001); provider satisfaction (65.4-79.2, p<0.01); capacity for service provision (47.4-76.4, p<0.0001); quality of services (40.5-67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0-52.6). The financial domain also showed improvement until 2007 (84.4-95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary.

Bringing human resources to the table: utilization of an HR balanced scorecard at Mayo Clinic.

PubMed

Fottler, Myron D; Erickson, Eric; Rivers, Patrick A

2006-01-01

Rather than viewing HR as a critical driver of organizational strategy and outcomes, most health care organizations see HR as a drain on the organization's bottom line. Only by aligning HR with the organizational strategy will HR leaders truly get a seat at the leadership table. HR professionals can overcome impediments and gain a seat at the table by learning the language of business and the ways in which organizational leaders use data to drive their decisions. This article shows how Mayo Clinic uses the popular Balanced Scorecard approach to align its measures of HR performance to the organization's strategic plan.

[Application of the balanced scorecard for evaluating the training process].

PubMed

Venturoli, Cristiana; Gamberoni, Loredana

2009-01-01

A training project in which nurses acted as tutors to novice nurses was introduced in the Ferrara University Hospital, with the aim of helping them to achieve the skills and professional expertise required in an operating theatre environment. Owing to the involvement of all the surgical divisions of the hospital and the continual addition of new staff, the Balanced Scorecard method (BSC) was used to assess the impact of training on the entire organization. The BSC method, a multidimensional method born in the USA in the 1990's, made it possible to assess the utility of training in the light of achieving institutional goals.

Creating a balanced scorecard for a hospital system.

PubMed

Pink, G H; McKillop, I; Schraa, E G; Preyra, C; Montgomery, C; Baker, G R

2001-01-01

In 1999, hospitals in Ontario, Canada, collaborated with a university-based research team to develop a report on the relative performance of individual hospitals in Canada's most populated province. The researchers used the balanced-scorecard framework advocated by Kaplan and Norton. Indicators of performance were developed in four areas: clinical utilization and outcomes, patient satisfaction, system integration and change, and financial performance and condition. The process of selecting, calculating, and validating meaningful indicators of financial performance and condition is outlined. Lessons learned along the way are provided. These lessons may prove valuable to other finance researchers and practitioners who are engaged in performance measurement endeavors.

Priority Determination for Higher Education Strategic Planning Using Balanced Scorecard, FAHP and TOPSIS (Case study: XYZ University)

NASA Astrophysics Data System (ADS)

Yudatama, Uky; Sarno, Riyanarto

2016-01-01

The process of strategic planning is needed by a higher education in some cases, especially in preparing to face the challenges and competition. The results of strategic planning will help the higher education to provide a framework for achieving a competitive advantage as well as determine the direction of future policy in accordance with the desired objectives. In recent decades, the Balanced Scorecard has been applied in the field of information technology as a very popular tool and is used extensively, because it is a model that can explain between information technologies with "Business Objectives" in a comprehensive manner. This study uses 4 perspectives in the Balanced Scorecard and 7 standards in higher education quality assessment as sub-criteria. Fuzzy AHP and Fuzzy TOPSIS are used to determine the priority as making strategic policy recommendations in a higher education. The final result of this research shows the score of Customer Perspective 0.35365 is higher than other perspective, while the score in Research and Student Affairs gains significant score when compared with the others, namely 0.69753948 is also higher. This means that both of them get very serious attention as a strategic planning basis for policy making.

Balanced scorecard: application in the General Panarcadian Hospital of Tripolis, Greece.

PubMed

Koumpouros, Yiannis

2013-01-01

The purpose of this paper is to discuss the application of the balanced scorecard (BSC) in the Greek public health sector. The basic balanced scorecard theory has been adopted in the characteristics and individualities of the Greek public health system. The theoretical model developed was applied in the General Panarcadian Hospital of Tripolis (GPHT) in Greece. GPHT is a representative paradigm of a big regional Greek public hospital. It has about 300 beds and many clinics and specialties (internal medicine, cardiology, general surgery, intensive care unit, artificial kidney unit, etc.). Strategic management was performed for almost three years. The BSC model was formulated in an appropriate software program. The problems (both technical and managerial) faced during a three-year period along with the results of this management approach are presented in the current paper. The paper highlights some important gaps in the Greek public health system, while proposing actions to be taken. The BSC theory can be very successful under certain conditions. Special attention is given to the peculiarities of the Greek public health situation. The paper presents for the first time a real life example of applying BSC in the Greek public health sector.

How Nutrition Sensitive Are the Nutrition Policies of New Zealand Food Manufacturers? A Benchmarking Study.

PubMed

Doonan, Rebecca; Field, Penny

2017-12-19

Nutrition sensitive policy addresses the underlying determinants of nutrition-related disease and is a powerful tool in reducing the incidence of non-communicable disease. Some members of the food industry have long standing commitments to health-oriented nutrition policies. The aim of this study was to develop and apply a balanced scorecard of nutrition sensitive indicators to the policies of influential New Zealand food and beverage manufacturers and explore factors affecting policy processes. The average nutrition sensitivity score of the twenty influential manufacturers policies was 42 against a benchmark of 75. Some manufacturers performed well whilst others had substantial scope for improvement, the largest variation was in policy development and implementation, whereas nutrition quality was relatively consistent. Manufacturers with written policy ( n = 11) scored on average three times higher than their counterparts with verbal policy. The value a manufacturer placed on nutrition influenced whether formal nutrition policies were developed. The reputational risk of failing to deliver on publicly declared nutrition commitments acted as an informal accountability mechanism. We conclude the balanced scorecard offers a useful tool for assessing the nutrition sensitivity of influential food and beverage manufacturers' policies. Our results provide a baseline for repeat assessments of the nutrition sensitivity of food manufacturers' policies.

How Nutrition Sensitive Are the Nutrition Policies of New Zealand Food Manufacturers? A Benchmarking Study

PubMed Central

Doonan, Rebecca

2017-01-01

Nutrition sensitive policy addresses the underlying determinants of nutrition-related disease and is a powerful tool in reducing the incidence of non-communicable disease. Some members of the food industry have long standing commitments to health-oriented nutrition policies. The aim of this study was to develop and apply a balanced scorecard of nutrition sensitive indicators to the policies of influential New Zealand food and beverage manufacturers and explore factors affecting policy processes. Results: The average nutrition sensitivity score of the twenty influential manufacturers policies was 42 against a benchmark of 75. Some manufacturers performed well whilst others had substantial scope for improvement, the largest variation was in policy development and implementation, whereas nutrition quality was relatively consistent. Manufacturers with written policy (n = 11) scored on average three times higher than their counterparts with verbal policy. The value a manufacturer placed on nutrition influenced whether formal nutrition policies were developed. The reputational risk of failing to deliver on publicly declared nutrition commitments acted as an informal accountability mechanism. We conclude the balanced scorecard offers a useful tool for assessing the nutrition sensitivity of influential food and beverage manufacturers’ policies. Our results provide a baseline for repeat assessments of the nutrition sensitivity of food manufacturers’ policies. PMID:29257049

Quality Measures for Dialysis: Time for a Balanced Scorecard.

PubMed

Kliger, Alan S

2016-02-05

Recent federal legislation establishes a merit-based incentive payment system for physicians, with a scorecard for each professional. The Centers for Medicare and Medicaid Services evaluate quality of care with clinical performance measures and have used these metrics for public reporting and payment to dialysis facilities. Similar metrics may be used for the future merit-based incentive payment system. In nephrology, most clinical performance measures measure processes and intermediate outcomes of care. These metrics were developed from population studies of best practice and do not identify opportunities for individualizing care on the basis of patient characteristics and individual goals of treatment. The In-Center Hemodialysis (ICH) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey examines patients' perception of care and has entered the arena to evaluate quality of care. A balanced scorecard of quality performance should include three elements: population-based best clinical practice, patient perceptions, and individually crafted patient goals of care. Copyright © 2016 by the American Society of Nephrology.

A framework for operationalization of strategic plans and metrics for corporate performance measurement in transportation asset management

NASA Astrophysics Data System (ADS)

Mteri, Hassan H.

This thesis investigated the business processes required to translate corporate-level strategic plans into tactical and operational plans in the context of transportation asset management. The study also developed a framework for effective performance measure for departments of transportation. The thesis was based on a case study of transportation agencies in the U.S.A. and Canada. The scope is therefore limited or more directly applicable to transportation assets such as pavement, bridges and culverts. The goal was to address the problem of translating or managing strategic plans, especially in the context of the public sector responsible for operating transportation infrastructure. It was observed that many agencies have been successful in formulating good strategic plans but they have performed relatively poorly in translating such corporate-level strategic plans into operational activities. A questionnaire survey was designed and targeted about 30 state agencies that are currently active in transportation asset management. Twenty one (21) transportation agencies in the USA and Canada responded to the questionnaire. The analysis of the questionnaire data showed that there is a lack of a standard approach to managing corporate strategic plans in transportation agencies. The results also indicated that most transportation agencies operate in three organizational levels but there was no systematic approach of translating goal and objectives from high level to lower levels. Approaches in performance measurement were found to vary from agency to agency. A number of limitations were identified in the existing practice on performance measurements. Key weaknesses include the large number of measures in use (as many as 25 or more), and the disconnection between the measures used and the corporate goals and objectives. Lessons from the private sector were thoroughly reviewed in order to build the groundwork for adapting existing tools to the public sector. The existing literature, assumptions and characteristics that make the Balanced Scorecards and strategy maps work effectively in the private sector were identified. Gaps in implementation of strategic plans and the use of Balanced Scorecard in the public sector were derived. Although Balanced Scorecards have previously been used to a limited extent in transportation agencies, the use of combined Balanced Scorecards and strategy maps with a much broader utility of translating strategic plans into tactical and operational activities for Transportation Asset Management is yet to be established. The thesis presents a framework to operationalize strategic plans through the combined application of Balanced Scorecards and strategy maps. The proposed framework aligns overarching objectives in all organizational levels: corporate, tactical, and operation, in which detail information is delegated from top level to lower levels. Furthermore, the thesis presents a proposed framework for developing and using effective corporate performance measures. The framework for performance measures provides a key tool for tracking progress and ensuring overall operationalization of strategic plans in transportation agencies. The thesis presents a methodology to assess existing performance measures so that agencies can reduce the number of measures, to be more effective and manageable. It was found that among other good characteristics, corporate performance measures must be tied to agency's goals and objectives and must be sensitive or responsive to program delivery activities and to the impacts of decisions about resource allocation.

Developing and using a balanced scorecard: a case study with SWOT analysis.

PubMed

Gumbus, Andra; Lussier, Robert N

2003-01-01

Have you tried to measure your laboratory's performance lately? Do you measure and assess financial results, customer satisfaction, internal process efficiency, and learning and growth? If any of these metrics are missing from your performance measurement system, you are not using the latest management tool that is sweeping the health-care industry--the balanced scorecard (BSC). This article begins with a discussion of the BSC and why you should use it in your laboratory, followed by SWOT analysis to assess the strengths, weaknesses, opportunities, and threats (SWOT) a BSC offers your laboratory. A laboratory case study is then presented to assist you in developing and using a BSC in your laboratory.

The Balanced Scorecard versus Total Quality Management: which is better for your organization?

PubMed

Schwartz, Jay

2005-10-01

Today's health care organizations must deal with managed care, government oversight, aging baby boomers, new technologies, and increasing pharmaceutical prices. It is imperative that health care organizations adopt some form of business strategy to manage the vast amount of information available. Two of the more popular strategies among health care organizations are the Balanced Scorecard and Total Quality Management. Which one of the strategies is best for an organization? The answer to this question is that it depends on the organization. This article provides the fundamentals of each strategy and contrasts their strengths and weaknesses, so that interested organizations can make informed decisions regarding the best strategy for each organization.

Reviewing the application of the balanced scorecard with implications for low-income health settings.

PubMed

Rabbani, Fauziah; Jafri, S M Wasin; Abbas, Farhat; Pappas, Gregory; Brommels, Mats; Tomson, Goran

2007-01-01

High-income countries (HICs) are increasingly making use of the balanced scorecard (BSC) in healthcare. Evidence about BSC usage in low-income countries (LICs) is deficient. This study assessed feasibility of BSC use in LICs. Systematic review of electronic databases shows that the BSC improved patient, staff, clinical, and financial outcomes in HICs. To translate the experience of BSC use in HICs to their use in LICs, the applicability parameters of the National Committee for Quality Assurance were applied. Despite contextual challenges, pilot testing of BSC use can be undertaken in selected LICs. Committed leadership, cultural readiness, quality information systems, viable strategic plans, and optimum resources are required.

The balanced scorecard as a strategic management tool: its application in the regional public health system in Campania.

PubMed

Impagliazzo, Cira; Ippolito, Adelaide; Zoccoli, Paola

2009-01-01

Health, as a primary and advanced need, can only be guaranteed through the appropriate management of dedicated resources. As in any situation where funds are limited, it is vital to have logical frameworks and tools to set up structures capable of making a complex system like the health service work. Only through an appropriate and competent activity of governance can such structures be identified, organized, and rendered operational. This can be achieved by using ad hoc tools such as the Balanced Scorecard. Its application in the case of the Regional Government of Campania indicates that it is a valid tool in all circumstances except in situations of crisis.

[The balanced scorecard--applications in a radiology department].

PubMed

Maurer, M H; Teichgräber, U; Kröncke, T J; Hamm, B; Lemke, A J

2012-12-01

The balanced scorecard (BSC) represents a comprehensive management tool for organizations with the aim to focus all activities on a chosen strategy. Targets for various perspectives of the environment such as the customer, financial, process, and potential perspective are linked with concrete measures, and cause-effect relationships between the objectives are analyzed. This article shows that the BSC can also be used for the comprehensive control of a radiology department and thus provides a meaningful contribution in organizing the various diagnostic and treatment services, the management of complex clinical environment and can be of help with the tasks in research and teaching. © Georg Thieme Verlag KG Stuttgart · New York.

The palliative care scorecard as an innovative approach in long-term care

PubMed Central

Esslinger, Adelheid Sussanne; Alzinger, Dagmar; Rager, Edeltraud

2009-01-01

Introduction In long-term care facilities professional concepts for palliative care are of great interest as individual needs of clients (residents, relatives, and friends) are in the focus of services. Case Within a long-term care facility of the Red Cross Organization in Germany, we developed a palliative care concept in 2008. It is integrated in the strategy of the whole organization. As the strategic management concept is based on the balanced scorecard, we introduced a palliative care scorecard. The facility offers 200 places for residents. It has established 27 strategic targets to achieve. One of these is to provide individual care. Another one is to integrate relatives of residents. One more deals with the integration of volunteers. We decided to implement a palliative care concept within the target system (e.g. develop individual pain therapy, create and coordinate interdisciplinary palliative care teams). Results The case shows how it is possible to integrate and strengthen the subject of palliative care within the existing management system of the organization. In order to translate the concept into action, it will be necessary to change the organizational culture into an ‘open minded house’. This especially means that all members of the organization have to be trained and sensitized for the matters of care at the end of life. Conclusion The development and implementation of an integrated concept of palliative care, which fits into the existing management system, is the base of a sustainable offer of specialized care for the residents and their social network. Therefore, not only the quality of care and life of the clients, but also the surviving of the facility on the market of care will be assured.

Application of the balanced scorecard to an academic medical center in Taiwan: the effect of warning systems on improvement of hospital performance.

PubMed

Chen, Hsueh-Fen; Hou, Ying-Hui; Chang, Ray-E

2012-10-01

The balanced scorecard (BSC) is considered to be a useful tool for management in a variety of business environments. The purpose of this article is to utilize the experimental data produced by the incorporation and implementation of the BSC in hospitals and to investigate the effects of the BSC red light tracking warning system on performance improvement. This research was designed to be a retrospective follow-up study. The linear mixed model was applied for correcting the correlated errors. The data used in this study were secondary data collected by repeated measurements taken between 2004 and 2010 by 67 first-line medical departments of a public academic medical center in Taipei, Taiwan. The linear mixed model of analysis was applied for multilevel analysis. Improvements were observed with various time lags, from the subsequent month to three months after red light warning. During follow-up, the red light warning system more effectively improved controllable costs, infection rates, and the medical records completion rate. This further suggests that follow-up management promotes an enhancing and supportive effect to the red light warning. The red light follow-up management of BSC is an effective and efficient tool where improvement depends on ongoing and consistent attention in a continuing effort to better administer medical care and control costs. Copyright © 2012. Published by Elsevier B.V.

Multidimensional evaluation of performance: experimental application of the balanced scorecard in Ferrara university hospital.

PubMed

Verzola, Adriano; Bentivegna, Roberto; Carandina, Gianni; Trevisani, Lucio; Gregorio, Pasquale; Mandini, Alberto

2009-09-08

One of the best-known performance planning and evaluation techniques utilising both monetary and non-monetary data is the Balanced Scorecard (BSC). This is a means of rationalising the global activity of a business in the attempt to create value, and to translate the company vision into a set of tactical objectives and measurable strategies. The aim of this study was to implement and evaluate the use of BSC in two departments of the St. Anna University Hospital, Ferrara: the Analysis Laboratory and Digestive Endoscopy operating units (OU). With the collaboration of the health workers involved, a precise methodological programme was pursued: Definition of the strategic map from 4 perspectives, according to Kaplan and Norton, Definition of the Key Performance Areas (KPA), or macro-objectives, Identification of the cause-effect relationships between KPAs, Identification of the sub-objectives of each KPA, Definition of the Key Performance Indicators (KPI), Definition of the weight/importance of each objective in the global evaluation. The information gathered permitted the definition of macro- and sub-objectives for each perspective, as well as determining the relevant indicators, standards, weights, frequency of detection and means of acquisition. Strategic maps showing the cause/effect relationships in each OU were created, as were 'evaluation panels', which describe the global performance of each department. For each perspective, the fundamental data were summarised in one table. Evaluation of each perspective yielded a positive result for the majority of the objectives, and the global result (including all 4 perspectives) was found to be satisfactory. The Balanced Scorecard was implemented in the abovementioned OUs of St. Anna University Hospital, Ferrara, after the health workers themselves realised the need for change.In our research the employees were pleased to be evaluated, not only for the financial outcomes, but also for the satisfaction of improving internal procedure, relationships with the community and their own growth/learning. BSC is an ideal point of contact between the financial and clinical dimensions of management. However, difficulties in its application were faced, among these, at least in the initial phase, the lack of information systems able to drive it, and the complexity of the research for specific indicators needed to be overcome. The time factor (on average, at least two years are required) and the availability of technological resources were also limiting factors.The rapid diffusion of BSC among the principal international profit and non-profit organisations is testament to its great potential. This project could be seen as a preparatory phase in the strategical analysis of a subsequent business plan.

Training the People’s Liberation Army Air Force Surface-to-Air Missile (SAM) Forces

DTIC Science & Technology

2016-01-01

Kyle Brady, and Lyle J. Morris , The U.S.-China Military Scorecard: Forces, Geography, and the Evolving Balance of Power, 1996–2017, Santa Monica, Calif...training articles from January 1, 2004, to December 31, 2006.72 At that time, KJB was published only three times a week ( Tuesdays , Thursdays, and...DeLuca, David A. Shlapak, David R. Frelinger, Burgess Laird, Kyle Brady, and Lyle J. Morris , The U.S.-China Military Scorecard: Forces, Geography

Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

PubMed Central

Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

2011-01-01

Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, p<0.0001); provider satisfaction (65.4–79.2, p<0.01); capacity for service provision (47.4–76.4, p<0.0001); quality of services (40.5–67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0–52.6). The financial domain also showed improvement until 2007 (84.4–95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. Conclusions The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

Developing a Scorecard to Assess Global Progress in Scaling Up Diarrhea Control Tools: A Qualitative Study of Academic Leaders and Implementers

PubMed Central

Rosinski, Alexander Anthony; Narine, Steven; Yamey, Gavin

2013-01-01

Background In 2010, diarrhea caused 0.75 million child deaths, accounting for nearly 12% of all under-five mortality worldwide. Many evidence-based interventions can reduce diarrhea mortality, including oral rehydration solution (ORS), zinc, and improved sanitation. Yet global coverage levels of such interventions remain low. A new scorecard of diarrhea control, showing how different countries are performing in their control efforts, could draw greater attention to the low coverage levels of proven interventions. Methods We conducted in-depth qualitative interviews with 21 experts, purposively sampled for their relevant academic or implementation expertise, to explore their views on (a) the value of a scorecard of global diarrhea control and (b) which indicators should be included in such a scorecard. We then conducted a ranking exercise in which we compiled a list of all 49 indicators suggested by the experts, sent the list to the 21 experts, and asked them to choose 10 indicators that they would include and 10 that they would exclude from such a scorecard. Finally, we created a “prototype” scorecard based on the 9 highest-ranked indicators. Results Key themes that emerged from coding the interview transcripts were: a scorecard could facilitate country comparisons; it could help to identify best practices, set priorities, and spur donor action; and it could help with goal-setting and accountability in diarrhea control. The nine highest ranking indicators, in descending order, were ORS coverage, rotavirus vaccine coverage, zinc coverage, diarrhea-specific mortality rate, diarrhea prevalence, proportion of population with access to improved sanitation, proportion with access to improved drinking water, exclusive breastfeeding coverage, and measles vaccine coverage. Conclusion A new scorecard of global diarrhea control could help track progress, focus prevention and treatment efforts on the most effective interventions, establish transparency and accountability, and alert donors and ministries of health to inadequacies in diarrhea control efforts. PMID:23874412

Modern management instruments--control of a water resources management association by means of an agreement on targets (balanced scorecard).

PubMed

von Seidlitz, A E; Londong, J

2001-01-01

Since the matter of water supply and sewage disposal is safeguarded in Germany, public concern would no longer appear to be directed at questions of disposal reliability, but almost exclusively to economic efficiency. The requirements with respect to sewage disposal are dominated not only by growing environmental regulations and technical challenges, but also to a major extent by a discussion on the costs arising. In order to ensure a viable and at the same time economic water supply and sewage disposal despite this, it is necessary to have a holistic corporate control system. As a counterpart to the river basin management approach adopted at the Wupperverband there is, on the business management side, the agreement on targets (balanced scorecard) as a management and controlling approach. This incorporates purely financial variables as well as non-financial variables in the economic valuation of corporate success. The starting point is the formulation of strategic goals, while including customer-oriented, in-company and forward-looking perspectives, taking into account at the same time the interactions between them. A major perspective of such balanced scorecards is customer satisfaction. By means of an intensive dialogue with members, licensing and supervisory authorities of the Wupperverband within the framework of a holistic corporate control, it has been possible not only to improve corporate success, but also, and more importantly, to achieve an appreciable increase in confidence.

Value-based metrics and Internet-based enterprises

NASA Astrophysics Data System (ADS)

Gupta, Krishan M.

2001-10-01

Within the last few years, a host of value-based metrics like EVA, MVA, TBR, CFORI, and TSR have evolved. This paper attempts to analyze the validity and applicability of EVA and Balanced Scorecard for Internet based organizations. Despite the collapse of the dot-com model, the firms engaged in e- commerce continue to struggle to find new ways to account for customer-base, technology, employees, knowledge, etc, as part of the value of the firm. While some metrics, like the Balance Scorecard are geared towards internal use, others like EVA are for external use. Value-based metrics are used for performing internal audits as well as comparing firms against one another; and can also be effectively utilized by individuals outside the firm looking to determine if the firm is creating value for its stakeholders.

Measuring business performance using indicators of ecologically sustainable organizations

NASA Astrophysics Data System (ADS)

Snow, Charles G., Jr.; Snow, Charles C.

2001-02-01

The purpose of this paper is to explore the use of ecology-based performance measures as a way of augmenting the Balanced Scorecard approach to organizational performance measurement. The Balanced Scorecard, as proposed by Kaplan and Norton, focuses on four primary dimensions; financial, internal-business-process, customer, and learning and growth perspectives. Recently, many 'green' organizational theorists have developed the concept of "Ecologically Sustainable Organizations" or ESOs, a concept rooted in open systems theory. The ESO is called upon to consider resource use and conservation as a strategy for long-term viability. This paper asserts that in order to achieve ESO status, an organization must not only measure but also reward resource conservation measures. Only by adding a fifth perspective for ecological dimensions will the entity be truly motivated toward ESO status.

Environmental performance evaluation and strategy management using balanced scorecard.

PubMed

Hsu, Yu-Lung; Liu, Chun-Chu

2010-11-01

Recently, environmental protection and regulations such as WEEE, ELV, and RoHS are rapidly emerging as an important issue for business to consider. The trend of swinging from end-of-pipe control to product design, green innovation, and even the establishment of image or brand has affected corporations in almost every corner in the world, and enlarged to the all modern global production network. Corporations must take proactive environmental strategies to response the challenges. This study adopts balanced scorecard structure and aim at automobile industries to understand the relationships of internal and external, financial and non-financial, and outcome and driving factors. Further relying on these relationships to draw the "map of environment strategy" to probe and understand the feasibility of environmental performance evaluation and environmental strategy control.

Analysis of performance measurement at HR-GR Department using the balance scorecard method

NASA Astrophysics Data System (ADS)

Vienni; Bachtiar, M.

2017-12-01

PT. X is a company engaged in logistics service in Indonesia. Every company will certainly face a dynamic business environment. Competitors not only from domestic but also from overseas. To be successful in achieving its objectives, company should have a comprehensive measurement system as a strategy feedback that will drive the performance of company. HR-GA department is department that coordinate directly with company’s management. Company through departments expect development goals in individual and also support of infrastructure will run smoothly. In 2015, company has taken steps to conduct a balanced scorecard as performance measurement. Nevertheless, a number of factors so it cannot run optimally. This study aims to analyse the current system and provided suggestions in order to give an overview to department related to its current performance. The results of data processing show that there are 8 objective strategies that have been formulated with 9 key performance indicators. Based on the results of scorecard, obtained values of 4.44 for customer perspective, 4.32 for internal business process perspective & 5.00 for learning and growth perspective. It concludes that performance based on perspectives are categorized very well

Applying the Balanced Scorecard approach in teaching hospitals: a literature review and conceptual framework.

PubMed

Trotta, Annarita; Cardamone, Emma; Cavallaro, Giusy; Mauro, Marianna

2013-01-01

Teaching hospitals (THs) simultaneously serve three different roles: offering medical treatment, teaching future doctors and promoting research. The international literature recognises such organisations as 'peaks of excellence' and highlights their economic function in the health system. In addition, the literature describes the urgent need to manage the complex dynamics and inefficiency issues that threaten the survival of teaching hospitals worldwide. In this context, traditional performance measurement systems that focus only on accounting and financial measures appear to be inadequate. Given that THs are highly specific and complex, a multidimensional system of performance measurement, such as the Balanced Scorecard (BSC), may be more appropriate because of the multitude of stakeholders, each of whom seek a specific type of accountability. The aim of the paper was twofold: (i) to review the literature on the BSC and its applications in teaching hospitals and (ii) to propose a scorecard framework that is suitable for assessing the performance of THs and serving as a guide for scholars and practitioners. In addition, this research will contribute to the ongoing debate on performance evaluation systems by suggesting a revised BSC framework and proposing specific performance indicators for THs. Copyright © 2012 John Wiley & Sons, Ltd.

Use of Balanced Indicators as a Management Tool in Nursing.

PubMed

Fugaça, Neidamar Pedrini Arias; Cubas, Marcia Regina; Carvalho, Deborah Ribeiro

2015-01-01

To develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. A single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. We identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators.

Having trouble with your strategy? Then map it.

PubMed

Kaplan, R S; Norton, D P

2000-01-01

If you were a military general on the march, you'd want your troops to have plenty of maps--detailed information about the mission they were on, the roads they would travel, the campaigns they would undertake, and the weapons at their disposal. The same holds true in business: a workforce needs clear and detailed information to execute a business strategy successfully. Until now, there haven't been many tools that can communicate both an organization's strategy and the processes and systems needed to implement that strategy. But authors Robert Kaplan and David Norton, cocreators of the balanced scorecard, have adapted that seminal tool to create strategy maps. Strategy maps let an organization describe and illustrate--in clear and general language--its objectives, initiatives, targets markets, performance measures, and the links between all the pieces of its strategy. Employees get a visual representation of how their jobs are tied to the company's overall goals, while managers get a clearer understanding of their strategies and a means to detect and correct any flaws in those plans. Using Mobil North American Marketing and Refining Company as an example, Kaplan and Norton walk through the creation of a strategy map and its four distinct regions--financial, customer, internal process, and learning and growth--which correspond to the four perspectives of the balanced scorecard. The authors show step by step how the Mobil division used the map to transform itself from a centrally controlled manufacturer of commodity products to a decentralized, customer-driven organization.

Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: the case of a public hospital system in Taiwan.

PubMed

Yang, Ming-Chin; Tung, Yu-Chi

2006-01-01

Examining whether the causal relationships among the performance indicators of the balanced scorecard (BSC) framework exist in hospitals is the aim of this article. Data were collected from all twenty-one general hospitals in a public hospital system and their supervising agency for the 3-year period, 2000-2002. The results of the path analyses identified significant causal relationships among four perspectives in the BSC model. We also verified the relationships among indicators within each perspective, some of which varied as time changed. We conclude that hospital administrators can use path analysis to help them identify and manage leading indicators when adopting the BSC model. However, they should also validate causal relationships between leading and lagging indicators periodically because the management environment changes constantly.

Modifying the Balanced Scorecard for a Network Industry The Case of the Clearing Industry

NASA Astrophysics Data System (ADS)

Chlistalla, Michael; Schaper, Torsten

The Balanced Scorecard (BSC) is a well-established framework for the management of a company as it integrates financial and non-financial perspectives. Little attention has been given to its theoretical and conceptual valuation. We illustrate how the stakeholder value theory corresponds with the concept of the BSC and show the importance of underlying cause-and-effect relationships between its perspectives. For the case of clearing in Europe which is currently facing profound changes, we present our three-phased approach how to adjust and to extend Kaplan and Norton’s original concept. We modify the generic BSC by adding risk management as a separate perspective and by integrating competition and IT. Based on multiple case studies, we then validate whether the modified BSC is suited to meet the specifics of the clearing industry.

Multidimensional evaluation of performance: experimental application of the balanced scorecard in Ferrara university hospital

PubMed Central

Verzola, Adriano; Bentivegna, Roberto; Carandina, Gianni; Trevisani, Lucio; Gregorio, Pasquale; Mandini, Alberto

2009-01-01

Background and Aims One of the best-known performance planning and evaluation techniques utilising both monetary and non-monetary data is the Balanced Scorecard (BSC). This is a means of rationalising the global activity of a business in the attempt to create value, and to translate the company vision into a set of tactical objectives and measurable strategies. The aim of this study was to implement and evaluate the use of BSC in two departments of the St. Anna University Hospital, Ferrara: the Analysis Laboratory and Digestive Endoscopy operating units (OU). Materials and methods With the collaboration of the health workers involved, a precise methodological programme was pursued: Definition of the strategic map from 4 perspectives, according to Kaplan and Norton, Definition of the Key Performance Areas (KPA), or macro-objectives, Identification of the cause-effect relationships between KPAs, Identification of the sub-objectives of each KPA, Definition of the Key Performance Indicators (KPI), Definition of the weight/importance of each objective in the global evaluation. Results The information gathered permitted the definition of macro- and sub-objectives for each perspective, as well as determining the relevant indicators, standards, weights, frequency of detection and means of acquisition. Strategic maps showing the cause/effect relationships in each OU were created, as were 'evaluation panels', which describe the global performance of each department. For each perspective, the fundamental data were summarised in one table. Evaluation of each perspective yielded a positive result for the majority of the objectives, and the global result (including all 4 perspectives) was found to be satisfactory. Discussion-Conclusion The Balanced Scorecard was implemented in the abovementioned OUs of St. Anna University Hospital, Ferrara, after the health workers themselves realised the need for change. In our research the employees were pleased to be evaluated, not only for the financial outcomes, but also for the satisfaction of improving internal procedure, relationships with the community and their own growth/learning. BSC is an ideal point of contact between the financial and clinical dimensions of management. However, difficulties in its application were faced, among these, at least in the initial phase, the lack of information systems able to drive it, and the complexity of the research for specific indicators needed to be overcome. The time factor (on average, at least two years are required) and the availability of technological resources were also limiting factors. The rapid diffusion of BSC among the principal international profit and non-profit organisations is testament to its great potential. This project could be seen as a preparatory phase in the strategical analysis of a subsequent business plan. PMID:19737409

Developing More Adaptive, Innovative, and Interactive Organizations.

ERIC Educational Resources Information Center

Doerfel, Marya L.; Ruben, Brent D.

2002-01-01

Presents a comprehensive view of benchmarking, including best-practice approaches to organizational assessment and improvement in higher education (the Malcolm Baldrige and "balanced scorecard" frameworks) and lessons that can be gleaned from the benchmarking process. (EV)

Palliative Care Scorecard.

PubMed

Kittelson, Sheri; Pierce, Read; Youngwerth, Jeanie

2017-05-01

In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public. Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard. The scorecard was organized into a format of quality measures identified by the Measuring What Matters (MWM) project that are defined as important to the team, automatically extracted from the electronic health record, valid, and can be impacted over time. The scorecard was initially created using University of Florida Health (UF) data, a new PC program, and successfully applied and implemented at University of Colorado Anschutz Medical Campus (CU), a second institution with a mature PC program. Clinical metrics are organized in the scorecard based on MWM and described in terms of the metric definition, rationale for selection, measure type (structure, process, or outcome), and whether this represents a direct or proxy measure. The process of constructing the scorecard helped identify areas within both systems for potential improvement in team structure, clinical processes, and outcomes. In addition, by automating data extraction, the scorecard decreases costs associated with manual data entry and extraction, freeing clinical staff to care for patients and increasing the value of PC delivered to patients.

Confronting Equity Issues on Campus: Implementing the Equity Scorecard in Theory and Practice

ERIC Educational Resources Information Center

Bensimon, Estela Mara, Ed.; Malcom, Lindsey, Ed.

2012-01-01

How can it be that 50 years after the passage of the Civil Rights Act, our institutions of higher education have still not found ways of reducing the higher education gaps for racial and ethnic groups? That is the question that informs and animates the Equity Scorecard model of organizational change. It shifts institutions' focus from what…

[Success factors in hospital management].

PubMed

Heberer, M

1998-12-01

The hospital environment of most Western countries is currently undergoing dramatic changes. Competition among hospitals is increasing, and economic issues have become decisive factors for the allocation of medical care. Hospitals therefore require management tools to respond to these changes adequately. The balanced scorecard is a method of enabling development and implementation of a business strategy that equally respects the financial requirements, the needs of the customers, process development, and organizational learning. This method was used to derive generally valid success factors for hospital management based on an analysis of an academic hospital in Switzerland. Strategic management, the focus of medical services, customer orientation, and integration of professional groups across the hospital value chain were identified as success factors for hospital management.

Using hybrid method to evaluate the green performance in uncertainty.

PubMed

Tseng, Ming-Lang; Lan, Lawrence W; Wang, Ray; Chiu, Anthony; Cheng, Hui-Ping

2011-04-01

Green performance measure is vital for enterprises in making continuous improvements to maintain sustainable competitive advantages. Evaluation of green performance, however, is a challenging task due to the dependence complexity of the aspects, criteria, and the linguistic vagueness of some qualitative information and quantitative data together. To deal with this issue, this study proposes a novel approach to evaluate the dependence aspects and criteria of firm's green performance. The rationale of the proposed approach, namely green network balanced scorecard, is using balanced scorecard to combine fuzzy set theory with analytical network process (ANP) and importance-performance analysis (IPA) methods, wherein fuzzy set theory accounts for the linguistic vagueness of qualitative criteria and ANP converts the relations among the dependence aspects and criteria into an intelligible structural modeling used IPA. For the empirical case study, four dependence aspects and 34 green performance criteria for PCB firms in Taiwan were evaluated. The managerial implications are discussed.

Using a nursing balanced scorecard approach to measure and optimize nursing performance.

PubMed

Jeffs, Lianne; Merkley, Jane; Richardson, Sandy; Eli, Jackie; McAllister, Mary

2011-04-01

The authors give an overview of one healthcare organization's experience in developing a nursing strategic plan and nursing balanced scorecard (NBS) using a focused planning process involving strategy mapping. The NBS is being used at this organization to manage the nursing strategic plan by leveraging and improving nursing processes and organizational capabilities as required, based on data and transparent communication of performance results to key stakeholders. Key strategies and insights may help other nurse leaders in developing or refining strategic approaches to measuring nursing performance. Vital to the success of an organization's strategic plan are ongoing endorsement, engagement and visibility of senior leaders. Quality of decisions made depends on the organization's ability to collect data from multiple sources using standardized definitions, mine data and extract them for statistical analysis and effectively present them in a compelling and understandable way to users and decision-makers.

Evaluating the effectiveness of implementing quality management practices in the medical industry.

PubMed

Yeh, T-M; Lai, H-P

2015-01-01

To discuss the effectiveness of 30 quality management practices (QMP) including Strategic Management, Balanced ScoreCard, Knowledge Management, and Total Quality Management in the medical industry. A V-shaped performance evaluation matrix is applied to identify the top ten practices that are important but not easy to use or implement. Quality Function Deployment (QFD) is then utilized to find key factors to improve the implementation of the top ten tools. The questionnaires were sent to the nursing staff and administrators in a hospital through e-mail and posts. A total of 250 copies were distributed and 217 copies were valid. The importance, easiness, and achievement (i.e., implementation level) of 30 quality management practices were used. Key factors for QMP implementation were sequenced in order of importance as top management involvement, inter-department communication and coordination, teamwork, hospital-wide participation, education and training, consultant professionalism, continuous internal auditing, computerized process, and incentive compensation. Top management can implement the V-shaped performance matrix to determine whether quality management practices need improvement and if so, utilize QFD to find the key factors for improvement.

Use of Balanced Indicators as a Management Tool in Nursing1

PubMed Central

Fugaça, Neidamar Pedrini Arias; Cubas, Marcia Regina; Carvalho, Deborah Ribeiro

2015-01-01

Objective: to develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. Method: a single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. Results: we identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Conclusion: although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators. PMID:26625995

A balanced scorecard approach in assessing IT value in healthcare sector: an empirical examination.

PubMed

Wu, Ing-Long; Kuo, Yi-Zu

2012-12-01

Healthcare sector indicates human-based and knowledge-intensive property. Massive IT investments are necessary to maintain competitiveness in this sector. The justification of IT investments is the major concern of senior management. Empirical studies examining IT value have found inconclusive results with little or no improvement in productivity. Little research has been conducted in healthcare sector. The balanced scorecard (BSC) strikes a balance between financial and non-financial measure and has been applied in evaluating organization-based performance. Moreover, healthcare organizations often consider their performance goal at customer satisfaction in addition to financial performance. This research thus proposed a new hierarchical structure for the BSC with placing both finance and customer at the top, internal process at the next, and learning and growth at the bottom. Empirical examination has found the importance of the new BSC structure in assessing IT investments. Learning and growth plays the initial driver for reaching both customer and financial performance through the mediator of internal process. This can provide deep insight into effectively managing IT resources in the hospitals.

Reframing for Crisis.

ERIC Educational Resources Information Center

Shepko, Robert; Douglas, Brian

1998-01-01

The "balanced scorecard" approach for making holistic decisions about organizational change offers a framework for analyzing four critical organizational perspectives (financial, customer, internal business, learning/innovation), using specific indicators of success that focus on the organization's vision or mission. It can be used…

Prevention and control of blood stream infection using the balanced scorecard approach.

PubMed

Rohsiswatmo, Rinawati; Rafika, Sarah; Marsubrin, Putri M T

2014-07-01

to obtain formulation of an effective and efficient strategy to overcome blood stream infection (BSI). operational research design with qualitative and quantitative approach. The study was divided into two stages. Stage I was an operational research with problem solving approach using qualitative and quantitative method. Stage II was performed using quantitative method, a form of an interventional study on strategy implementation, which was previously established in stage I. The effective and efficient strategy for the prevention and control of infection in neonatal unit Cipto Mangunkusumo (CM) Hospital was established using Balanced Scorecard (BSC) approach, which involved several related processes. the BSC strategy was proven to be effective and efficient in substantially reducing BSI from 52.31°/oo to 1.36°/oo in neonates with birth weight (BW) 1000-1499 g (p=0.025), and from 29.96°/oo to 1.66°/oo in BW 1500-1999 g (p=0.05). Gram-negative bacteria still predominated as the main cause of BSI in CMH Neonatal Unit. So far, the sources of the microorganisms were thought to be from the environment of treatment unit (tap water filter and humidifying water in the incubator). Significant reduction was also found in neonatal mortality rate weighing 1000-1499 g at birth, length of stay, hospitalization costs, and improved customer satisfaction. effective and efficient infection prevention and control using BSC approach could significantly reduce the rate of BSI. This approach may be applied for adult patients in intensive care unit with a wide range of adjustment.

Saving money, saving lives.

PubMed

Meliones, J

2000-01-01

In 1996, Duke Children's Hospital was in serious trouble. Its $11 million annual operating loss had forced administrators to make cutbacks. As a result, some caregivers felt that the quality of care had deteriorated. Parents' complaints were on the rise. Frustrated staff members were quitting. In this article, Jon Meliones, DCH's chief medical director, candidly describes how his debt-ridden hospital transformed itself into a vibrant and profitable one. The problem, he realized, was that each group in DCH was focusing only on its individual mission. Doctors and nurses wanted to restore their patients to health; they didn't want to have to think about costs. Hospital administrators, for their part, were focused only on controlling wildly escalating health care costs. To keep DCH afloat, clinicians and administrators needed to work together. By listening to staff concerns, turning reams of confusing data into useful information, taking a fresh approach to teamwork, and using the balanced scorecard method, Meliones and his colleagues brought DCH back to life. Developing and implementing the balanced scorecard approach wasn't easy: it took a pilot project, a top-down reorganization, development of a customized information system, and systematic work redesign. But their efforts paid off. Customer satisfaction ratings jumped 18%. Improvements to internal business processes reduced the average length of stay 21% while the readmission rate fell from 7% to 3%. The cost per patient dropped nearly $5,000. And DCH recorded profits of $4 million in 2000. This first-person account is required reading for any executive seeking to revitalize a sagging organization. Meliones shares the operating principles DCH followed to become a thriving business.

The office of strategy management.

PubMed

Kaplan, Robert S; Norton, David P

2005-10-01

There is a disconnect in most companies between strategy formulation and strategy execution. On average, 95% of a company's employees are unaware of, or do not understand, its strategy. If employees are unaware of the strategy, they surely cannot help the organization implement it effectively. It doesn't have to be like this. For the past 15 years, the authors have studied companies that achieved performance breakthroughs by adopting the Balanced Scorecard and its associated tools to help them better communicate strategy to their employees and to guide and monitor the execution of that strategy. Some companies, of course, have achieved better, longer-lasting improvements than others. The organizations that have managed to sustain their strategic focus have typically established a new corporate-level unit to oversee all activities related to strategy: an office of strategy management (OS M). The OSM, in effect, acts as the CEO's chief of staff. It coordinates an array of tasks: communicating corporate strategy; ensuring that enterprise-level plans are translated into the plans of the various units and departments; executing strategic initiatives to deliver on the grand design; aligning employees' plans for competency development with strategic objectives; and testing and adapting the strategy to stay abreast of the competition. The OSM does not do all the work, but it facilitates the processes so that strategy is executed in an integrated fashion across the enterprise. Although the companies that Kaplan and Norton studied use the Balanced Scorecard as the framework for their strategy management systems, the authors say the lessons of the OSM are applicable even to companies that do not use it.

A better gauge of corporate performance.

PubMed

Weber, D O

2001-01-01

Traditional methods of measuring organizational value aren't working very well. Instead, an organization's viability should be gauged from four perspectives, according to Robert S. Kaplan and David P. Norton, co-creators of the Balanced Scorecard. These perspectives--financial strength, customer service and satisfaction, internal operating efficiency, and learning and growth--become the underpinnings of a "balanced" tool with which leaders can assess corporate performance in the knowledge-based marketplace.

Stakeholder Relationships in Higher Education

ERIC Educational Resources Information Center

Kettunen, Juha

2015-01-01

The purpose of this study is to develop a stakeholder map to describe the most important stakeholders and the process of stakeholder relationships in higher education. According to the perspective of the balanced scorecard, the classification of stakeholders integrates stakeholders into strategic management. Stakeholder maps are essential in…

[Balanced scorecard for performance measurement of a nursing organization in a Korean hospital].

PubMed

Hong, Yoonmi; Hwang, Kyung Ja; Kim, Mi Ja; Park, Chang Gi

2008-02-01

The purpose of this study was to develop a balanced scorecard (BSC) for performance measurement of a Korean hospital nursing organization and to evaluate the validity and reliability of performance measurement indicators. Two hundred fifty-nine nurses in a Korean hospital participated in a survey questionnaire that included 29-item performance evaluation indicators developed by investigators of this study based on the Kaplan and Norton's BSC (1992). Cronbach's alpha was used to test the reliability of the BSC. Exploratory and confirmatory factor analysis with a structure equation model (SEM) was applied to assess the construct validity of the BSC. Cronbach's alpha of 29 items was .948. Factor analysis of the BSC showed 5 principal components (eigen value >1.0) which explained 62.7% of the total variance, and it included a new one, community service. The SEM analysis results showed that 5 components were significant for the hospital BSC tool. High degree of reliability and validity of this BSC suggests that it may be used for performance measurements of a Korean hospital nursing organization. Future studies may consider including a balanced number of nurse managers and staff nurses in the study. Further data analysis on the relationships among factors is recommended.

SAM in a Nutshell.

ERIC Educational Resources Information Center

Givens, Larry R.

2000-01-01

Explains what the Association of Higher Education Facilities Officers' Strategic Assessment Model (SAM) is and how to use it to achieve organizational excellence through continuous improvement. Showing features of both the Malcolm Baldrige programs and the Balanced Scorecard, the SAM components are described along with an explanation of the four…

The Balanced Scorecard

ERIC Educational Resources Information Center

Kaplan, Robert S.; Miyake, Dylan N.

2010-01-01

Ten years ago, the Atlanta Public Schools had low and declining student achievement, demoralized teachers, crumbling buildings, high turnover among superintendents (average tenure of two years) and disaffected parents pulling their children out of the system. More than 60 percent of the city's high school students missed at least two weeks of…

Determining and Communicating the Value of the Special Library.

ERIC Educational Resources Information Center

Matthews, Joseph R.

2003-01-01

Discusses performance measures for libraries that will indicate the goodness of the library and its services. Highlights include a general evaluation model that includes input, process, output, and outcome measures; balanced scorecard approach that includes financial perspectives; focusing on strategy; strategies for change; user criteria for…

Perioperative prediction of agitated (hyperactive) delirium after cardiac surgery in adults - The development of a practical scorecard.

PubMed

Mufti, Hani N; Hirsch, Gregory M

2017-12-01

Delirium is a temporary mental disorder that occurs frequently among hospitalized patients. In this study we sought to develop a user-friendly scorecard based on perioperative features to identify patients at risk of developing agitated delirium after cardiac surgery. Retrospective analysis was performed on adult patients undergoing cardiac surgery in a single center. A parsimonious predictive model was created, with subsequent internal validation. Then a simple scorecard was developed that can be used to predict the probability of agitated delirium. Among the 5584 patients who met the study criteria, 614 (11.4%) developed postoperative agitated delirium. Independent predictors of postoperative agitated delirium were age, male gender, history of cerebrovascular disease, procedure other than isolated Coronary Arteries Bypass Surgery, transfusion of blood products within the first 48h, mechanical ventilation for >24h, length of stay in the Intensive Care Unit. The scorecard stratified patients into 4 categories at risk of postoperative agitated delirium ranging from <5% to >30%. Using a large cohort of adult patient's undergoing cardiac surgery, a user-friendly scorecard was developed and validated, which will facilitate the implementation of timely interventions to mitigate adverse effects of agitated delirium in this high risk population. Copyright © 2017 Elsevier Inc. All rights reserved.

Performance measurement for supply chain management and evaluation criteria determination for reverse supply chain management

NASA Astrophysics Data System (ADS)

Kongar, N. Elif

2004-12-01

Today, since customers are able to obtain similar-quality products for similar prices, the lead time has become the only preference criterion for most of the consumers. Therefore, it is crucial that the lead time, i.e., the time spent from the raw material phase till the manufactured good reaches the customer, is minimized. This issue can be investigated under the title of Supply Chain Management (SCM). An efficiently managed supply chain can lead to reduced response time for customers. To achieve this, continuous observation of supply chain efficiency, i.e., a constant performance evaluation of the current SCM is required. Widely used conventional performance measurement methods lack the ability to evaluate a SCM since the supply chain is a dynamic system that requires a more thorough and flexible performance measurement technique. Balanced Scorecard (BS) is an efficient tool for measuring the performance of dynamic systems and has a proven capability of providing the decision makers with the appropriate feedback data. In addition to SCM, a relatively new management field, namely reverse supply chain management (RSCM), also necessitates an appropriate evaluation approach. RSCM differs from SCM in many aspects, i.e., the criteria used for evaluation, the high level of uncertainty involved etc., not allowing the usage of identical evaluation techniques used for SCM. This study proposes a generic Balanced Scorecard to measure the performance of supply chain management while defining the appropriate performance measures for SCM. A scorecard prototype, ESCAPE, is presented to demonstrate the evaluation process.

Treating technology as a luxury? 10 necessary tools.

PubMed

Berger, Steven H

2007-02-01

Technology and techniques that every hospital should acquire and use for effective financial management include: Daily dashboards. Balanced scorecards. Benchmarking. Flexible budgeting and monitoring. Labor management systems. Nonlabor management analysis. Service, line, physician, and patient-level reporting and analysis. Cost accounting technology. Contract management technology. Denials management software.

The Balanced Scorecard: A Management System for Wilford Hall Medical Center - The Premier Air Force Medical Enterprise

DTIC Science & Technology

1999-04-01

meanings and functions of human actions. These meanings and functions take the form of qualitative descriptions and explanations ( Denzin , Lincoln 1994...a value-free framework ( Denzin , 1994). Equally important was the learning and educating about performance drivers versus outcome measures. Performance

[Clinical integration in the chronic patient].

PubMed

Carretero-Alcántara, Luis; Comes-Górriz, Natividad; Borrás-López, Agustina; Rodríguez-Balo, Alberto; Seara-Aguilar, Germán

2014-01-01

Castilla-La Mancha Health Service is developing the integration of care levels due to the challenge of an aging population in the region. Aging is associated with chronic diseases and an increasing number of concomitant diseases. This poses a major care challenge care, with more fragile patients and new needs. This also requires a sustainable approach: the concurrence of several chronic diseases affects the cost of care, which is especially acute in times of severe economic crisis. One of the pillars of the strategy for dealing with chronic diseases in our region is care integration, in an effort to adapt the organization to the new needs. The Balanced Scorecard or Integrated Scorecard of the integration process was introduced as it has been designed. The integration of primary and hospital care at an organizational level has already been completed, and the development of integrated care processes has also been performed in order to achieve real integration at care level. To help finance this, a prospective capitation system is gradually being implemented, achieving a convergence of per capita costs in the different health areas integrated. Nurses has a key role in this process, their skills as educators and trainers in self-care, in the role of case managers of patients with particularly complex conditions, and the role of professional liaison to improve the transition between care areas and units. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Developing Communities: Serving ACE through Tertiary Education

ERIC Educational Resources Information Center

Sofo, Francesco

2011-01-01

Purpose: The purpose of this paper is to review the focus and practice of Adult and Community Education (ACE) as well as its conceptualization and delivery and to suggest parameters for an approach based on excellence, a balanced scorecard and performance to meet community needs. Design/methodology/approach: The review examines key aspects of the…

The Construct Validation of Learning Organization and Its Influence upon Firm Performance in Mainland China

ERIC Educational Resources Information Center

Li, Mingfei; Lu, Xiaojun

2007-01-01

This paper examines the applicability of the learning organization concept and its influence upon firm performance in mainland China. Based on the theoretical framework proposed by Watkins and Marsick, four dimensions of the learning organization instead of seven dimensions were identified. A balanced scorecard-based performance evaluation…

Continuous Improvement in Business Education: Insights from the For-Profit Sector and Business School Deans.

ERIC Educational Resources Information Center

Bailey, Allan R.; Chow, Chee W.; Hadad, Kamal M.

1999-01-01

The balanced scorecard, a customer-based continuous improvement system, can be applied to business schools. Business deans (n=38) suggested goals and measures for a customer perspective, including such factors as stakeholders, program and service quality, public image, teaching/learning excellence, curriculum excellence, fund raising, and human…

A Framework for Achieving e-Business Success

ERIC Educational Resources Information Center

Kumar, U.; Maheshwari, M.; Kumar, V.

2004-01-01

This paper presents the findings of an empirical study of critical factors associated with e-business success. An a priori model relating the success factors to e-business success is developed. The study uses the "balanced scorecard" methodology to measure the success of e-business organizations, as the authors believe that financial measures are…

Comparative Performance Data for Critical Access Hospitals

ERIC Educational Resources Information Center

Pink, George H.; Slifkin, Rebecca T.; Coburn, Andrew F.; Gale, John A.

2004-01-01

Context: Among small rural hospitals, there is a growing recognition of the need to measure and report on the use of resources and the safety and quality of the services provided. Dashboards, clinical value compasses, and balanced scorecards are approaches to performance measurement that have been adopted by many health care organizations.…

Most Wired 2006: measuring value.

PubMed

Solovy, Alden

2006-07-01

As the Most Wired hospitals incorporate information technology into their strategic plans, they combine a"balanced scorecard"approach with classic business analytics to measure how well IT delivers on their goals. To find out which organizations made this year's 100 Most Wired list, as well as those named in other survey categories, go to the foldout section.

Building an International Student Market: Educational-Balanced Scorecard Solutions for Regional Australian Cities

ERIC Educational Resources Information Center

Forbes, Linda; Hamilton, John

2004-01-01

There is an international student market suitable for regional Australia, but each region is different. Hence, each region must determine, target and niche market to its best potential international student customer base. For international education there remains scant, relevant, data for regional Australia, hence complete regional approaches to…

Cost (and Quality and Value) of Information Technology Support in Large Research Universities.

ERIC Educational Resources Information Center

Peebles, Christopher S.; Antolovic, Laurie

1999-01-01

Shows how financial and quality measures associated with the Balanced Scorecard (developed by Kaplan and Norton to measure organizational performance) can be applied to information technology (IT) user education and support in large research universities. Focuses on University Information Technology Services that has measured the quality of IT…

[Development of nursing key performance indicators for an intensive care unit by using a balanced scorecard].

PubMed

Choi, Yun Jeong; Lim, Ji Young; Lee, Young Whee; Kim, Hwa Soon

2008-10-01

The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC). This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs. Two main visions of nursing service for ICUs were established. These were 'realization of harmonized professional nursing with human respect' and 'recovery of health through specialized nursing' respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC. The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

Designing Performance Measurement For Supply Chain's Actors And Regulator Using Scale Balanced Scorecard And Data Envelopment Analysis

NASA Astrophysics Data System (ADS)

Kusrini, Elisa; Subagyo; Aini Masruroh, Nur

2016-01-01

This research is a sequel of the author's earlier conducted researches in the fields of designing of integrated performance measurement between supply chain's actors and regulator. In the previous paper, the design of performance measurement is done by combining Balanced Scorecard - Supply Chain Operation Reference - Regulator Contribution model and Data Envelopment Analysis. This model referred as B-S-Rc-DEA model. The combination has the disadvantage that all the performance variables have the same weight. This paper investigates whether by giving weight to performance variables will produce more sensitive performance measurement in detecting performance improvement. Therefore, this paper discusses the development of the model B-S-Rc-DEA by giving weight to its performance'variables. This model referred as Scale B-S-Rc-DEA model. To illustrate the model of development, some samples from small medium enterprises of leather craft industry supply chain in province of Yogyakarta, Indonesia are used in this research. It is found that Scale B-S-Rc-DEA model is more sensitive to detecting performance improvement than B-S- Rc-DEA model.

Establishment proper of the balanced scorecard indicators to support decision making in a university: a case study in Institut Teknologi Indonesia

NASA Astrophysics Data System (ADS)

Theresia, L.; Lahuddin, A. H.; Bangun, R.

2017-12-01

Balanced Scorecard (BSC) is a powerful tool in decision making process. Nevertheless, it is not rare that the BSC does not give satisfactory results because the indicators chosen do not reflect the needs of the organization. Therefore, indicator establishment is very crucial in the utilization of BSC. This research aims to determine the indicators BSC for a university and the research is a case study in Institut Teknologi Indonesia (ITI). In this study, BSC structure and indicators, comparison made by 4 previous researchers was used as the initial guide to determine the structure and indicators of ITI. And then, questionnaires were distributed to selected respondents and a focus group discussion (FGD) was conducted in order to produce indicators of BSC based on the mental model of the ITI. It is found 15 indicators based on the mental model of ITI. Furthermore, the relationships between the indicators are seen as dynamic relationships, and by using system dynamics, some feedback loops that are considered critical to organizational success can be identified and isolated.

A novel hybrid MCDM model for performance evaluation of research and technology organizations based on BSC approach.

PubMed

Varmazyar, Mohsen; Dehghanbaghi, Maryam; Afkhami, Mehdi

2016-10-01

Balanced Scorecard (BSC) is a strategic evaluation tool using both financial and non-financial indicators to determine the business performance of organizations or companies. In this paper, a new integrated approach based on the Balanced Scorecard (BSC) and multi-criteria decision making (MCDM) methods are proposed to evaluate the performance of research centers of research and technology organization (RTO) in Iran. Decision-Making Trial and Evaluation Laboratory (DEMATEL) are employed to reflect the interdependencies among BSC perspectives. Then, Analytic Network Process (ANP) is utilized to weight the indices influencing the considered problem. In the next step, we apply four MCDM methods including Additive Ratio Assessment (ARAS), Complex Proportional Assessment (COPRAS), Multi-Objective Optimization by Ratio Analysis (MOORA), and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) for ranking of alternatives. Finally, the utility interval technique is applied to combine the ranking results of MCDM methods. Weighted utility intervals are computed by constructing a correlation matrix between the ranking methods. A real case is presented to show the efficacy of the proposed approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

Applying the balanced scorecard to local public health performance measurement: deliberations and decisions

PubMed Central

Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

2009-01-01

Background All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Discussion Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? Summary An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process. PMID:19426508

Applying the balanced scorecard to local public health performance measurement: deliberations and decisions.

PubMed

Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

2009-05-08

All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

Process evaluation of the implementation of scorecard-based antenatal risk assessment, care pathways and interdisciplinary consultation: the Healthy Pregnancy 4 All study.

PubMed

Vos, A A; van Voorst, S F; Posthumus, A G; Waelput, A J M; Denktaş, S; Steegers, E A P

2017-09-01

To evaluate the implementation of a complex intervention in the antenatal healthcare field in 14 Dutch municipalities. The intervention consisted of the implementation of a systematic scorecard-based risk assessment in pregnancy, subsequent patient-tailored care pathways, and consultations of professionals from different medical and social disciplines. Saunders's seven-step method was used for the development of a programme implementation monitoring plan, with specific attention to the setting and context of the programme. Data were triangulated from multiple sources, and prespecified criteria were applied to examine the evidence for implementation. Six out of 11 municipalities (54%) met the implementation criteria for the entire risk assessment programme, whereas three municipalities (27%) met the criteria if the three components of implementation were analysed separately. A process evaluation of implementation of a complex intervention is possible. The results can be used to improve understanding of the associations between specific programme elements and programme outcomes on effectiveness of the intervention. Additionally, the results are important for formative purposes to assess how future implementation of antenatal risk assessment can be improved in comparable contexts. Copyright © 2017. Published by Elsevier Ltd.

Delivering quality of care while managing the interests of all stakeholders.

PubMed

Stopper, Andrea; Raddatz, Agnieszka; Grassmann, Aileen; Stuard, Stefano; Menzer, Marcus; Possnien, Gernot; Scatizzi, Laura; Marcelli, Daniele

2011-01-01

National healthcare systems worldwide face growing challenges to reconcile interests of patients for high-quality medical care and of payers for sustainable and affordable funding. Advances in the provision of renal replacement therapy can only be made by developing and implementing appropriate sophisticated and state-of-the-art business models that include reimbursement schemes for comprehensive care packages. Such business models must succeed in integrating and reconciling the interests of all stakeholders. NephroCare as dialysis provider has adopted and tailored recognized management techniques, i.e. Balanced Scorecard and Kaizen, to achieve these goals. Success of the complete business model package is tangible - strategies initiated to improve treatment quality even at the cost of providers have been translated into win-win scenarios for the complete stakeholder community. Room for improvement exists: the possibility to extend the portfolio of service offerings within the comprehensive care frame, as well as the challenge for achieving a balance between the stability of targets while keeping these up to date concerning new insights. Copyright © 2011 S. Karger AG, Basel.

Scorecard cardiovascular medicine. Its impact and future directions.

PubMed

Topol, E J; Califf, R M

1994-01-01

Public release of operator-specific data for cardiovascular procedures has set a new precedent, introducing the "scorecard" era. Justification exists for public disclosure, but the mechanics of appropriate data release are complex from a clinical, statistical, and logistic standpoint. Scorecard medicine may appropriately promote regionalization of medical centers and consolidation of services, but unless the process is directed effectively, it may impair the development of new treatments because of a more restrictive clinical practice environment. We propose revamping our current system to facilitate rapid and accurate access to outcome data in the local practice environment so that improvement in practice occurs on a voluntary basis rather than in response to punitive restrictions. A rational plan needs to be developed for dealing with high-risk patients, perhaps through compensation in regression models used to calculate expected outcomes, and for the start-up of novice physicians. Special provisions are needed to promote clinical research. Before procedures are done, it would be ideal to provide a full disclosure informed consent, whereby the physician reports operator-specific data and the patient's decision-making process is facilitated. Overall, appropriate implementation of scorecards could ultimately lead to a substantial improvement in the quality of U.S. cardiovascular medicine.

Rhetoric or Reality? Do Accounting Education and Experience Increase Weighting on Environmental Performance in a Balanced Scorecard?

ERIC Educational Resources Information Center

Wynder, Monte; Wellner, Kai-Uwe; Reinhard, Karin

2013-01-01

We are nearing the end of the United Nations' Decade of Education for Sustainable Development (2005-2014). There has been substantial rhetoric in education and business forums, and many universities have integrated sustainability into their accounting curricula, but what effect is accounting education having? This study considers whether the…

Perceptions of Community College Presidents: Total Quality Management Performance Measures at Their Colleges

ERIC Educational Resources Information Center

Riccardi, Mark T.

2009-01-01

Continuous Quality Improvement (CQI) measures such as Total Quality Management (TQM), Strategic Planning, Six Sigma, and the Balanced Scorecard are often met with skepticism among leaders of higher education. This study attempts to fill a gap in the literature regarding the study of relationships among specific variables, or building blocks,…

In Search of an Integrative Theme for the Undergraduate Business Curriculum

ERIC Educational Resources Information Center

Sherman, W. Richard

2007-01-01

The Business Core is typically a set of courses in the curriculum of many business schools which provides the student with a breadth of knowledge across all business disciplines. The purpose of this paper is to introduce a curricular model based upon the balanced scorecard (BSC) developed by Kaplan & Norton (1996). With its multi-dimensional…

Working toward More Engaged and Successful Accounting Students: A Balanced Scorecard Approach

ERIC Educational Resources Information Center

Fredin, Amy; Fuchsteiner, Peter; Portz, Kris

2015-01-01

Prior research indicates that student engagement is the key to student success, as measured by college grades, degree completion, and graduate school enrollment. We propose a set of goals and objectives for accounting students, in particular, to help them become engaged not only in the educational process, but also in the accounting profession.…

Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

PubMed

Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

2008-01-01

The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. 2007 John Wiley & Sons, Ltd

Participatory evaluation of disaster resilience performance with urban stakeholders: An implementation case study before and after the 2015 Nepal Ghorka earthquake

NASA Astrophysics Data System (ADS)

Khazai, B.; Anhorn, J.; Burton, C.

2016-12-01

Approaches that make resilience tangible and operational for decision makers have to deal effectively with the degree of impact and change required through different strategic actions in addressing agreed-upon resilience goals. A Resilience Performance Scorecard (RPS) has been designed to enable local stakeholders in identifying existing strengths and weaknesses through providing information on key performance targets along six dimensions of urban resilience both at the city and sub-city district level of geography. The purpose in the development of the Scorecard approach is to build a tool that can provide information on the overall resilience performance and capture the key functional and organizational areas for urban resilience with local government officials. The Resilience Performance Scorecard (RPS) was developed jointly by the Center for Disaster Management and Risk Reduction Technology (CEDIM) at Karlsruhe Institute of Technology, the South Asia Institute (SAI) at Heidelberg University, the and Global Earthquake Model (GEM) Foundation. It was initially implemented with the Lalitpur Sub-Metropolitan Municipality in Nepal one year before the 25 April 7.8 magnitude Gorkha earthquake event as a self-evaluation tool through a fully participatory process with local stakeholders. In a follow-up participatory assessment and implementation of the RPS one month after the earthquake, the results of the participatory resilience investigation demonstrate areas where action towards resilience should be prioritized and reflect the change in perception of resilience among the stakeholders in the face of a large damaging event.

The balanced scorecard framework-a case study of patient and employee satisfaction: what happens when it does not work as planned?

PubMed

Lorden, Andrea; Coustasse, Alberto; Singh, Karan P

2008-01-01

The successful utilization of the balanced scorecard (BSC) framework in health care has been demonstrated in the literature. Given these successes, a financially struggling hospital implemented a BSC framework intervention which attempted a culture change centered upon patient satisfaction which it hoped would translate to improved financial stability. Despite the evidence of BSC successes, the intervention, entitled Route 99, did not succeed in this hospital. This case study was conducted to identify learnable lessons and confounding factors associated with the successes and failures of Route 99. Metrics for patient satisfaction and employee satisfaction were examined as reflections of the intervention, the BSC framework, and the confounding financial condition of the hospital. Through case study methodology, mean quarterly patient satisfaction scores tabulated by an outside vendor for inpatient and outpatient services were divided into four time intervals and compared through analysis of variance. Employee satisfaction was measured through a hospital-provided 12-question employee survey, administered through convenience sampling at the beginning and 7 months into Route 99. Each question utilized a 5-point Likert scale and generated two samples which were verified for sample independence through chi-square analysis. Mann-Whitney U test was used for comparison. Inpatient patient satisfaction scores exhibited a nonsignificant upward trend. However, the analysis of variance demonstrated a significant rise in outpatient patient satisfaction (p < .05). An interesting finding was that employee satisfaction declined (p < .05) significantly for supervisors and directors in three areas. The inverse relationship between patient satisfaction and employee satisfaction is in contrast to that found in the literature by the authors. Examination of the BSC framework, the hospital's financial standing, and the metrics for patient satisfaction and employee satisfaction illuminated the importance of management transparency, leadership support, appropriate metric selection, and the strength of the BSC under turbulent circumstances.

Motivations-Attributes-Skills-Knowledge Model as Framework for Leadership Assessment Balanced Scorecards: An Empirical Study

ERIC Educational Resources Information Center

Bellamy, Chris D.

2013-01-01

Over the course of history many leaders have made their mark on society. These leaders have led uprisings, movements, and organizations that have left legacy's in today's society. Leaders such as Martin Luther King, Adolph Hitler, and Jack Welch have displayed behaviors and leadership competencies which motivated their followers. These…

Resource Allocation with the Use of the Balanced Scorecard and the Triple Bottom Line in Education

ERIC Educational Resources Information Center

Nguyen, Chi Hong

2007-01-01

In terms of the economic bottom line, effective school leaders are now supposed to pay close attention to two central tasks which involve managing resources and devising operational strategies in their action plans. Taking a postmodern viewpoint, the first part of this paper aims to discuss the significance of resource allocation in education and…

A Balanced Scorecard-Based Model for Evaluating E-Learning and Conventional Pedagogical Activities in Nursing

ERIC Educational Resources Information Center

Hovelja, Tomaž; Vavpotic, Damjan; Žvanut, Boštjan

2016-01-01

The evaluation of e-learning and conventional pedagogical activities in nursing programmes has focused either on a single pedagogical activity or the entire curriculum, and only on students' or teachers' perspective. The goal of this study was to design and test a novel approach for evaluation of e-learning and conventional pedagogical activities…

Developing an Indicator System for Schools of Choice: A Balanced Scorecard Approach

ERIC Educational Resources Information Center

Brown, Richard S.; Wohlstetter, Priscilla; Liu, Sunny

2008-01-01

This article describes the process of developing an indicator system that goes beyond a single indicator of school progress or performance. The system relies on a set of school indicators that uses data that public schools routinely report to state agencies for compliance purposes. The framework for the indicator system is based on the idea of…

The Strategic Micro-Firm: A Role Play In Management Training for Dynamic Businesses

ERIC Educational Resources Information Center

Barnabe, Federico; Busco, Cristiano; Davidsen, Pal I.; Lambri, Maurizio; Zatta, Gianfranco

2013-01-01

Purpose: The purpose of this paper is to present the main characteristics of the role-playing game "Strategic Micro-Firm" which aims to reproduce the fundamental features of a complex supply chain. Design/methodology/approach: A specific role-playing game is presented, in which a Balanced Scorecard is used as the reporting device and is…

Using a Balance Scorecard Approach to Evaluate the Value of Service Learning Projects in Online Courses

ERIC Educational Resources Information Center

Schwieger, Dana

2015-01-01

Service learning projects serve as a valuable tool for applying course concepts in a way to benefit both the students and community. However, they often require a significant amount of additional effort beyond that required of assigning conventional homework problems. When the projects take place in an online course setting, the level of…

Balanced Scorecard: A Strategy for the Quality Improvement of Islamic Higher Education

ERIC Educational Resources Information Center

Ilyasin, Mukhamd; Zamroni

2017-01-01

The main issue in improving the quality of Islamic Higher Education is to increase the competence and professionalism of teachers and education personnel to achieve its vision and mission in the middle of the complexity of the demands of society and the changing times. so that the quality of education and governance of Islamic Religion clean and…

Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia

PubMed Central

Teklehaimanot, Hailay D.; Teklehaimanot, Awash; Tedella, Aregawi A.; Abdella, Mustofa

2016-01-01

In 2004, Ethiopia introduced a community-based Health Extension Program to deliver basic and essential health services. We developed a comprehensive performance scoring methodology to assess the performance of the program. A balanced scorecard with six domains and 32 indicators was developed. Data collected from 1,014 service providers, 433 health facilities, and 10,068 community members sampled from 298 villages were used to generate weighted national, regional, and agroecological zone scores for each indicator. The national median indicator scores ranged from 37% to 98% with poor performance in commodity availability, workforce motivation, referral linkage, infection prevention, and quality of care. Indicator scores showed significant difference by region (P < 0.001). Regional performance varied across indicators suggesting that each region had specific areas of strength and deficiency, with Tigray and the Southern Nations, Nationalities and Peoples Region being the best performers while the mainly pastoral regions of Gambela, Afar, and Benishangul-Gumuz were the worst. The findings of this study suggest the need for strategies aimed at improving specific elements of the program and its performance in specific regions to achieve quality and equitable health services. PMID:26928842

Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia.

PubMed

Teklehaimanot, Hailay D; Teklehaimanot, Awash; Tedella, Aregawi A; Abdella, Mustofa

2016-05-04

In 2004, Ethiopia introduced a community-based Health Extension Program to deliver basic and essential health services. We developed a comprehensive performance scoring methodology to assess the performance of the program. A balanced scorecard with six domains and 32 indicators was developed. Data collected from 1,014 service providers, 433 health facilities, and 10,068 community members sampled from 298 villages were used to generate weighted national, regional, and agroecological zone scores for each indicator. The national median indicator scores ranged from 37% to 98% with poor performance in commodity availability, workforce motivation, referral linkage, infection prevention, and quality of care. Indicator scores showed significant difference by region (P < 0.001). Regional performance varied across indicators suggesting that each region had specific areas of strength and deficiency, with Tigray and the Southern Nations, Nationalities and Peoples Region being the best performers while the mainly pastoral regions of Gambela, Afar, and Benishangul-Gumuz were the worst. The findings of this study suggest the need for strategies aimed at improving specific elements of the program and its performance in specific regions to achieve quality and equitable health services. © The American Society of Tropical Medicine and Hygiene.

Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: qualitative evidence using the most significant change technique.

PubMed

Ho, Lara S; Labrecque, Guillaume; Batonon, Isatou; Salsi, Viviana; Ratnayake, Ruwan

2015-01-01

More than a decade of conflict has weakened the health system in the Democratic Republic of Congo and decreased its ability to respond to the needs of the population. Community scorecards have been conceived as a way to increase accountability and responsiveness of service providers, but there is limited evidence of their effects, particularly in fragile and conflict-affected contexts. This paper describes the implementation of community scorecards within a community-driven reconstruction project in two provinces of eastern Democratic Republic of Congo. Between June 2012 and November 2013, 45 stories of change in the health system were collected from village development committee, health committee, community members (20 men and 18 women) and healthcare providers (n = 7) in 25 sites using the Most Significant Change technique. Stories were analyzed qualitatively for content related to the types and mechanisms of change observed. The most salient changes were related to increased transparency and community participation in health facility management, and improved quality of care. Quality of care included increased access to services, improved patient-provider relationships, improved performance of service providers, and improved maintenance of physical infrastructure. Changes occurred through many different mechanisms including provider actions in response to information, pressure from community representatives, or supervisors; and joint action and improved collaboration by health facility committees and providers. Although it is often assumed that confrontation is a primary mechanism for citizens to change state-provided services, this study demonstrates that healthcare providers may also be motivated to change through other means. Positive experiences of community scorecards can provide a structured space for interface between community members and the health system, allowing users to voice their opinions and preferences and bridge information gaps for both users and frontline healthcare providers. When solutions to problems identified through the scorecard are locally accessible, users and healthcare providers are able to work together to implement mutually acceptable solutions that improve quality of health services, and make them more responsive to users' needs.

Leader development transformation in the Army Nurse Corps.

PubMed

Funari, Tamara S; Ford, Kathleen; Schoneboom, Bruce A

2011-01-01

The Army Nurse (AN) Corps is undergoing a historic transformation. Under the leadership of its Chief, MG Patricia Horoho, the Corps developed and implemented the AN Campaign Plan to insure that the Corps has the right capability and capacity to meet the current and future needs of the US Army. This article describes the work conducted by the AN Corps Leadership Imperative Action Team (Leader IAT) to develop full-spectrum leaders for the future. The mission of the Leader IAT is derived from both the AN Campaign plan as well as the operational objectives defined in the AN balanced scorecard. As a result of the analysis conducted during preparation of the AN Campaign Plan, several key gaps were identified regarding the Army Nurse Corps' ability to match leadership talents with the diverse demands of current missions, as well as its adaptability and flexibility to be prepared for unknown future missions. This article also introduces the Leadership Capability Map and other initiatives implemented to ensure the development of full-spectrum leaders who will be effective in the future military healthcare environment.

A rapid assessment scorecard to identify informal settlements at higher maternal and child health risk in Mumbai.

PubMed

Osrin, David; Das, Sushmita; Bapat, Ujwala; Alcock, Glyn A; Joshi, Wasundhara; More, Neena Shah

2011-10-01

The communities who live in urban informal settlements are diverse, as are their environmental conditions. Characteristics include inadequate access to safe water and sanitation, poor quality of housing, overcrowding, and insecure residential status. Interventions to improve health should be equity-driven and target those at higher risk, but it is not clear how to prioritise informal settlements for health action. In implementing a maternal and child health programme in Mumbai, India, we had conducted a detailed vulnerability assessment which, though important, was time-consuming and may have included collection of redundant information. Subsequent data collection allowed us to examine three issues: whether community environmental characteristics were associated with maternal and newborn healthcare and outcomes; whether it was possible to develop a triage scorecard to rank the health vulnerability of informal settlements based on a few rapidly observable characteristics; and whether the scorecard might be useful for future prioritisation. The City Initiative for Newborn Health documented births in 48 urban slum areas over 2 years. Information was collected on maternal and newborn care and mortality, and also on household and community environment. We selected three outcomes-less than three antenatal care visits, home delivery, and neonatal mortality-and used logistic regression and classification and regression tree analysis to test their association with rapidly observable environmental characteristics. We developed a simple triage scorecard and tested its utility as a means of assessing maternal and newborn health risk. In analyses on a sample of 10,754 births, we found associations of health vulnerability with inadequate access to water, toilets, and electricity; non-durable housing; hazardous location; and rental tenancy. A simple scorecard based on these had limited sensitivity and positive predictive value, but relatively high specificity and negative predictive value. The scorecard needs further testing in a range of urban contexts, but we intend to use it to identify informal settlements in particular need of family health interventions in a subsequent program.

The innovation scorecard for continuous improvement applied to translational science.

PubMed

Kotarba, Joseph A; Wooten, Kevin

2017-10-01

This paper reports on the baseline stage of a qualitative evaluation of the application of the Innovative Scorecard (ISC) to the Clinical and Translational Science Award (CTSA) at the University of Texas Medical Branch (UTMB) at Galveston. The ISC is adopted from the established Balanced Scorecard system for strategic planning and performance management. In formulating the evaluation, we focused on the organizational identity literature. The initial evaluation consisted of a series of semi-structured interviews with 22 participants of the ISC Boot Camp conducted in July 2015. The logic of grounded theory pointed to the clustering of perceptions of the ISC around respondents' occupational locations at UTMB. Administrators anticipate the expansion of planning activities to include a wider range of participants under the current CTSA award period (2015-2020) than under our first CTSA approval period (2009-2014). A common viewpoint among the senior scientists was that the scientific value of their work will continue to speak for itself without requiring the language of business. Junior scientists looked forward to the ISC's emphasis on increasingly horizontal leadership that will give them more access to and more control over their work and resources. Postdocs and senior staff welcomed increased involvement in the total research process at UTMB. The report concludes with strategies for future follow-up.

MQSA National Statistics

MedlinePlus

... Standards Act and Program MQSA Insights MQSA National Statistics Share Tweet Linkedin Pin it More sharing options ... but should level off with time. Archived Scorecard Statistics 2018 Scorecard Statistics 2017 Scorecard Statistics 2016 Scorecard ...

Validation and Adjustment of the Leipzig-Halifax Acute Aortic Dissection Type A Scorecard.

PubMed

Mejàre-Berggren, Hanna; Olsson, Christian

2017-11-01

The novel Leipzig-Halifax (LH) scorecard for acute aortic dissection type A (AADA) stratifies risk of in-hospital death based on age, malperfusion syndromes, critical preoperative state, and coronary disease. The study aim was to externally validate the LH scorecard performance and, if adequate, propose adjustments. All consecutive AADA patients operated on from 1996 to 2016 (n = 509) were included to generate an external validation cohort. Variables related to in-hospital death were analyzed using univariable and multivariable analysis. The LH scorecard was applied to the validation cohort, compared with the original study, and variable selection was adjusted using validation measures for discrimination and calibration. In-hospital mortality rate was 17.7% (LH cohort 18.7%). Critical preoperative state and Penn class non-Aa were independent predictors (odds ratio [OR] 2.42 and 2.45, respectively) of in-hospital death. The LH scorecard was adjusted to include Penn class non-Aa, critical preoperative state, and coronary disease. Assessing discrimination, area under receiver operator characteristic curve for the LH scorecard was 0.61 versus 0.66 for the new scorecard (p = 0.086). In-hospital mortality rates in low-, medium-, and high-risk groups were 14%, 15%, and 48%, respectively (LH scorecard) versus 11%, 23%, and 43%, respectively (new scorecard), and goodness-of-fit p value was 0.01 versus 0.86, indicating better calibration by the new scorecard. A lower Akaike information criterion value, 464 versus 448, favored the new scorecard. Through adjustment of the LH scorecard after external validation, prognostic performance improved. Further validated, the LH scorecard could be a valuable risk prediction tool. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Leading to High Performance: A Case Study of the Role of the Balanced Scorecard in Improving Urban Secondary Schools

ERIC Educational Resources Information Center

Brown, Pamela C.

2010-01-01

The onset of the standards-based movement in education in the early 1980's, bolstered by the passing of the No Child Left Behind Act (NCLBA) of 2002, led many school districts to shift from a culture of regulatory, process-oriented compliance to one that is more results-oriented, primarily based on state-adopted summative assessment targets in…

[Development and Application of a Performance Prediction Model for Home Care Nursing Based on a Balanced Scorecard using the Bayesian Belief Network].

PubMed

Noh, Wonjung; Seomun, Gyeongae

2015-06-01

This study was conducted to develop key performance indicators (KPIs) for home care nursing (HCN) based on a balanced scorecard, and to construct a performance prediction model of strategic objectives using the Bayesian Belief Network (BBN). This methodological study included four steps: establishment of KPIs, performance prediction modeling, development of a performance prediction model using BBN, and simulation of a suggested nursing management strategy. An HCN expert group and a staff group participated. The content validity index was analyzed using STATA 13.0, and BBN was analyzed using HUGIN 8.0. We generated a list of KPIs composed of 4 perspectives, 10 strategic objectives, and 31 KPIs. In the validity test of the performance prediction model, the factor with the greatest variance for increasing profit was maximum cost reduction of HCN services. The factor with the smallest variance for increasing profit was a minimum image improvement for HCN. During sensitivity analysis, the probability of the expert group did not affect the sensitivity. Furthermore, simulation of a 10% image improvement predicted the most effective way to increase profit. KPIs of HCN can estimate financial and non-financial performance. The performance prediction model for HCN will be useful to improve performance.

Medical records department and balanced scorecard approach.

PubMed

Ajami, Sima; Ebadsichani, Afsaneh; Tofighi, Shahram; Tavakoli, Nahid

2013-01-01

The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously. The main goal of this study was to assess the MRD performance with BSC approach in a hospital. This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran. To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed. The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively. The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital.

Using evidence to strengthen accountability for health financing in Sierra Leone.

PubMed

Lebbie, Sowo A; Le Voir, Rosanna; Tom-Kargbo, Joanna; Yilla, Mohamed Drissa; Kamara, Abu Bakarr; Nam, Sara L

2016-12-01

In 2012, the government of Sierra Leone cut the national budget allocation to the health sector. Civil society organizations planned a nationwide health budget advocacy campaign, coinciding with the 2012 general elections, to hold future leaders to account on financing for women's and children's health. As part of the campaign, Evidence for Action produced district health budget tracking scorecards. The scorecards presented Ministry of Finance data on the allocation and disbursement of health funds in each district. The data were communicated using simple, non-technical language so that citizens could understand the key messages and take action. A total of 5600 scorecards were shared at district electoral forums attended by political candidates, community members, and health activists. Since the election, the proportion of the total government budget allocated to health increased from 7.4% in 2012 to 11.2% in 2014. However, transforming politicians' commitments and pledges into implementation has been challenging, confirming that accountability is a long-term process. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Rethinking traditional methods for measuring intellectual capital.

PubMed

Corso, John A

2007-01-01

Historically, approaches to measuring intellectual capital have included both conventional accounting-based measures, such as variants of the market-to-book ratio, and more progressive measures, such as the measurement of intangible assets found in approaches such as the Balanced Scorecard and Human Resource Accounting. As greater emphasis is placed on intellectual capital and its various aspects in the continually growing service and knowledge economy, the use of assessment instruments to inventory the alignment, balance, and variety of intellectual capacities and metrics that assess the effectiveness of succession planning may represent new directions in which organizations can head in the measurement of this important construct.

Bringing Cost-Wise Readiness to the Deckplates of a Strike Fighter Squadron Using the Balanced Scorecard

DTIC Science & Technology

2013-12-01

equity employed). Customer measures, such as customer satisfaction , are intended to measure the company’s performance from the customer’s perspective...link between a non-financial measure and a firm’s financial performance. For example, one could meet objectives relating to customer satisfaction ... customer satisfaction . Who then is the customer of a strike fighter squadron? Kaplan and Norton (2004) write extensively about 61 the value

Hospital marketing.

PubMed

Carter, Tony

2003-01-01

This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

History & implementation of Item Unique Identification (IUID) - Has it Improved Asset Visibility?

DTIC Science & Technology

2012-03-27

figure 3) as of November 2011 on their progress in implementing IUID38: 10 Objectives • Policy Updates • Systems Updates (AIS and ERP ...Implement SAP Enhancement Pack – Nov 2013 • Design & build LMP IUID solution – Aug 2014 • Integrate & test with Trading Partners, Army IUID...issues Objectives • Policy Updates • Systems Updates (AIS and ERP ) • Contract Compliance Rate • Physical Marking • Use of IUID Registry IUID Scorecard

Comparing 2 National Organization-Level Workplace Health Promotion and Improvement Tools, 2013–2015

PubMed Central

Lang, Jason E.; Davis, Whitney D.; Jones-Jack, Nkenge H.; Mukhtar, Qaiser; Lu, Hua; Acharya, Sushama D.; Molloy, Meg E.

2016-01-01

Creating healthy workplaces is becoming more common. Half of employers that have more than 50 employees offer some type of workplace health promotion program. Few employers implement comprehensive evidence-based interventions that reach all employees and achieve desired health and cost outcomes. A few organization-level assessment and benchmarking tools have emerged to help employers evaluate the comprehensiveness and rigor of their health promotion offerings. Even fewer tools exist that combine assessment with technical assistance and guidance to implement evidence-based practices. Our descriptive analysis compares 2 such tools, the Centers for Disease Control and Prevention’s Worksite Health ScoreCard and Prevention Partners’ WorkHealthy America, and presents data from both to describe workplace health promotion practices across the United States. These tools are reaching employers of all types (N = 1,797), and many employers are using a comprehensive approach (85% of those using WorkHealthy America and 45% of those using the ScoreCard), increasing program effectiveness and impact. PMID:27685429

Sustainability Education and Accounting Experience. What Motivates Higher Valuation of Environmental Performance?: A Commentary on "Rhetoric or Reality? Do Accounting Education and Experience Increase Weighting on Environmental Performance in a Balanced Scorecard?"

ERIC Educational Resources Information Center

Schaltegger, Stefan

2013-01-01

Accounting has been accused of being a cause of unsustainable management, but is also seen as being a means to support corporate sustainability and improvement. In both views the introduction of environmental and sustainability topics in accounting education is widely supported. The main finding from the study by Wynder, Wellner, and Reinhard…

The development of an integrated Indonesian health care model using Kano's model, quality function deployment and balanced scorecard

NASA Astrophysics Data System (ADS)

Jonny, Zagloed, Teuku Yuri M.

2017-11-01

This paper aims to present an integrated health care model for Indonesian health care industry. Based on previous researches, there are two health care models in the industry such as decease- and patient-centered care models. In their developments, the patient-centered care model is widely applied due to its capability in reducing cost and improving quality simultaneously. However, there is still no comprehensive model resulting in cost reduction, quality improvement, patient satisfaction and hospital profitability simultaneously. Therefore, this research is intended to develop that model. In doing so, first, a conceptual model using Kano's Model, Quality Function Deployment (QFD) and Balanced Scorecard (BSC) is developed to generate several important elements of the model as required by stakeholders. Then, a case study of an Indonesian hospital is presented to evaluate the validity of the model using correlation analysis. As a result, it can be concluded that the model is validated implying several managerial insights among its elements such as l) leadership (r=0.85) and context of the organization (r=0.77) improve operations; 2) planning (r=0.96), support process (r=0.87) and continual improvement (r=0.95) also improve operations; 3) operations improve customer satisfaction (r=0.89) and financial performance (r=0.93) and 4) customer satisfaction improves the financial performance (0.98).

Performance evaluation of extension education centers in universities based on the balanced scorecard.

PubMed

Wu, Hung-Yi; Lin, Yi-Kuei; Chang, Chi-Hsiang

2011-02-01

This study aims at developing a set of appropriate performance evaluation indices mainly based on balanced scorecard (BSC) for extension education centers in universities by utilizing multiple criteria decision making (MCDM). Through literature reviews and experts who have real practical experiences in extension education, adequate performance evaluation indices have been selected and then utilizing the decision making trial and evaluation laboratory (DEMATEL) and analytic network process (ANP), respectively, further establishes the causality between the four BSC perspectives as well as the relative weights between evaluation indices. According to this previous result, an empirical analysis of the performance evaluation of extension education centers of three universities at Taoyuan County in Taiwan is illustrated by applying VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR). From the analysis results, it indicates that "Learning and growth" is the significant influential factor and it would affect the other three perspectives. In addition, it is discovered that "Internal process" perspective as well as "Financial" perspective play important roles in the performance evaluation of extension education centers. The top three key performance indices are "After-sales service", "Turnover volume", and "Net income". The proposed evaluation model could be considered as a reference for extension education centers in universities to prioritize their improvements on the key performance indices after performing VIKOR analyses. 2010 Elsevier Ltd. All rights reserved.

Medical records department and balanced scorecard approach

PubMed Central

Ajami, Sima; Ebadsichani, Afsaneh; Tofighi, Shahram; Tavakoli, Nahid

2013-01-01

Context: The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously. Aims: The main goal of this study was to assess the MRD performance with BSC approach in a hospital. Materials and Methods: This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran. Statistical Analysis Used: To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed. Results: The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively. Conclusions: The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital. PMID:24083257

A diabetes scorecard does not improve HbA(1c), blood pressure, lipids, aspirin usage, exercise and diabetes knowledge over 9 months: a randomized controlled trial.

PubMed

Irwig, M S; Sood, P; Ni, D; Amass, T; Khurana, P S; Jayanthi, V V; Wang, L; Adler, S M

2012-09-01

To test (1) whether a diabetes scorecard can improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage and exercise; (2) if the scorecard will motivate and/or educate patients to improve their scores for subsequent visits; and (3) whether the scorecard will improve rates of clinical inertia. Five physicians enrolled 103 patients ≥ 40 years old with uncontrolled Type 2 diabetes [HbA(1c) ≥ 64 mmol/mol (8.0%)] to randomly receive either a diabetes scorecard or not during four clinical visits over a 9-month period. The population was predominantly urban with a disproportionately higher percentage of black people than the general population. Our scorecard assigned points to six clinical variables, with a perfect total score of 100 points corresponding to meeting all targets. The primary outcomes were total scores and HbA(1c) in the scorecard and control groups at 9 months. There were no significant differences between the control and scorecard groups at visits 1 and 4 in total score, HbA(1c) , blood pressure, LDL cholesterol, aspirin usage, exercise or knowledge about diabetic targets. By visit 4 both the control and scorecard groups had statistically significant improvements with their mean total score (9 and 7 points, respectively), HbA(1c) [-9 mmol/mol (-0.8%) and -15 mmol/mol (-1.4%), respectively] and aspirin usage (33% increase and 16% increase, respectively). Rates of clinical inertia were low throughout the study. A diabetes scorecard did not improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage, exercise or diabetic knowledge in an urban population with uncontrolled Type 2 diabetes. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

A new matrix for scoring the functionality of national laboratory networks in Africa: introducing the LABNET scorecard

PubMed Central

Datema, Tjeerd; Keita-Sow, Mah-Sere; Ndihokubwayo, Jean-Bosco; Isadore, Jocelyn; Oskam, Linda; Nkengasong, John; Lewis, Kim

2016-01-01

Background Functional national laboratory networks and systems are indispensable to the achievement of global health security targets according to the International Health Regulations. The lack of indicators to measure the functionality of national laboratory network has limited the efficiency of past and current interventions to enhance laboratory capacity in resource-limited-settings. Scorecard for laboratory networks We have developed a matrix for the assessment of national laboratory network functionality and progress thereof, with support from the African Society of Laboratory Medicine and the Association of Public Health Laboratories. The laboratory network (LABNET) scorecard was designed to: (1) Measure the status of nine overarching core capabilities of laboratory network required to achieve global health security targets, as recommended by the main normative standards; (2) Complement the World Health Organization joint external evaluation tool for the assessment of health system preparedness to International Health Regulations (2005) by providing detailed information on laboratory systems; and (3) Serve as a clear roadmap to guide the stepwise implementation of laboratory capability to prevent, detect and act upon infectious threats. Conclusions The application of the LABNET scorecard under the coordination of the African Society of Laboratory Medicine and the Association of Public Health Laboratories could contribute to the design, monitoring and evaluation of upcoming Global Health Security Agenda-supported laboratory capacity building programmes in sub Saharan-Africa and other resource-limited settings, and inform the development of national laboratory policies and strategic plans. Endorsement by the World Health Organization Regional Office for Africa is foreseen. PMID:28879141

The U.S.-China Military Scorecard: Forces, Geography, and the Evolving Balance of Power, 1996-2017

DTIC Science & Technology

2015-01-01

forces. The Base Force study (1990), the Bottom- Up Review (1993), the Commission on the Roles and Missions of the Armed Forces (1995), the first...Report on the Bottom- Up Review , Washington, D.C.: Office of the Secretary of Defense, October 1993; Commission on the Roles and Missions of the...could be used to counter the sensors carried onboard the ASBMs. Other counters may be passive in nature , including strict emission control on the part

Nurse staffing and system integration and change indicators in acute care hospitals: evidence from a balanced scorecard.

PubMed

McGillis Hall, Linda; Peterson, Jessica; Baker, G Ross; Brown, Adalsteinn D; Pink, George H; McKillop, Ian; Daniel, Imtiaz; Pedersen, Cheryl

2008-01-01

This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.

Human-System Integration Scorecard Update to VB.Net

NASA Technical Reports Server (NTRS)

Sanders, Blaze D.

2009-01-01

The purpose of this project was to create Human-System Integration (HSI) scorecard software, which could be utilized to validate that human factors have been considered early in hardware/system specifications and design. The HSI scorecard is partially based upon the revised Human Rating Requirements (HRR) intended for NASA's Constellation program. This software scorecard will allow for quick appraisal of HSI factors, by using visual aids to highlight low and rapidly changing scores. This project consisted of creating a user-friendly Visual Basic program that could be easily distributed and updated, to and by fellow colleagues. Updating the Microsoft Word version of the HSI scorecard to a computer application will allow for the addition of useful features, improved easy of use, and decreased completion time for user. One significant addition is the ability to create Microsoft Excel graphs automatically from scorecard data, to allow for clear presentation of problematic areas. The purpose of this paper is to describe the rational and benefits of creating the HSI scorecard software, the problems and goals of project, and future work that could be done.

Promoting physical activity among youth through community-based prevention marketing.

PubMed

Bryant, Carol A; Courtney, Anita H; McDermott, Robert J; Alfonso, Moya L; Baldwin, Julie A; Nickelson, Jen; McCormack Brown, Kelli R; Debate, Rita D; Phillips, Leah M; Thompson, Zachary; Zhu, Yiliang

2010-05-01

Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age) called VERB Summer Scorecard. Based on the national VERB media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. The VERB Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9-step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens.

The potential of an online and mobile health scorecard for preventing chronic disease.

PubMed

Miron-Shatz, Talya; Ratzan, Scott C

2011-08-01

This article proposes a digital or electronic health scorecard to help prevent chronic disease. Today, chronic diseases--such as diabetes, cardiovascular diseases, and cancer--are among the most prevalent, costly, and preventable of all health problems. Yet, no credible, broadly distributed tool exists for monitoring and promoting health of large populations. The Take Care scorecard, we propose, will be a parsimonious way to both convey to people what measures they need to take to maintain their health and prevent or control chronic disease. The scorecard will aggregate several health and lifestyle indicators, such as blood pressure, body mass index, smoking and exercising, and allow the person to score him- or herself, coming up with a single number that assesses where he or she stands in terms of health. The terms used in the scorecard are easily comprehended by laypeople and are intended for usage that is not necessarily mediated by a physician, although it can be easily applied in the clinical setting. The measures included in the scorecard were selected on the basis of converging medical evidence attesting to their significance in curbing chronic disease. While the scorecard can also be used in a pen-and-paper manner, the increasing global popularity and accessibility of online and mobile content makes such a scorecard a potentially powerful and cost-effective means of increasing health.

Paying physician group practices for quality: A statewide quasi-experiment.

PubMed

Conrad, Douglas A; Grembowski, David; Perry, Lisa; Maynard, Charles; Rodriguez, Hector; Martin, Diane

2013-12-01

This article presents the results of a unique quasi-experiment of the effects of a large-scale pay-for-performance (P4P) program implemented by a leading health insurer in Washington state during 2001-2007. The authors received external funding to provide an objective impact evaluation of the program. The program was unique in several respects: (1) It was designed dynamically, with two discrete intervention periods-one in which payment incentives were based on relative performance (the "contest" period) and a second in which payment incentives were based on absolute performance compared to achievable benchmarks. (2) The program was designed in collaboration with large multispecialty group practices, with an explicit run-in period to test the quality metrics. Public reporting of the quality scorecard for all participating medical groups was introduced 1 year before the quality incentive payment program's inception, and continued throughout 2002-2007. (3) The program was implemented in stages with distinct medical groups. A control group of comparable group practices also was assembled, and difference-in-differences methodology was applied to estimate program effects. Case mix measures were included in all multivariate analyses. The regression design permitted a contrast of intervention effects between the "contest" approach in the sub-period of 2003-2004 and the absolute standard, "achievable benchmarks of care" approach in sub-period 2005-2007. Most of the statistically significant quality incentive program coefficients were small and negative (opposite to program intent). A consistent pattern of differential intervention impact in the sub-periods did not emerge. Cumulatively, the probit regression estimates indicate that neither the quality scorecard nor the quality incentive payment program had a significant positive effect on general clinical quality. Based on key informant interviews with medical leaders, practicing physicians, and administrators of the participating groups, the authors conclude that several factors likely combined to dampen program effects: (1) modest size of the incentive; (2) use of rewards only, rather than a balance of rewards and penalties; (3) targeting incentive payments to the group, thus potentially weakening incentive effects at the individual level. Copyright © 2013 Elsevier Inc. All rights reserved.

Increasing physical activity in children 8 to 12 years old: experiences with VERB Summer Scorecard.

PubMed

McDermott, Robert J; Davis, Jenna L; Bryant, Carol A; Courtney, Anita H; Alfonso, Moya L

2010-08-01

Interventions which facilitate physical activity of youth are vital for promoting community health and reducing obesity. This study assessed the results of a community-driven program, VERB Summer Scorecard, as knowledge of exposure to and awareness of community-based interventions for physical activity among youth could inform design and implementation of such interventions. A total of 2,215 youth ages 8 to 12 years responded to a survey about physical activity. Ordinal logistic regression suggested that youth who participated in this program were 1.73 times (95% CI = 1.41, 2.11) more likely to report high physical activity than nonparticipating youth 9 mo. after the intervention's first full-scale application. The program appeared to appeal more to girls than boys. Such results are encouraging for use in communities.

Constructing a strategy map for banking institutions with key performance indicators of the balanced scorecard.

PubMed

Wu, Hung-Yi

2012-08-01

This study presents a structural evaluation methodology to link key performance indicators (KPIs) into a strategy map of the balanced scorecard (BSC) for banking institutions. Corresponding with the four BSC perspectives (finance, customer, internal business process, and learning and growth), the most important evaluation indicators of banking performance are synthesized from the relevant literature and screened by a committee of experts. The Decision Making Trial and Evaluation Laboratory (DEMATEL) method, a multiple criteria analysis tool, is then employed to determine the causal relationships between the KPIs, to identify the critical central and influential factors, and to establish a visualized strategy map with logical links to improve banking performance. An empirical application is provided as an example. According to the expert evaluations, the three most essential KPIs for banking performance are customer satisfaction, sales performance, and customer retention rate. The DEMATEL results demonstrate a clear road map to assist management in prioritizing the performance indicators and in focusing attention on the strategy-related activities of the crucial indicators. According to the constructed strategy map, management could better invest limited resources in the areas that need improvement most. Although these strategy maps of the BSC are not universal, the research results show that the presented approach is an objective and feasible way to construct strategy maps more justifiably. The proposed framework can be applicable to institutions in other industries as well. Copyright © 2011 Elsevier Ltd. All rights reserved.

A balanced scorecard for health services in Afghanistan.

PubMed

Peters, David H; Noor, Ayan Ahmed; Singh, Lakhwinder P; Kakar, Faizullah K; Hansen, Peter M; Burnham, Gilbert

2007-02-01

The Ministry of Public Health (MOPH) in Afghanistan has developed a balanced scorecard (BSC) to regularly monitor the progress of its strategy to deliver a basic package of health services. Although frequently used in other health-care settings, this represents the first time that the BSC has been employed in a developing country. The BSC was designed via a collaborative process focusing on translating the vision and mission of the MOPH into 29 core indicators and benchmarks representing six different domains of health services, together with two composite measures of performance. In the absence of a routine health information system, the 2004 BSC for Afghanistan was derived from a stratified random sample of 617 health facilities, 5719 observations of patient-provider interactions, and interviews with 5597 patients, 1553 health workers, and 13,843 households. Nationally, health services were found to be reaching more of the poor than the less-poor population, and providing for more women than men, both key concerns of the government. However, serious deficiencies were found in five domains, and particularly in counselling patients, providing delivery care during childbirth, monitoring tuberculosis treatment, placing staff and equipment, and establishing functional village health councils. The BSC also identified wide variations in performance across provinces; no province performed better than the others across all domains. The innovative adaptation of the BSC in Afghanistan has provided a useful tool to summarize the multidimensional nature of health-services performance, and is enabling managers to benchmark performance and identify strengths and weaknesses in the Afghan context.

Using the CDC Worksite Health ScoreCard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine.

PubMed

Safeer, Richard; Bowen, Wendy; Maung, Zaw; Lucik, Meg

2018-02-01

The aim of this study was to determine whether the Centers for Disease Control and Prevention Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers. Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks. Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two. Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

Measuring Teachers and Learners' Perceptions of the Quality of Their Online Learning Experience

ERIC Educational Resources Information Center

Gómez-Rey, Pilar; Barbera, Elena; Fernández-Navarro, Francisco

2016-01-01

This article explores the quality of the online learning experience based on the Sloan-C framework and the Online Learning Consortium's (OLC) quality scorecard. The OLC index has been implemented to evaluate quality in online programs from different perspectives. Despite this, the opinions of learners are ignored, and it is built using feedback…

Utilization of Small Businesses in Navy Subcontracting

DTIC Science & Technology

2016-06-01

10 2.   DOD Procurement Scorecard ...........................................................11 3. D.  GOVERNMENT ACCOUNTABILITY OFFICE...Firms conducting business with the federal government are required to take into account small-business concerns in the acquisition process. Subpart 19.7...including increased loan provisions, higher lending limits, tax cuts for small businesses, and implements several of the Task Forces’ recommendations

Using DEMATEL approach to develop relationships of performance indicators on sustainable service only supply chain performance measurement

NASA Astrophysics Data System (ADS)

Leksono, EB; Suparno; Vanany, I.

2018-04-01

Service only supply chain (SOSC) concept is service supply chain (SSC) implementation on pure services. The globalization and stakeholder pressure makes operation of SSC should give the attention to the environment effect, community, economic and intangibility assets. SOSC performance measurement (SOSCPM) may be developed for measuring of performance for sustainability aspects and intangibility assets to meet customer satisfaction. This article discusses sustainable SOSCPM based on balanced scorecard (BSC), include sustainability aspects, intangibility and relations between perspectives and indicators. From literature review, it is found 34 performance indicators that must be confirm to expert and SC actors by survey. From survey validation using weighted average and level of consensus, it is found 29 valid indicators for processed by DEMATEL. From DEMATEL, it is found 26 indicators can be used on sustainable SOSCPM. Furthermore, innovation and growth perspective most influence to other, and customer perspective most important. Intangibility indicators incorporated on innovation and growth perspective very related with human resources. Finally, relations between perspectives and indicator used to design of BSC strategy maps.

The use and design of the BSC in the health care sector: A systematic literature review for Italy, Spain, and Portugal.

PubMed

Gonzalez-Sanchez, Maria Beatriz; Broccardo, Laura; Martins Pires, Amélia Maria

2018-01-01

The aim of this paper is to gain a better understanding of how the balanced scorecard (BSC) has evolved in Spain, Italy, and Portugal. It reviews all the articles on the BSC in the health care sector written between 1992 and 2015 by Spanish, Italian, or Portuguese authors and published in Spanish, Italian, or Portuguese as well as in English. Our study first shows the state of knowledge on BSC in health care for a homogeneous group of Southern European countries. Second, it uncovers the perspectives, indicators, and generation used in the countries under observation to reveal the extent to which this management tool has evolved. Third, it analyses international variations in design and use within the health care context, especially in the United States. Moreover, it also highlights a number of important issues. The BSC is in its early stage of development in these 3 countries, which do not use it as a tool to implement strategy and align all of the elements that help integrate the organization. Copyright © 2017 John Wiley & Sons, Ltd.

[Supply services at health facilities: measuring performance].

PubMed

Dacosta Claro, I

2001-01-01

Performance measurement, in their different meanings--either balance scorecard or outputs measurement--have become an essential tool in today's organizations (World-Class organizations) to improve service quality and reduce costs. This paper presents a performance measurement system for the hospital supply chain. The system is organized in different levels and groups of indicators in order to show a hierarchical, coherent and integrated vision of the processes. Thus, supply services performance is measured according to (1) financial aspects, (2) customers satisfaction aspects and (3) internal aspects of the processes performed. Since the informational needs of the managers vary within the administrative structure, the performance measurement system is defined in three hierarchical levels. Firstly, the whole supply chain, with the different interrelation of activities. Secondly, the three main processes of the chain--physical management of products, purchasing and negotiation processes and the local storage units. And finally, the performance measurement of each activity involved. The system and the indicators have been evaluated with the participation of 17 health services of Quebec (Canada), however, and due to the similarities of the operation, could be equally implemented in Spanish hospitals.

Financial dashboard reporting for the hospital industry.

PubMed

Cleverley, W O

2001-01-01

Most senior executives and board members experience information overload in their decision making roles. They simply receive an excessive amount of unrelated data that is not benchmarked to standards that enable them to make effective decisions. This is an unfortunate situation given the information technology and the availability of public data that exists today. Many firms in a variety of industry sectors have combined the concept of "balanced scorecards" with "dashboard" reporting to revamp their senior level executive reporting systems. A sample dashboard reporting system for a hospital is outlined in this paper.

Strategic planning for neuroradiologists.

PubMed

Berlin, Jonathan W; Lexa, Frank J

2012-08-01

Strategic planning is becoming essential to neuroradiology as the health care environment continues to emphasize cost efficiency, teamwork and collaboration. A strategic plan begins with a mission statement and vision of where the neuroradiology division would like to be in the near future. Formalized strategic planning frameworks, such as the strengths, weaknesses, opportunities and threats (SWOT), and the Balanced Scorecard frameworks, can help neuroradiology divisions determine their current position in the marketplace. Communication, delegation, and accountability in neuroradiology is essential in executing an effective strategic plan. Copyright © 2012 Elsevier Inc. All rights reserved.

A Model for Semantic Equivalence Discovery for Harmonizing Master Data

NASA Astrophysics Data System (ADS)

Piprani, Baba

IT projects often face the challenge of harmonizing metadata and data so as to have a "single" version of the truth. Determining equivalency of multiple data instances against the given type, or set of types, is mandatory in establishing master data legitimacy in a data set that contains multiple incarnations of instances belonging to the same semantic data record . The results of a real-life application define how measuring criteria and equivalence path determination were established via a set of "probes" in conjunction with a score-card approach. There is a need for a suite of supporting models to help determine master data equivalency towards entity resolution—including mapping models, transform models, selection models, match models, an audit and control model, a scorecard model, a rating model. An ORM schema defines the set of supporting models along with their incarnation into an attribute based model as implemented in an RDBMS.

Linking Workplace Health Promotion Best Practices and Organizational Financial Performance: Tracking Market Performance of Companies With Highest Scores on the HERO Scorecard.

PubMed

Grossmeier, Jessica; Fabius, Ray; Flynn, Jennifer P; Noeldner, Steven P; Fabius, Dan; Goetzel, Ron Z; Anderson, David R

2016-01-01

The aim of the study was to evaluate the stock performance of publicly traded companies that received high scores on the HERO Employee Health Management Best Practices Scorecard in Collaboration with Mercer© based on their implementation of evidence-based workplace health promotion practices. A portfolio of companies that received high scores in a corporate health and wellness self-assessment was simulated based on past market performance and compared with past performance of companies represented on the Standard and Poor's (S&P) 500 Index. Stock values for a portfolio of companies that received high scores in a corporate health and wellness self-assessment appreciated by 235% compared with the S&P 500 Index appreciation of 159% over a 6-year simulation period. Robust investment in workforce health and well-being appears to be one of multiple practices pursued by high-performing, well-managed companies.

Developing a Security Metrics Scorecard for Healthcare Organizations.

PubMed

Elrefaey, Heba; Borycki, Elizabeth; Kushniruk, Andrea

2015-01-01

In healthcare, information security is a key aspect of protecting a patient's privacy and ensuring systems availability to support patient care. Security managers need to measure the performance of security systems and this can be achieved by using evidence-based metrics. In this paper, we describe the development of an evidence-based security metrics scorecard specific to healthcare organizations. Study participants were asked to comment on the usability and usefulness of a prototype of a security metrics scorecard that was developed based on current research in the area of general security metrics. Study findings revealed that scorecards need to be customized for the healthcare setting in order for the security information to be useful and usable in healthcare organizations. The study findings resulted in the development of a security metrics scorecard that matches the healthcare security experts' information requirements.

Improving the College Scorecard: Using Student Feedback to Create an Effective Disclosure

ERIC Educational Resources Information Center

Morgan, Julie Margetta; Dechter, Gadi

2012-01-01

The White House will soon unveil a final version of its "college scorecard"--an online tool giving college-bound students and their families a hype-free snapshot of reliable information about any U.S. campus: real costs, graduation rates, student debt statistics, and earning potential of graduates. The college scorecard is a good idea…

The predictive validity of the HERO Scorecard in determining future health care cost and risk trends.

PubMed

Goetzel, Ron Z; Henke, Rachel Mosher; Benevent, Richele; Tabrizi, Maryam J; Kent, Karen B; Smith, Kristyn J; Roemer, Enid Chung; Grossmeier, Jessica; Mason, Shawn T; Gold, Daniel B; Noeldner, Steven P; Anderson, David R

2014-02-01

To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into "high" versus "low" scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends. "High" scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of -1.6% over 3 years) compared with "low" scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring "low." The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.

Applications of the balanced scorecard for strategic management and performance measurement in the health sector.

PubMed

Behrouzi, Farshad; Shaharoun, Awaluddin Mohamed; Ma'aram, Azanizawati

2014-05-01

In order to attain a useful balanced scorecard (BSC), appropriate performance perspectives and indicators are crucial to reflect all strategies of the organisation. The objectives of this survey were to give an insight regarding the situation of the BSC in the health sector over the past decade, and to afford a generic approach of the BSC development for health settings with specific focus on performance perspectives, performance indicators and BSC generation. After an extensive search based on publication date and research content, 29 articles published since 2002 were identified, categorised and analysed. Four critical attributes of each article were analysed, including BSC generation, performance perspectives, performance indicators and auxiliary tools. The results showed that 'internal business process' was the most notable BSC perspective as it was included in all reviewed articles. After investigating the literature, it was concluded that its comprehensiveness is the reason for the importance and high usage of this perspective. The findings showed that 12 cases out of 29 reviewed articles (41%) exceeded the maximum number of key performance indicators (KPI) suggested in a previous study. It was found that all 12 cases were large organisations with numerous departments (e.g. national health organisations). Such organisations require numerous KPI to cover all of their strategic objectives. It was recommended to utilise the cascaded BSC within such organisations to avoid complexity and difficulty in gathering, analysing and interpreting performance data. Meanwhile it requires more medical staff to contribute in BSC development, which will result in greater reliability of the BSC.

Cooperation and competition: balanced scorecard and hospital privatization.

PubMed

Aidemark, Lars-Göran

2010-01-01

In 2000 the Skåne Region (a public authority) and a private contractor made a five-year agreement for the provision of both in-patient care and out-patient medical services to about 30,000 inhabitants in the south-east part of the region. The Skåne Region is the main provider of health care to about one million inhabitants in the south of Sweden and is responsible for all health care (private and public), including ten hospitals. This paper seeks to answer the question of how the Skåne Region can control and cooperate with a private contractor, entering into competition with the public health care providers in the region. This is a longitudinal study conducted between 2001-2006. It is based on 28 taped interviews with employees responsible for the contracting process, participating observations and comprehensive secondary material. The study presents experiences made by the contractor and the public authority on how to work out and follow-up assignments within the health care sector regarding patient interest, public interest and professional medical interest. Measurement within the frames of the balanced scorecard (BSC) made it possible to control both volumes and health care quality delivered by the private competing contractor. The political purchaser claims that the Skåne Region has established a cost-effective and successful control system based on trust and measurement. This paper reports on a control system, between public purchaser and a private provider within health care, that focuses on and follow-up not only health care production but also health care quality.

Use of Self-Organizing Maps for Balanced Scorecard analysis to monitor the performance of dialysis clinic chains.

PubMed

Cattinelli, Isabella; Bolzoni, Elena; Barbieri, Carlo; Mari, Flavio; Martin-Guerrero, José David; Soria-Olivas, Emilio; Martinez-Martinez, José Maria; Gomez-Sanchis, Juan; Amato, Claudia; Stopper, Andrea; Gatti, Emanuele

2012-03-01

The Balanced Scorecard (BSC) is a validated tool to monitor enterprise performances against specific objectives. Through the choice and the evaluation of strategic Key Performance Indicators (KPIs), it provides a measure of the past company's outcome and allows planning future managerial strategies. The Fresenius Medical Care (FME) BSC makes use of 30 KPIs for a continuous quality improvement strategy within its dialysis clinics. Each KPI is monthly associated to a score that summarizes the clinic efficiency for that month. Standard statistical methods are currently used to analyze the BSC data and to give a comprehensive view of the corporate improvements to the top management. We herein propose the Self-Organizing Maps (SOMs) as an innovative approach to extrapolate information from the FME BSC data and to present it in an easy-readable informative form. A SOM is a computational technique that allows projecting high-dimensional datasets to a two-dimensional space (map), thus providing a compressed representation. The SOM unsupervised (self-organizing) training procedure results in a map that preserves similarity relations existing in the original dataset; in this way, the information contained in the high-dimensional space can be more easily visualized and understood. The present work demonstrates the effectiveness of the SOM approach in extracting useful information from the 30-dimensional BSC dataset: indeed, SOMs enabled both to highlight expected relationships between the KPIs and to uncover results not predictable with traditional analyses. Hence we suggest SOMs as a reliable complementary approach to the standard methods for BSC interpretation.

Creating a nursing strategic planning framework based on evidence.

PubMed

Shoemaker, Lorie K; Fischer, Brenda

2011-03-01

This article describes an evidence-informed strategic planning process and framework used by a Magnet-recognized public health system in California. This article includes (1) an overview of the organization and its strategic planning process, (2) the structure created within nursing for collaborative strategic planning and decision making, (3) the strategic planning framework developed based on the organization's balanced scorecard domains and the new Magnet model, and (4) the process undertaken to develop the nursing strategic priorities. Outcomes associated with the structure, process, and key initiatives are discussed throughout the article. Copyright © 2011 Elsevier Inc. All rights reserved.

Business Performance Measurements in Asset Management with the Support of Big Data Technologies

NASA Astrophysics Data System (ADS)

Campos, Jaime; Sharma, Pankaj; Jantunen, Erkki; Baglee, David; Fumagalli, Luca

2017-09-01

The paper reviews the performance measurement in the domain of interest. Important data in asset management are further, discussed. The importance and the characteristics of today's ICTs capabilities are also mentioned in the paper. The role of new concepts such as big data and data mining analytical technologies in managing the performance measurements in asset management are discussed in detail. The authors consequently suggest the use of the modified Balanced Scorecard methodology highlighting both quantitative and qualitative aspects, which is crucial for optimal use of the big data approach and technologies.

Measured success.

PubMed

Chambers, David W

2002-01-01

Some practices "wing it," some pick outcomes after the fact in order to look good. But neither of these approaches creates much confidence that next year will be okay, let alone better. Using measurement to improve practice requires understanding the interplay among mission, vision, core values, key success factors, and performance indicators. Combined intelligently, these five elements drive strategic planning and budgeting. They also lead to monitoring progress toward success. This is best done with a balanced scorecard that includes leading and lagging indicators of mission and vision. Indicators should be sampled to represent the practice and monitored against targets to propel the practice toward success.

A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England

PubMed Central

2011-01-01

Background The National Institute for Health Research (NIHR) was established in 2006 with the aim of creating an applied health research system embedded within the English National Health Service (NHS). NIHR sought to implement an approach for monitoring its performance that effectively linked early indicators of performance with longer-term research impacts. We attempted to develop and apply a conceptual framework for defining appropriate key performance indicators for NIHR. Method Following a review of relevant literature, a conceptual framework for defining performance indicators for NIHR was developed, based on a hybridisation of the logic model and balanced scorecard approaches. This framework was validated through interviews with key NIHR stakeholders and a pilot in one division of NIHR, before being refined and applied more widely. Indicators were then selected and aggregated to create a basket of indicators aligned to NIHR's strategic goals, which could be reported to NIHR's leadership team on a quarterly basis via an oversight dashboard. Results Senior health research system managers and practitioners endorsed the conceptual framework developed and reported satisfaction with the breadth and balance of indicators selected for reporting. Conclusions The use of the hybrid conceptual framework provides a pragmatic approach to defining performance indicators that are aligned to the strategic aims of a health research system. The particular strength of this framework is its capacity to provide an empirical link, over time, between upstream activities of a health research system and its long-term strategic objectives. PMID:21435265

SCOPE: a scorecard for osteoporosis in Europe.

PubMed

Kanis, J A; Borgström, F; Compston, J; Dreinhöfer, K; Nolte, E; Jonsson, L; Lems, W F; McCloskey, E V; Rizzoli, R; Stenmark, J

2013-01-01

The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis. The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union (EU27). The information researched covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap). There was a marked difference in fracture risk among the EU27. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27, only a minority of patients at high risk receive treatment for osteoporosis even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. The scorecard will enable healthcare professionals and policy makers to assess their country's general approach to the disease and provide indicators to inform future provision of healthcare.

Hospital on a page: standardizing data presentation to drive quality improvement.

PubMed

Heenan, Michael; DiEmanuele, Michelle; Hayward-Murray, Kathryn; Dadgar, Ladan

2012-01-01

Over the past five years, the Credit Valley Hospital (CVH) invested time and financial and human resources into performance measurement systems. In doing so, CVH launched a number of data tools including electronic scorecards and dashboards. However, the processes and accountability structures associated with the tools struggled to gain credibility with clinical and administrative leadership as the performance measurement system was primarily driven by the technology rather than a sound information strategy. Although a corporate-level scorecard was regularly updated, program-related scorecards and other measurement tools were only populated when programs reported to the board, at the time of accreditation or as a result of regulatory requirements. In addition, information contained in data reports was often presented in a manner that did not engage clinical and corporate decision-makers in the key issues of quality, access and sustainability. Following the release of its new strategic plan in 2009, CVH renewed its performance measurement framework and the methods by which it presented data so that the organization's strategic plan could be implemented and measured from the boardroom to the bedside. Long, complex spreadsheets were transformed into strategically designed, easy-to-understand, easy-to-access reports released in a standardized method in terms of format, media, content and timing. The following article describes the method CVH adopted to communicate the organization's performance and the role it played in enhancing the culture of quality and patient safety within the hospital.

A new matrix for scoring the functionality of national laboratory networks in Africa: introducing the LABNET scorecard.

PubMed

Ondoa, Pascale; Datema, Tjeerd; Keita-Sow, Mah-Sere; Ndihokubwayo, Jean-Bosco; Isadore, Jocelyn; Oskam, Linda; Nkengasong, John; Lewis, Kim

2016-01-01

Functional national laboratory networks and systems are indispensable to the achievement of global health security targets according to the International Health Regulations. The lack of indicators to measure the functionality of national laboratory network has limited the efficiency of past and current interventions to enhance laboratory capacity in resource-limited-settings. We have developed a matrix for the assessment of national laboratory network functionality and progress thereof, with support from the African Society of Laboratory Medicine and the Association of Public Health Laboratories. The laboratory network (LABNET) scorecard was designed to: (1) Measure the status of nine overarching core capabilities of laboratory network required to achieve global health security targets, as recommended by the main normative standards; (2) Complement the World Health Organization joint external evaluation tool for the assessment of health system preparedness to International Health Regulations (2005) by providing detailed information on laboratory systems; and (3) Serve as a clear roadmap to guide the stepwise implementation of laboratory capability to prevent, detect and act upon infectious threats. The application of the LABNET scorecard under the coordination of the African Society of Laboratory Medicine and the Association of Public Health Laboratories could contribute to the design, monitoring and evaluation of upcoming Global Health Security Agenda-supported laboratory capacity building programmes in sub Saharan-Africa and other resource-limited settings, and inform the development of national laboratory policies and strategic plans. Endorsement by the World Health Organization Regional Office for Africa is foreseen.

Using the CDC's Worksite Health ScoreCard as a Framework to Examine Worksite Health Promotion and Physical Activity.

PubMed

Gutermuth, Leah K; Hager, Erin R; Pollack Porter, Keshia

2018-06-21

Worksite health promotion programs are emerging as an effective approach for addressing the adult obesity epidemic and improving the overall health of employees. We conducted a scoping review to identify articles that described a physical activity component (eg, promoted increased physical or reduced sitting time) of a worksite health promotion intervention. Our search specified full-length articles published in English from January 2000 through July 2015. We used the Centers for Disease Control and Prevention's Worksite Health ScoreCard, a validated tool, as a framework to summarize information on organizational supports strategies (18 questions) and physical activity strategies (9 questions) implemented by worksite health promotion programs. We also determined whether or not the included studies reported significant (P < .05) improvements in physical activity. We identified 18 worksite health promotion programs; 11 produced significant improvements in physical activity. Incentives, health risk assessments, health promotion committees, leadership support, marketing, and subsidies or discounts for use of exercise facilities were the most effective organizational supports strategies cited, and physical activity seminars, classes, and workshops were the most effective physical activity strategies cited. The use of the Health ScoreCard allowed for a practical interpretation of our findings, which can inform next steps for the field. Future research should explore the relationships between components of worksite health promotion programs and their outcomes to further develop best practices that can improve worker health and promote physical activity.

Make-to-order manufacturing - new approach to management of manufacturing processes

NASA Astrophysics Data System (ADS)

Saniuk, A.; Waszkowski, R.

2016-08-01

Strategic management must now be closely linked to the management at the operational level, because only in such a situation the company can be flexible and can quickly respond to emerging opportunities and pursue ever-changing strategic objectives. In these conditions industrial enterprises seek constantly new methods, tools and solutions which help to achieve competitive advantage. They are beginning to pay more attention to cost management, economic effectiveness and performance of business processes. In the article characteristics of make-to-order systems (MTO) and needs associated with managing such systems is identified based on the literature analysis. The main aim of this article is to present the results of research related to the development of a new solution dedicated to small and medium enterprises manufacture products solely on the basis of production orders (make-to- order systems). A set of indicators to enable continuous monitoring and control of key strategic areas this type of company is proposed. A presented solution includes the main assumptions of the following concepts: the Performance Management (PM), the Balanced Scorecard (BSC) and a combination of strategic management with the implementation of operational management. The main benefits of proposed solution are to increase effectiveness of MTO manufacturing company management.

Multidimensional evaluation of performance with experimental application of balanced scorecard: a two year experience

PubMed Central

2011-01-01

Background In today's dynamic health-care system, organizations such as hospitals are required to improve their performance for multiple stakeholders and deliver an integrated care that means to work effectively, be innovative and organize efficiently. Achieved goals and levels of quality can be successfully measured by a multidimensional approach like Balanced Scorecard (BSC). The aim of the study was to verify the opportunity to introduce BSC framework to measure performance in St. Anna University Hospital of Ferrara, applying it to the Clinical Laboratory Operative Unit in order to compare over time performance results and achievements of assigned targets. Methods In the first experience with BSC we distinguished four perspectives, according to Kaplan and Norton, identified Key Performance Areas and Key Performance Indicators, set standards and weights for each objective, collected data for all indicators, recognized cause-and-effect relationships in a strategic map. One year later we proceeded with the next data collection and analysed the preservation of framework aptitude to measure Operative Unit performance. In addition, we verified the ability to underline links between strategic actions belonging to different perspectives in producing outcomes changes. Results The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the specific perspective contribution to overall performance enhancement. After time results comparison was possible depending on the selection of feasible and appropriate key performance indicators, which was occasionally limited by data collection problems. Conclusions The first use of BSC to compare performance at Operative Unit level, in course of time, suggested this framework can be successfully adopted for results measuring and revealing effective health factors, allowing health-care quality improvements. PMID:21586111

Multidimensional evaluation of performance with experimental application of balanced scorecard: a two year experience.

PubMed

Lupi, Silvia; Verzola, Adriano; Carandina, Gianni; Salani, Manuela; Antonioli, Paola; Gregorio, Pasquale

2011-05-17

In today's dynamic health-care system, organizations such as hospitals are required to improve their performance for multiple stakeholders and deliver an integrated care that means to work effectively, be innovative and organize efficiently. Achieved goals and levels of quality can be successfully measured by a multidimensional approach like Balanced Scorecard (BSC). The aim of the study was to verify the opportunity to introduce BSC framework to measure performance in St. Anna University Hospital of Ferrara, applying it to the Clinical Laboratory Operative Unit in order to compare over time performance results and achievements of assigned targets. In the first experience with BSC we distinguished four perspectives, according to Kaplan and Norton, identified Key Performance Areas and Key Performance Indicators, set standards and weights for each objective, collected data for all indicators, recognized cause-and-effect relationships in a strategic map. One year later we proceeded with the next data collection and analysed the preservation of framework aptitude to measure Operative Unit performance. In addition, we verified the ability to underline links between strategic actions belonging to different perspectives in producing outcomes changes. The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the specific perspective contribution to overall performance enhancement. After time results comparison was possible depending on the selection of feasible and appropriate key performance indicators, which was occasionally limited by data collection problems. The first use of BSC to compare performance at Operative Unit level, in course of time, suggested this framework can be successfully adopted for results measuring and revealing effective health factors, allowing health-care quality improvements.

Multi-Attribute Strategy and Performance Architectures in R&D: The Case of The Balanced Scorecard

DTIC Science & Technology

2006-03-01

learning.    We also found that balance, accessibility, transparency, and participation are increasingly  being  seen  as desirable features of the strategy...project would have never  seen  the light of the day. I am especially  thankful to Steven Popper for giving me the confidence to take on this challenging...among a ranking of 16 R&D  related problems perceived by the members for two years, 1993 & 1995 (Ellis, 1997.)  Traditionally R&D was  seen  as a rather

Wheels, hubs and spokes: incorporating a scorecard into a business continuity programme.

PubMed

Stourac, Tracy

2014-01-01

A scorecard can provide much more than periodic measurements; it can actually serve as the 'hub' of a programme. By taking a strategic look at what one is trying to accomplish, using consistent messaging, following a flexible but defined process and creating an actionable report for the senior leadership, a programme can be built that not only gets attention but is also efficient and effective. The scorecard establishes accountability and consistency while creating a brand for a business continuity programme.

Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

PubMed

Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

2015-12-01

We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

Development of balanced key performance indicators for emergency departments strategic dashboards following analytic hierarchical process.

PubMed

Safdari, Reza; Ghazisaeedi, Marjan; Mirzaee, Mahboobeh; Farzi, Jebrail; Goodini, Azadeh

2014-01-01

Dynamic reporting tools, such as dashboards, should be developed to measure emergency department (ED) performance. However, choosing an effective balanced set of performance measures and key performance indicators (KPIs) is a main challenge to accomplish this. The aim of this study was to develop a balanced set of KPIs for use in ED strategic dashboards following an analytic hierarchical process. The study was carried out in 2 phases: constructing ED performance measures based on balanced scorecard perspectives and incorporating them into analytic hierarchical process framework to select the final KPIs. The respondents placed most importance on ED internal processes perspective especially on measures related to timeliness and accessibility of care in ED. Some measures from financial, customer, and learning and growth perspectives were also selected as other top KPIs. Measures of care effectiveness and care safety were placed as the next priorities too. The respondents placed least importance on disease-/condition-specific "time to" measures. The methodology can be presented as a reference model for development of KPIs in various performance related areas based on a consistent and fair approach. Dashboards that are designed based on such a balanced set of KPIs will help to establish comprehensive performance measurements and fair benchmarks and comparisons.

Tool for Human-Systems Integration Assessment: HSI Scorecard

NASA Technical Reports Server (NTRS)

Whitmore, Nihriban; Sandor, Aniko; McGuire, Kerry M.; Berdich, Debbie

2009-01-01

This paper describes the development and rationale for a human-systems integration (HSI) scorecard that can be used in reviews of vehicle specification and design. This tool can be used to assess whether specific HSI related criteria have been met as part of a project milestone or critical event, such as technical reviews, crew station reviews, mockup evaluations, or even review of major plans or processes. Examples of HSI related criteria include Human Performance Capabilities, Health Management, Human System Interfaces, Anthropometry and Biomechanics, and Natural and Induced Environments. The tool is not intended to evaluate requirements compliance and verification, but to review how well the human related systems have been considered for the specific event and to identify gaps and vulnerabilities from an HSI perspective. The scorecard offers common basis, and criteria for discussions among system managers, evaluators, and design engineers. Furthermore, the scorecard items highlight the main areas of system development that need to be followed during system lifecycle. The ratings provide a repeatable quantitative measure to what has been often seen as only subjective commentary. Thus, the scorecard is anticipated to be a useful HSI tool to communicate review results to the institutional and the project office management.

Response to ProPublica's Rebuttal of Our Critique of the Surgeon Scorecard

PubMed Central

Friedberg, Mark W.; Bilimoria, Karl Y.; Pronovost, Peter J.; Shahian, David M.; Damberg, Cheryl L.; Zaslavsky, Alan M.

2016-01-01

Abstract In the summer of 2015, ProPublica published its Surgeon Scorecard, which displays “Adjusted Complication Rates” for individual, named surgeons for eight surgical procedures performed in hospitals. Public reports of provider performance have the potential to improve the quality of health care that patients receive. A valid performance report can drive quality improvement and usefully inform patients' choices of providers. However, performance reports with poor validity and reliability are potentially damaging to all involved. In September 2015, RAND released a critique of the Scorecard authored by a group of health policy researchers from RAND and other institutions, and on October 7, 2015 ProPublica published a rebuttal of our critique. In this follow-on Perspective, we revisit the main points in our initial critique, summarize ProPublica's rebuttal, explain why this rebuttal fails to address our methodological concerns, provide suggestions on how to validate and improve the Scorecard, and explain why we continue to advise potential users of the Scorecard, as it is currently constructed, not to consider it a valid or reliable predictor of the health outcomes any individual surgeon is likely to provide. PMID:28083432

Developing Agency for Equity-Minded Change

ERIC Educational Resources Information Center

Felix, Eric R.; Bensimon, Estela Mara; Hanson, Debbie; Gray, James; Klingsmith, Libby

2015-01-01

This chapter highlights the use of the Equity Scorecard with the Community College of Aurora. The Equity Scorecard is a theory-based strategy that assists community colleges in embedding equity into their institutional norms, practices, and policies.

A Research on Performance Measurement Based on Economic Valued-Added Comprehensive Scorecard

NASA Astrophysics Data System (ADS)

Chen, Qin; Zhang, Xiaomei

With the development of economic, the traditional performance mainly rely on financial indicators could not satisfy the need of work. In order to make the performance measurement taking the best services for business goals, this paper proposed Economic Valued-Added Comprehensive Scorecard based on research of shortages and advantages of EVA and BSC .We used Analytic Hierarchy Process to build matrix to solve the weighting of EVA Comprehensive Scorecard. At last we could find the most influence factors for enterprise value forming the weighting.

A Methodological Critique of the ProPublica Surgeon Scorecard

PubMed Central

Friedberg, Mark W.; Pronovost, Peter J.; Shahian, David M.; Safran, Dana Gelb; Bilimoria, Karl Y.; Elliott, Marc N.; Damberg, Cheryl L.; Dimick, Justin B.; Zaslavsky, Alan M.

2016-01-01

Abstract On July 14, 2015, ProPublica published its Surgeon Scorecard, which displays “Adjusted Complication Rates” for individual, named surgeons for eight surgical procedures performed in hospitals. Public reports of provider performance have the potential to improve the quality of health care that patients receive. A valid performance report can drive quality improvement and usefully inform patients' choices of providers. However, performance reports with poor validity and reliability are potentially damaging to all involved. This article critiques the methods underlying the Scorecard and identifies opportunities for improvement. Until these opportunities are addressed, the authors advise users of the Scorecard—most notably, patients who might be choosing their surgeons—not to consider the Scorecard a valid or reliable predictor of the health outcomes any individual surgeon is likely to provide. The authors hope that this methodological critique will contribute to the development of more-valid and more-reliable performance reports in the future. PMID:28083411

A Generic Framework of Performance Measurement in Networked Enterprises

NASA Astrophysics Data System (ADS)

Kim, Duk-Hyun; Kim, Cheolhan

Performance measurement (PM) is essential for managing networked enterprises (NEs) because it greatly affects the effectiveness of collaboration among members of NE.PM in NE requires somewhat different approaches from PM in a single enterprise because of heterogeneity, dynamism, and complexity of NE’s. This paper introduces a generic framework of PM in NE (we call it NEPM) based on the Balanced Scorecard (BSC) approach. In NEPM key performance indicators and cause-and-effect relationships among them are defined in a generic strategy map. NEPM could be applied to various types of NEs after specializing KPIs and relationships among them. Effectiveness of NEPM is shown through a case study of some Korean NEs.

Method of evaluating the impact of ERP implementation critical success factors - a case study in oil and gas industries

NASA Astrophysics Data System (ADS)

Gajic, Gordana; Stankovski, Stevan; Ostojic, Gordana; Tesic, Zdravko; Miladinovic, Ljubomir

2014-01-01

The so far implemented enterprise resource planning (ERP) systems have in many cases failed to meet the requirements regarding the business process control, decrease of business costs and increase of company profit margin. Therefore, there is a real need for an evaluation of the influence of ERP on the company's performance indicators. Proposed in this article is an advanced model for the evaluation of the success of ERP implementation on organisational and operational performance indicators in oil-gas companies. The recommended method establishes a correlation between a process-based method, a scorecard model and ERP critical success factors. The method was verified and tested on two case studies in oil-gas companies using the following procedure: the model was developed, tested and implemented in a pilot gas-oil company, while the results were implemented and verified in another gas-oil company.

Early interventions and lessons from Harvard Business Review.

PubMed

Chong, Siow-Ann

2007-11-01

To describe the establishment and development of an Early Psychosis Intervention Programme in Singapore that is based on a business model and with concepts drawn from the corporate world. The author who directed this programme describes the circumstances that led to this initiative, the ideas borrowed and adapted from the corporate world, and the lessons learnt in setting up this intervention programme. The modus operandi of the programme is based on the Balanced Scorecard - a model which stresses four equally important components: customers, internal processes, financial health and learning and innovation. Other complementary actions like creating a sense of urgency, forging a vision with a core ideology, empowerment of team members, creating short-term wins, anchoring the changes and finding meaning in the work are vital for the programme to thrive. This model also emphasizes the importance of accountability through the measurability of indicators. These indicators included a significant reduction in the duration of untreated psychosis, a positive change in the referral patterns with better engagement of the primary health-care sector and an improvement in the quality of care for the patients. Much can be learnt from the business world in building and maintaining a public mental health programme. Effective change also requires effective leadership, and the successful implementation of certain strategic steps.

Development of Risk Assessment Matrix for NASA Engineering and Safety Center

NASA Technical Reports Server (NTRS)

Malone, Roy W., Jr.; Moses, Kelly

2004-01-01

This paper describes a study, which had as its principal goal the development of a sufficiently detailed 5 x 5 Risk Matrix Scorecard. The purpose of this scorecard is to outline the criteria by which technical issues can be qualitatively and initially prioritized. The tool using this score card has been proposed to be one of the information resources the NASA Engineering and Safety Center (NESC) takes into consideration when making decisions with respect to incoming information on safety concerns across the entire NASA agency. The contents of this paper discuss in detail each element of the risk matrix scorecard, definitions for those elements and the rationale behind the development of those definitions. This scorecard development was performed in parallel with the tailoring of the existing Futron Corporation Integrated Risk Management Application (IRMA) software tool. IRMA was tailored to fit NESC needs for evaluating incoming safety concerns and was renamed NESC Assessment Risk Management Application (NAFMA) which is still in developmental phase.

Developing Indicators for the Child and Youth Mental Health System in Ontario.

PubMed

Yang, Julie; Kurdyak, Paul; Guttmann, Astrid

2016-01-01

When the Government of Ontario launched a comprehensive mental health and addictions strategy, the Institute for Clinical Evaluative Sciences (ICES) was tasked with developing a scorecard for ongoing monitoring of the child and youth mental health system. Using existing administrative and survey-based healthcare and education data, researchers at ICES developed a scorecard consisting of 25 indicators that described at-risk populations, child and youth mental healthcare and relevant outcomes. This scorecard is the first in Canada to report on performance indicators for the child and youth mental health system and provides a model for monitoring child and youth mental health using routinely collected administrative data.

Creating healthy work environments: a strategic perspective.

PubMed

Adamson, Bonnie J

2010-01-01

Although I find Graham Lowe and Ben Chan's logic model and work environment metrics thought provoking, a healthy work environment framework must be more comprehensive and consider the addition of recommended diagnostic tools, vehicles to deliver the necessary change and a sustainability strategy that allows for the tweaking and refinement of ideas. Basic structure is required to frame and initiate an effective process, while allowing creativity and enhancements to be made by organizations as they learn. I support the construction of a suggested Canadian health sector framework for measuring the health of an organization, but I feel that organizations need to have some freedom in that design and the ability to incorporate their own indicators within the established proven drivers. Reflecting on my organization's experience with large-scale transformation efforts, I find that emotional intelligence along with formal leadership development and front-line engagement in Lean process improvement activities are essential for creating healthy work environments that produce the balanced set of outcomes listed in my hospital's Balanced Scorecard.

Creating an Equity State of Mind: A Learning Process

ERIC Educational Resources Information Center

Pickens, Augusta Maria

2012-01-01

The Diversity Scorecard Project evaluated in this study was created by the University of Southern California's Center for Urban Education. It was designed to create awareness among institutional members about the state of inequities in educational outcomes for underrepresented students. The Diversity Scorecard Project facilitators' aimed to…

Evaluation of the Service Review Model with Performance Scorecards

ERIC Educational Resources Information Center

Szabo, Thomas G.; Williams, W. Larry; Rafacz, Sharlet D.; Newsome, William; Lydon, Christina A.

2012-01-01

The current study combined a management technique termed "Service Review" with performance scorecards to enhance staff and consumer behavior in a human service setting consisting of 11 supervisors and 56 front-line staff working with 9 adult consumers with challenging behaviors. Results of our intervention showed that service review and…

What Leaders Need to Know and Do: A Leadership Competencies Scorecard

ERIC Educational Resources Information Center

Ruben, Brent D.

2006-01-01

Brent Ruben introduces readers to a framework that surveys, summarizes, and synthesizes a broad cross section of the contemporary writings on leadership. The book organizes that literature into five broad competency areas, each of which is composed of a number of themes, and provides a Leadership Competencies Scorecard Inventory that allows…

Consortial Collaboration and the Creation of an Assessment Instrument for Community-Based Learning

ERIC Educational Resources Information Center

Murphy, Margueritte S.; Flowers, Kathleen S.

2017-01-01

This article describes the development of the Community-Based Learning (CBL) Scorecard by a grant-funded consortium of liberal arts institutions. The aim of the scorecard was to promote assessment that improves student learning with an instrument that employs a quantitative scale, allowing for benchmarking across institutions. Extensive interviews…

[Application of the balanced scorecard for evaluating the training process].

PubMed

Picogna, Michele

2009-01-01

Over the last 20 years systems for standardizing nursing care have been elaborated and refined. Such systems are widely employed in teaching and research but very little in clinical practice (Kautz D., et al., 2006) ) However, it would be useful to integrate these systems with synthetic descriptions of nursing intervention to improve our knowledge of "offer and demand" in this field (Jungher, 2006). It is no coincidence that these systems are used more in countries where the type of health system makes it necessary to quantify the contribution of each single health operator in the overall care procedure. The aim of the study was to assess the relevance of the different classifications , considering them not only influenced by nursing but also to some degree influential.

VERB [TM] Summer Scorecard: Increasing Tween Girls' Vigorous Physical Activity

ERIC Educational Resources Information Center

Alfonso, Moya L.; Thompson, Zachary; McDermott, Robert J.; Colquitt, Gavin; Jones, Jeffery A.; Bryant, Carol A.; Courtney, Anita H.; Davis, Jenna L.; Zhu, Yiliang

2013-01-01

Objective: We assessed changes in the frequency of self-reported physical activity (PA) among tween girls exposed and not exposed to the VERB [TM] Summer Scorecard (VSS) intervention in Lexington, Kentucky, during 2004, 2006, and 2007. Methods: Girls who reported 0-1 day per week of PA were classi?ed as having "little or no" PA. Girls…

A Scorecard on Gender Equality and Girls' Education in Asia, 1990-2000. Advocacy Brief

ERIC Educational Resources Information Center

Unterhalter, Elaine; Rajagopalan, Rajee; Challender, Chloe

2005-01-01

Background: Existing measures for access to and efficiency in the school system are very limited as measures of gender equality, even though there have been marked improvements in sex-disaggregated data. A methodology for developing a scorecard which measures gender equality in schooling and education partly based on Amartya Sen's capability…

Impacting Student Access through Federal Policy Changes: How College Presidents Interpret "The College Scorecard"

ERIC Educational Resources Information Center

Posillico, Joseph J.

2017-01-01

There has been significant growth in the number of regulations placed on colleges and universities in recent years. This type of growth contributes to the complex environment that exists for colleges and universities. The study focuses on the federal government's consumer information mandate and the release of "The College Scorecard."…

Characteristics of "Tween" Participants and Non-Participants in the VERB[TM] Summer Scorecard Physical Activity Promotion Program

ERIC Educational Resources Information Center

Nickelson, Jen; Alfonso, Moya L.; McDermott, Robert J.; Bumpus, Elizabeth C.; Bryant, Carol A.; Baldwin, Julie A.

2011-01-01

Creating community-based opportunities for youth to be physically active is challenging for many municipalities. A Lexington, Kentucky community coalition designed and piloted a physical activity program, "VERB[TM] summer scorecard (VSS)", leveraging the brand equity of the national VERB[TM]--It's What You Do! campaign. Key elements of…

The climate change performance scorecard and carbon estimates for national forest

Treesearch

John W. Coulston; Kellen Nelson; Christopher W. Woodall; David Meriwether; Gregory A. Reams

2012-01-01

The U.S. Forest Service manages 20 percent of the forest land in the United States. Both the Climate Change Performance Scorecard and the revised National Forest Management Act require the assessment of carbon stocks on these lands. We present circa 2010 estimates of carbon stocks for each national forest and recommendations to improve these estimates.

Structured scoring of supporting nursing tasks to enhance early discharge in geriatric rehabilitation: The BACK-HOME quasi-experimental study.

PubMed

Holstege, M S; Bakkers, E; van Balen, R; Gussekloo, J; Achterberg, W P; Caljouw, M A A

2016-12-01

In geriatric rehabilitation it is important to have timely discharge of patients, especially if they have low nursing support needs. However, no instruments are available to identify early discharge potential. To evaluate if weekly scoring of a nursing support scorecard in the evenings/nights and discussing the results in the multidisciplinary team meeting, leads to potential differences in discharge of geriatric rehabilitation patients. Quasi-experimental study with a reference cohort (n=200) and a Back-Home implementation cohort (n=283). Patients in geriatric rehabilitation in the four participating skilled nursing facilities in the Netherlands. Implementation of the nursing support scorecard during one year consisted of (1) weekly scoring of the scorecard to identify the supporting nursing tasks during the evenings/nights by trained nurses, and (2) discussion of the results in a multidisciplinary team meeting to establish if discharge home planning was feasible. Data on patients' characteristics and setting before admission were collected at admission; at discharge, the length of stay, discharge destination and barriers for discharge were collected by the nursing staff. Both cohorts were comparable with regard to median age, gender [reference cohort: 81 (IQR 75-88) years; 66% females vs. Back-Home cohort 82 (IQR 76-87) years; 71% females] and reasons for admission: stroke (23% vs. 23%), joint replacement (12% vs. 13%), traumatic injuries (31% vs. 34%), and other (35% vs. 30%). Overall, the median length of stay for the participants discharged home in the reference cohort was 56 (IQR 29-81) days compared to 46 (IQR 30-96) days in the Back-Home cohort (p=0.08). When no home adjustments were needed, participants were discharged home after 50 (IQR 29.5-97) days in the reference cohort, and after 42.5 (IQR 26-64.8) days in the Back-Home cohort (p=0.03). Reasons for discharge delay were environmental factors (36.7%) and patient-related factors, such as mental (21.5%) and physical capacity (33.9%). Structured scoring of supporting nursing tasks for geriatric rehabilitation patients may lead to earlier discharge from a skilled nursing facility to home, if no home adjustments are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of Colonoscopy Quality Measures Across Various Practice Settings and the Impact of Performance Scorecards.

PubMed

Inra, Jennifer A; Nayor, Jennifer; Rosenblatt, Margery; Mutinga, Muthoka; Reddy, Sarathchandra I; Syngal, Sapna; Kastrinos, Fay

2017-04-01

Quality performance measures for screening colonoscopy vary among endoscopists. The impact of practice setting is unknown. We aimed to (1) compare screening colonoscopy performance measures among three different US practice settings; (2) evaluate factors associated with adenoma detection; and (3) assess a scorecard intervention on performance metrics. This multi-center prospective study compared patient, endoscopist, and colonoscopy characteristics performed at a tertiary care hospital (TCH), community-based hospital (CBH), and private practice group (PPG). Withdrawal times (WT), cecal intubation, and adenoma detection rates (ADR) were compared by site at baseline and 12 weeks following scorecard distribution. Generalized linear mixed models identified factors associated with adenoma detection. Twenty-eight endoscopists performed colonoscopies on 1987 asymptomatic, average-risk individuals ≥50 years. Endoscopist and patient characteristics were similar across sites. The PPG screened more men (TCH: 42.8%, CBH: 45.0%, PPG: 54.2%; p < 0.0001). Preparation quality varied with good/excellent results in 70.6, 88.3, and 92% of TCH, CBH, and PPG cases, respectively (p < 0.0001). Male ADRs, cecal intubation, and WT exceeded recommended benchmarks despite variable results at each site; female ADRs were <15% at the PPG which screened the fewest females. Performance remained unchanged following scorecard distribution. Adenoma detection was associated with increasing patient age, male gender, WT, adequate preparation, but not practice setting. Each practice performed high-quality screening colonoscopy. Scorecards did not improve performance metrics. Preparation quality varies among practice settings and can be modified to improve adenoma detection.

Social and Student Engagement and Support: The Sloan-C Quality Scorecard for the Administration of Online Programs

ERIC Educational Resources Information Center

Moore, Janet C.; Shelton, Kaye

2013-01-01

As combinations of place-based, blended and fully online education proliferate, so do options for support and services. Aligning with regional accreditation criteria, the Sloan-C Quality Scorecard for the Administration of Online Programs is a useful way for institutions to measure and compare the quality of social and student engagement and…

12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

Code of Federal Regulations, 2014 CFR

2014-01-01

... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

Code of Federal Regulations, 2013 CFR

2013-01-01

... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

Code of Federal Regulations, 2012 CFR

2012-01-01

... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

A Framework for Six Sigma Project Selection in Higher Educational Institutions, Using a Weighted Scorecard Approach

ERIC Educational Resources Information Center

Holmes, Monica C.; Jenicke, Lawrence O.; Hempel, Jessica L.

2015-01-01

Purpose: This paper discusses the importance of the Six Sigma selection process, describes a Six Sigma project in a higher educational institution and presents a weighted scorecard approach for project selection. Design/Methodology/Approach: A case study of the Six Sigma approach being used to improve student support at a university computer help…

Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management.

PubMed

Jiménez-Rodríguez, Enrique; Feria-Domínguez, José Manuel; Sebastián-Lacave, Alonso

2018-03-30

Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData ® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.

Are performance measurement systems useful? Perceptions from health care.

PubMed

Demartini, Chiara; Trucco, Sara

2017-01-31

Prior literature identified the use of Performance Measurement Systems (PMS) as crucial in addressing improved processes of care. Moreover, a strategic use of PMS has been found to enhance quality, compared to non-strategic use, although a clear understanding of this linkage is still to be achieved. This paper deals with the test of direct and indirect models related to the link between the strategic use of PMS and the level of improved processes in health care organizations. Indirect models were mediated by the degree of perceived managerial discretion. A PLS analysis on a survey of 97 Italian managers working for health care organizations in the Lombardy region was conducted. The response rate was 77.6%. The strategic use of PMS in health care organizations directly and significantly (p < 0.001) enhances performance in terms of improved processes. Perceived managerial discretion is positively and significantly (p < 0.001) affected by the strategic use of PMS, whereas the mediation effect is non-significant. This study contributes to the literature investigating the design and implementation of a non-financial measurement tool, such as the non-financial information included into a balanced scorecard (BSC), in health care organizations. Managers in health care organizations can benefit from the strategic use of PMS to effectively allocate their time to strategic opportunities and threats, which might arise and affect organizational, output-related performance, such as improving processes.

Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management

PubMed Central

Jiménez-Rodríguez, Enrique; Sebastián-Lacave, Alonso

2018-01-01

Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls. PMID:29601529

Strategic planning and radiology practice management in the new health care environment.

PubMed

Sharpe, Richard E; Mehta, Tejas S; Eisenberg, Ronald L; Kruskal, Jonathan B

2015-01-01

Current comprehensive health care reform in the United States demands that policy makers, insurers, providers, and patients work in reshaping the health care system to deliver care that is both more affordable and of higher quality. A tectonic shift is under way that runs contrary to the traditional goal of radiology groups to perform and interpret large numbers of imaging examinations. In fact, radiology service requisitions now must be evaluated for their appropriateness, possibly resulting in a reduction in the number of imaging studies performed. To be successful, radiology groups will have to restructure their business practices and strategies to align with the emerging health care paradigm. This article outlines a four-stage strategic framework that has aided corporations in achieving their goals and that can be readily adapted and applied by radiologists. The four stages are (a) definition and articulation of a purpose, (b) clear definition of strategic goals, (c) prioritization of specific strategic enablers, and (d) implementation of processes for tracking progress and enabling continuous adaptation. The authors provide practical guidance for applying specific tools such as analyses of strengths, weaknesses, opportunities, and threats (so-called SWOT analyses), prioritization matrices, and balanced scorecards to accomplish each stage. By adopting and applying these tools within the strategic framework outlined, radiology groups can position themselves to succeed in the evolving health care environment. RSNA, 2015

Model Multi Criteria Decision Making with Fuzzy ANP Method for Performance Measurement Small Medium Enterprise (SME)

NASA Astrophysics Data System (ADS)

Rahmanita, E.; Widyaningrum, V. T.; Kustiyahningsih, Y.; Purnama, J.

2018-04-01

SMEs have a very important role in the development of the economy in Indonesia. SMEs assist the government in terms of creating new jobs and can support household income. The number of SMEs in Madura and the number of measurement indicators in the SME mapping so that it requires a method.This research uses Fuzzy Analytic Network Process (FANP) method for performance measurement SME. The FANP method can handle data that contains uncertainty. There is consistency index in determining decisions. Performance measurement in this study is based on a perspective of the Balanced Scorecard. This research approach integrated internal business perspective, learning, and growth perspective and fuzzy Analytic Network Process (FANP). The results of this research areframework a priority weighting of assessment indicators SME.

A methodology toward manufacturing grid-based virtual enterprise operation platform

NASA Astrophysics Data System (ADS)

Tan, Wenan; Xu, Yicheng; Xu, Wei; Xu, Lida; Zhao, Xianhua; Wang, Li; Fu, Liuliu

2010-08-01

Virtual enterprises (VEs) have become one of main types of organisations in the manufacturing sector through which the consortium companies organise their manufacturing activities. To be competitive, a VE relies on the complementary core competences among members through resource sharing and agile manufacturing capacity. Manufacturing grid (M-Grid) is a platform in which the production resources can be shared. In this article, an M-Grid-based VE operation platform (MGVEOP) is presented as it enables the sharing of production resources among geographically distributed enterprises. The performance management system of the MGVEOP is based on the balanced scorecard and has the capacity of self-learning. The study shows that a MGVEOP can make a semi-automated process possible for a VE, and the proposed MGVEOP is efficient and agile.

System of Indicators in the Innovation Management: Business Intelligence Applied to Tourism

NASA Astrophysics Data System (ADS)

Lozada, Dayana; Araque, Francisco; Castillo, Jose Manuel; Salguero, Alberto; Delgado, Cecilia; Noda, Marcia; Hernández, Gilberto

The work presents an approach to study mechanisms that allows managers the Innovation Management (IM) measurements. It is assumed, as main motivation, the analysis of patterns for the design of an integral system of indicators. A methodology that integrates the thought process, focusing on the Business Intelligence and the Balance Scorecard will be presented. A group of indexes based on the multidimensionality of IM in organizations of the sector of tourism is proposed. To approach this quality it is necessary to contextualize, in the conditions of sectoral operation, the theories, models and systems used in our approach. It has been used intervention methods like experts' criteria, consensus search techniques by means of surveys, consultation of documents, and statistical methods such as analysis of the main components.

Financial management and dental school equity, Part II: Tactics.

PubMed

Chambers, David W; Bergstrom, Roy

2004-04-01

Financial management includes all processes that build organizations' equity through accumulating assets in strategically important areas. The tactical aspects of financial management are budget deployment and monitoring. Budget deployment is the process of making sure that costs are fairly allocated. Budget monitoring addresses issues of effective uses and outcomes of resources. This article describes contemporary deployment and monitoring mechanisms, including revenue positive and marginal analysis, present value, program phases, options logic, activity-based costing, economic value added, cost of quality, variance reconciliation, and balanced scorecards. The way financial decisions are framed affects comparative decision-making and even influences the arithmetic of accounting. Familiarity with these concepts should make it possible for dental educators to more fully participate in discussions about the relationships between budgeting and program strategy.

[Instruments of management accounting in german hospitals - potentials for competitive advantage and status quo].

PubMed

Berens, W; Lachmann, M; Wömpener, A

2011-03-01

The aim of this study is to provide an analysis of the status quo for the usage of instruments of management accounting in German hospitals. 600 managing directors of German hospitals were asked to answer a questionnaire about the usage of management accounting instruments in their hospitals. We obtained 121 usable datasets, which are evaluated in this study. A significant increase in the usage of management accounting instruments can be observed over time. The respondents have an overall positive perception of the usage of these instruments. Cost accounting and information systems are among the most widely used instruments, while widely discussed concepts like the balanced scorecard or clinical pathways show surprisingly low usage rates. © Georg Thieme Verlag KG Stuttgart · New York.

Application and Survey of Business Intelligence (BI) Tools within the Context of Military Decision Making

DTIC Science & Technology

2012-06-01

International Financial Reporting Standards ( IFRS ) are principles-based Standards, Interpretations and the Framework (1989) adopted by the International...direction of the organization and based on a four- perspective view of the world: Financial measures supported by customer, internal, and learning and...scorecard applications, financial consolidation, and statutory and financial reporting . 27 7. Performance Scorecards and Dashboards Dashboards and

Predicting in-hospital mortality after redo cardiac operations: development of a preoperative scorecard.

PubMed

Launcelott, Sebastian; Ouzounian, Maral; Buth, Karen J; Légaré, Jean-Francois

2012-09-01

The present study generated a risk model and an easy-to-use scorecard for the preoperative prediction of in-hospital mortality for patients undergoing redo cardiac operations. All patients who underwent redo cardiac operations in which the initial and subsequent procedures were performed through a median sternotomy were included. A logistic regression model was created to identify independent preoperative predictors of in-hospital mortality. The results were then used to create a scorecard predicting operative risk. A total of 1,521 patients underwent redo procedures between 1995 and 2010 at a single institution. Coronary bypass procedures were the most common previous (58%) or planned operations (54%). The unadjusted in-hospital mortality for all redo cases was higher than for first-time procedures (9.7% vs. 3.4%; p<0.001). Independent predictors of in-hospital mortality were a composite urgency variable (odds ratio [OR], 3.47), older age (70-79 years, OR, 2.74; ≥80 years, OR, 3.32), more than 2 previous sternotomies (OR, 2.69), current procedure other than isolated coronary or valve operation (OR, 2.64), preoperative renal failure (OR, 1.89), and peripheral vascular disease (PVD) (OR, 1.55); all p<0.05. A scorecard was generated using these independent predictors, stratifying patients undergoing redo cardiac operations into 6 risk categories of in-hospital mortality ranging from <5% risk to >40%. Reoperation represents a significant proportion of modern cardiac surgical procedures and is often associated with significantly higher mortality than first-time operations. We created an easy-to-use scorecard to assist clinicians in estimating operative mortality to ensure optimal decision making in the care of patients facing redo cardiac operations. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Application of Lean Healthcare methodology in a urology department of a tertiary hospital as a tool for improving efficiency.

PubMed

Boronat, F; Budia, A; Broseta, E; Ruiz-Cerdá, J L; Vivas-Consuelo, D

To describe the application of the Lean methodology as a method for continuously improving the efficiency of a urology department in a tertiary hospital. The implementation of the Lean Healthcare methodology in a urology department was conducted in 3 phases: 1) team training and improvement of feedback among the practitioners, 2) management by process and superspecialisation and 3) improvement of indicators (continuous improvement). The indicators were obtained from the Hospital's information systems. The main source of information was the Balanced Scorecard for health systems management (CUIDISS). The comparison with other autonomous and national urology departments was performed through the same platform with the help of the Hospital's records department (IASIST). A baseline was established with the indicators obtained in 2011 for the comparative analysis of the results after implementing the Lean Healthcare methodology. The implementation of this methodology translated into high practitioner satisfaction, improved quality indicators reaching a risk-adjusted complication index (RACI) of 0.59 and a risk-adjusted mortality rate (RAMR) of 0.24 in 4 years. A value of 0.61 was reached with the efficiency indicator (risk-adjusted length of stay [RALOS] index), with a savings of 2869 stays compared with national Benchmarking (IASIST). The risk-adjusted readmissions index (RARI) was the only indicator above the standard, with a value of 1.36 but with progressive annual improvement of the same. The Lean methodology can be effectively applied to a urology department of a tertiary hospital to improve efficiency, obtaining significant and continuous improvements in all its indicators, as well as practitioner satisfaction. Team training, management by process, continuous improvement and delegation of responsibilities has been shown to be the fundamental pillars of this methodology. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Computational intelligence for the Balanced Scorecard: studying performance trends of hemodialysis clinics.

PubMed

Cattinelli, Isabella; Bolzoni, Elena; Chermisi, Milena; Bellocchio, Francesco; Barbieri, Carlo; Mari, Flavio; Amato, Claudia; Menzer, Marcus; Stopper, Andrea; Gatti, Emanuele

2013-07-01

The Balanced Scorecard (BSC) is a general, widely employed instrument for enterprise performance monitoring based on the periodic assessment of strategic Key Performance Indicators that are scored against preset targets. The BSC is currently employed as an effective management support tool within Fresenius Medical Care (FME) and is routinely analyzed via standard statistical methods. More recently, the application of computational intelligence techniques (namely, self-organizing maps) to BSC data has been proposed as a way to enhance the quantity and quality of information that can be extracted from it. In this work, additional methods are presented to analyze the evolution of clinic performance over time. Performance evolution is studied at the single-clinic level by computing two complementary indexes that measure the proportion of time spent within performance clusters and improving/worsening trends. Self-organizing maps are used in conjunction with these indexes to identify the specific drivers of the observed performance. The performance evolution for groups of clinics is modeled under a probabilistic framework by resorting to Markov chain properties. These allow a study of the probability of transitioning between performance clusters as time progresses for the identification of the performance level that is expected to become dominant over time. We show the potential of the proposed methods through illustrative results derived from the analysis of BSC data of 109 FME clinics in three countries. We were able to identify the performance drivers for specific groups of clinics and to distinguish between countries whose performances are likely to improve from those where a decline in performance might be expected. According to the stationary distribution of the Markov chain, the expected trend is best in Turkey (where the highest performance cluster has the highest probability, P=0.46), followed by Portugal (where the second best performance cluster dominates, with P=0.50), and finally Italy (where the second best performance cluster has P=0.34). These results highlight the ability of the proposed methods to extract insights about performance trends that cannot be easily extrapolated using standard analyses and that are valuable in directing management strategies within a continuous quality improvement policy. Copyright © 2013 Elsevier B.V. All rights reserved.

Standardized screening for periodontitis as an integral part of multidisciplinary management of adults with type 2 diabetes: an observational cross-sectional study of cohorts in the USA and UK

PubMed Central

Pumerantz, Andrew S; Bissett, Susan M; Dong, Fanglong; Ochoa, Cesar; Wassall, Rebecca R; Davila, Heidi; Barbee, Melanie; Nguyen, John; Vila, Pamela; Preshaw, Philip M

2017-01-01

Objective To determine prevalence and factors predictive of periodontitis by using a standardized assessment model in adults with type 2 diabetes. Research design and methods We performed an observational cross-sectional study to determine the burden of periodontitis in adults with type 2 diabetes attending urban, ambulatory referral centers in the USA and UK. Full-mouth probing was performed and periodontitis was diagnosed based on either a low (≥5 mm at ≥1 site) or high pocket probing-depth threshold (≥6 mm at ≥1 site). Results were stratified into a five-stage schema and integrated with other clinical variables into the novel Diabetes Cross-Disciplinary Index to function as a balanced health scorecard. Corresponding demographic and routinely collected health data were obtained and comparisons were made between patients with and without periodontitis. Multivariable logistic regression was performed to identify factors predictive of the presence or absence of periodontitis. Results Between our two cohorts, 253 patients were screened. Caucasians comprised >90% and Hispanic Americans >75% of the UK and US cohorts, respectively. Males and females were equally distributed; mean age was 53.6±11 years; and 17 (6.7%) were edentulous. Of the 236 dentate patients, 128 (54.2%) had periodontitis by low threshold and 57 (24.2%) by high threshold. Just 17 (7.2%) were periodontally healthy. No significant differences in age, HbA1c, blood pressure, body mass index, low-density lipoprotein cholesterol, or smoking status (all p>0.05) were identified between those with or without periodontitis (regardless of threshold) and none was found to be a significant predictor of disease. Conclusions Periodontitis is frequent in adults with type 2 diabetes and all should be screened. Periodontal health status can be visualized with other comorbidities and complications using a novel balanced scorecard that could facilitate patient–clinician communication, shared decision-making, and prioritization of individual healthcare needs. PMID:28761663

Assessing the Value of a College Degree in Outdoor Education or Recreation: Institutional Comparisons Using the College Scorecard and Surveys of Faculty and Employers

ERIC Educational Resources Information Center

Seaman, Jayson; Bell, Brent J.; Trauntvein, Nate

2017-01-01

In this article, we report on research undertaken in 2016 to assess a number of trends influencing the current status of degree-granting outdoor programs in the United States, including factors that bear on the value of degrees. We analyze data provided by the U.S. Department of Education's College Scorecard and results of a survey comparing 59…

Quality initiatives: lean approach to improving performance and efficiency in a radiology department.

PubMed

Kruskal, Jonathan B; Reedy, Allen; Pascal, Laurie; Rosen, Max P; Boiselle, Phillip M

2012-01-01

Many hospital radiology departments are adopting "lean" methods developed in automobile manufacturing to improve operational efficiency, eliminate waste, and optimize the value of their services. The lean approach, which emphasizes process analysis, has particular relevance to radiology departments, which depend on a smooth flow of patients and uninterrupted equipment function for efficient operation. However, the application of lean methods to isolated problems is not likely to improve overall efficiency or to produce a sustained improvement. Instead, the authors recommend a gradual but continuous and comprehensive "lean transformation" of work philosophy and workplace culture. Fundamental principles that must consistently be put into action to achieve such a transformation include equal involvement of and equal respect for all staff members, elimination of waste, standardization of work processes, improvement of flow in all processes, use of visual cues to communicate and inform, and use of specific tools to perform targeted data collection and analysis and to implement and guide change. Many categories of lean tools are available to facilitate these tasks: value stream mapping for visualizing the current state of a process and identifying activities that add no value; root cause analysis for determining the fundamental cause of a problem; team charters for planning, guiding, and communicating about change in a specific process; management dashboards for monitoring real-time developments; and a balanced scorecard for strategic oversight and planning in the areas of finance, customer service, internal operations, and staff development. © RSNA, 2012.

Scorecards and social accountability for improved maternal and newborn health services: A pilot in the Ashanti and Volta regions of Ghana.

PubMed

Blake, Carolyn; Annorbah-Sarpei, Nii Ankonu; Bailey, Claire; Ismaila, Yakubu; Deganus, Sylvia; Bosomprah, Samuel; Galli, Francesco; Clark, Sarah

2016-12-01

With the limited availability of quality emergency obstetric and newborn care (EmONC) in Ghana, and a lack of dialogue on the issue at district level, the Evidence for Action (E4A) program (2011-2015) initiated a pilot intervention using a social accountability approach in two regions of Ghana. Using scorecards to assess and improve maternal and newborn health services, the intervention study evaluated the effectiveness of engaging multiple, health and non-health sector stakeholders at district level to improve the enabling environment for quality EmONC. The quantitative study component comprised two rounds of assessments in 37 health facilities. The qualitative component is based on an independent prospective policy study. Results show a marked growth in a culture of accountability, with heightened levels of community participation, transparency, and improved clarity of lines of accountability among decision-makers. The breadth and type of quality of care improvements were dependent on the strength of community and government engagement in the process, especially in regard to more complex systemic changes. Engaging a broad network of stakeholders to support MNH services has great potential if implemented in ways that are context-appropriate and that build around full collaboration with government and civil society stakeholders. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Ten years of preanalytical monitoring and control: Synthetic Balanced Score Card Indicator

PubMed Central

López-Garrigós, Maite; Flores, Emilio; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

2015-01-01

Introduction Preanalytical control and monitoring continue to be an important issue for clinical laboratory professionals. The aim of the study was to evaluate a monitoring system of preanalytical errors regarding not suitable samples for analysis, based on different indicators; to compare such indicators in different phlebotomy centres; and finally to evaluate a single synthetic preanalytical indicator that may be included in the balanced scorecard management system (BSC). Materials and methods We collected individual and global preanalytical errors in haematology, coagulation, chemistry, and urine samples analysis. We also analyzed a synthetic indicator that represents the sum of all types of preanalytical errors, expressed in a sigma level. We studied the evolution of those indicators over time and compared indicator results by way of the comparison of proportions and Chi-square. Results There was a decrease in the number of errors along the years (P < 0.001). This pattern was confirmed in primary care patients, inpatients and outpatients. In blood samples, fewer errors occurred in outpatients, followed by inpatients. Conclusion We present a practical and effective methodology to monitor unsuitable sample preanalytical errors. The synthetic indicator results summarize overall preanalytical sample errors, and can be used as part of BSC management system. PMID:25672466

Creating an outcomes framework.

PubMed

Doerge, J B

2000-01-01

Four constructs used to build a framework for outcomes management for a large midwestern tertiary hospital are described in this article. A system framework outlining a model of clinical integration and population management based in Steven Shortell's work is discussed. This framework includes key definitions of high-risk patients, target groups, populations and community. Roles for each level of population management and how they were implemented in the health care system are described. A point of service framework centered on seven dimensions of care is the next construct applied on each nursing unit. The third construct outlines the framework for role development. Three roles for nursing were created to implement strategies for target groups that are strategic disease categories; two of those roles are described in depth. The philosophy of nursing practice is centered on caring and existential advocacy. The final construct is the modification of the Dartmouth model as a common framework for outcomes. System applications of the scorecard and lessons learned in the 2-year process of implementation are shared

Evaluating building performance in healthcare facilities: an organizational perspective.

PubMed

Steinke, Claudia; Webster, Lynn; Fontaine, Marie

2010-01-01

Using the environment as a strategic tool is one of the most cost-effective and enduring approaches for improving public health; however, it is one that requires multiple perspectives. The purpose of this article is to highlight an innovative methodology that has been developed for conducting comprehensive performance evaluations in public sector health facilities in Canada. The building performance evaluation methodology described in this paper is a government initiative. The project team developed a comprehensive building evaluation process for all new capital health projects that would respond to the aforementioned need for stakeholders to be more accountable and to better integrate the larger organizational strategy of facilities. The Balanced Scorecard, which is a multiparadigmatic, performance-based business framework, serves as the underlying theoretical framework for this initiative. It was applied in the development of the conceptual model entitled the Building Performance Evaluation Scorecard, which provides the following benefits: (1) It illustrates a process to link facilities more effectively to the overall mission and goals of an organization; (2) It is both a measurement and a management system that has the ability to link regional facilities to measures of success and larger business goals; (3) It provides a standardized methodology that ensures consistency in assessing building performance; and (4) It is more comprehensive than traditional building evaluations. The methodology presented in this paper is both a measurement and management system that integrates the principles of evidence-based design with the practices of pre- and post-occupancy evaluation. It promotes accountability and continues throughout the life cycle of a project. The advantage of applying this framework is that it engages health organizations in clarifying a vision and strategy for their facilities and helps translate those strategies into action and measurable performance outcomes.

Disease management 360 degrees: a scorecard approach to evaluating TRICARE's programs for asthma, congestive heart failure, and diabetes.

PubMed

Yang, Wenya; Dall, Timothy M; Zhang, Yiduo; Hogan, Paul F; Arday, David R; Gantt, Cynthia J

2010-08-01

To assess the effect of TRICARE's asthma, congestive heart failure, and diabetes disease management programs using a scorecard approach. EVALUATION MEASURES: Patient healthcare utilization, financial, clinical, and humanistic outcomes. Absolute measures were translated into effect size and incorporated into a scorecard. Actual outcomes for program participants were compared with outcomes predicted in the absence of disease management. The predictive equations were established from regression models based on historical control groups (n = 39,217). Z scores were calculated for the humanistic measures obtained through a mailed survey. Administrative records containing medical claims, patient demographics and characteristics, and program participation status were linked using an encrypted patient identifier (n = 57,489). The study time frame is 1 year prior to program inception through 2 years afterward (October 2005-September 2008). A historical control group was identified with the baseline year starting October 2003 and a 1-year follow-up period starting October 2004. A survey was administered to a subset of participants 6 months after baseline assessment (39% response rate). Within the observation window--24 months for asthma and congestive heart failure, and 15 months for the diabetes program--we observed modest reductions in hospital days and healthcare cost for all 3 programs and reductions in emergency visits for 2 programs. Most clinical outcomes moved in the direction anticipated. The scorecard provided a useful tool to track performance of 3 regional contractors for each of 3 diseases and over time.

Bega - Android-Based Beergame Simulation Software for Interactive Training and Innovation

NASA Astrophysics Data System (ADS)

Lestyánszka Škůrková, Katarína; Szander, Norina

2013-12-01

The supply chain management challenges and inventory holding problems can easily be demonstrated by the widely known BeerGame simulation. In the Szabó-Szoba R&D Laboratory, we developed an android-based software application for tablets and smart phones for the purpose of having an adaptable, entertaining and effective program which can provide a real life experience to the participants about the nature of the bullwhip effect. Having an appropriate and comprehensive performance measurement system with the critical parameters and KPIs is inevitable for finding the right solutions - We used four perspectives of the Balanced Scorecard method. The innovative force of our research is based on the trainings: the discussion on outcomes and the team learning. The purpose of the current development is to build a new feature in the software: an artificial client can substitute one or more players in the supply chain, which makes decisions by using genetic algorithms.

Environmental management on the basis of Complex Regional Indicators Concept: case of the Murmansk region

NASA Astrophysics Data System (ADS)

Kozlov, A.; Gutman, S.; Zaychenko, I.; Rytova, E.; Nijinskaya, P.

2015-09-01

The article presents an approach to sustainable environmental development of the Murmansk region of the Russian Federation based on the complex regional indicators as a transformation of a balance scorecard method. The peculiarities of Murmansk region connected with sustainable environmental development are described. The complex regional indicators approach allows to elaborate the general concept of complex regional development taking into consideration economic and non-economic factors with the focus on environmental aspects, accumulated environmental damage in particular. General strategic chart of sustainable environmental development of the Murmansk region worked out on the basis of complex regional indicators concept is composed. The key target indicators of sustainable ecological development of the Murmansk region are presented for the following strategic chart components: regional finance; society and market; industry and entrepreneurship; training, development and innovations. These charts are to be integrated with international environmental monitoring systems.

Strategic planning as a tool for achieving alignment in academic health centers.

PubMed

Higginbotham, Eve J; Church, Kathryn C

2012-01-01

After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare.

Venous thromboembolism in medical outpatients - a cross-sectional survey of risk assessment and prophylaxis.

PubMed

Lawall, Holger; Matthiessen, Andreas; Hohmann, Volker; Bramlage, Peter; Haas, Sylvia; Schellong, Sebastian

2011-01-01

The degree of thromboprophylaxis in medical outpatients is low despite a substantial risk for venous thromboembolism (VTE). This may be attributable to difficulties in assessing risk. Assessment tools like the Haas' scorecard aid in determining the need for thromboprophylaxis. We aimed at evaluating how the use of this tool may aid physicians in appropriately using anticoagulants. This was an epidemiological, cross-sectional survey of acute medically ill patients with limited mobility treated by general practitioners and internists. Risk assessment for VTE by the treating physician was compared to calculated risk. Of 8,123 patients evaluated between August 2006 and April 2008, 7,271 fulfilled the in- and exclusion criteria. Mean age was 69.4 ± 13.6 years, and 45.2% were male. Of these 82.8% were high risk based on their acute medical condition, 37.9% based on their underlying chronic condition. Immobilisation, heart failure, pneumonia, age, obesity, and major varicosis were the most frequently encountered risk factors. The agreement between the Haas' scorecard and physician indicated risk was high. At least 94.1% of patients with high risk received adequate anticoagulation mostly as low molecular weight heparins for a mean duration of 15.1 ± 30.5 days. There is a substantial risk for VTE in medical outpatients. Using a simple structured scorecard resulted in an overall appropriate risk assessment and high degree of anticoagulation. The scorecard may provide a tool to improve the overall awareness for VTE risk in medical outpatients, substantially improving the degree of prophylaxis in a patient population with largely underestimated risk.

Eco-design pilot project in China - Monsoon offer 2 upgrade

NASA Astrophysics Data System (ADS)

Thai, Roselyne; Liu, Guoguo

2017-11-01

During COP21, Schneider Electric has committed that 100% of our new products would be eco-designed to tackle climate change. Launched in 2015, this initiative ecoDesign WayTM was tested on some pilot projects. This project covers the first ecoDesign WayTM pilot in China on an overvoltage or under voltage protective device used in both residential and industrial sectors, called Monsoon. Under the name ecoDesign WayTM, a method and a process have been deployed. The 3 main ecoDesign WayTM phases are: phase 1 - Marketing & Technique handshake, Phase 2 - ecoDesign WayTM follow-up and Phase 3 - Marketing communication. During the project, EIME from Bureau Veritas CODDE and ecoDesign WayTM scorecard from EVEA consulting are two core tools for eco-design implementation. They are respectively used for life cycle assessment and eco-design performance comparison. Thanks to the approach, compared to previous range, pollution emissions and resource depletion along the whole life cycle of product have decreased (reduction of 55% for energy depletion and 85% for water depletion). Global warming potential has dramatically decreased by 98.4% and air pollution by 33%. Meanwhile, the recycling rate has been improved by 18%, and recycled PA is used. The ecoDesign WayTM scorecard is stored as referent document for any customer request. Moreover, customers can access RoHS certificate, REACh declaration, PEP and EoLI in Check a product, an online environmental data repository, available 24/7.

Individualized Performance Feedback to Surgical Residents Improves Appropriate Venous Thromboembolism Prophylaxis Prescription and Reduces Potentially Preventable VTE: A Prospective Cohort Study.

PubMed

Lau, Brandyn D; Arnaoutakis, George J; Streiff, Michael B; Howley, Isaac W; Poruk, Katherine E; Beaulieu, Robert; Ellison, Trevor A; Van Arendonk, Kyle J; Kraus, Peggy S; Hobson, Deborah B; Holzmueller, Christine G; Black, James H; Pronovost, Peter J; Haut, Elliott R

2016-12-01

To investigate the effect of providing personal clinical effectiveness performance feedback to general surgery residents regarding prescription of appropriate venous thromboembolism (VTE) prophylaxis. Residents are frequently charged with prescribing medications for patients, including VTE prophylaxis, but rarely receive individual performance feedback regarding these practice habits. This prospective cohort study at the Johns Hopkins Hospital compared outcomes across 3 study periods: (1) baseline, (2) scorecard alone, and (3) scorecard plus coaching. All general surgery residents (n = 49) and surgical patients (n = 2420) for whom residents wrote admission orders during the first 9 months of the 2013-2014 academic year were included. Outcomes included the proportions of patients prescribed appropriate VTE prophylaxis, patients with preventable VTE, and residents prescribing appropriate VTE prophylaxis for every patient, and results from the Accreditation Council for Graduate Medical Education resident survey. At baseline, 89.4% of patients were prescribed appropriate VTE prophylaxis and only 45% of residents prescribed appropriate prophylaxis for every patient. During the scorecard period, appropriate VTE prophylaxis prescription significantly increased to 95.4% (P < 0.001). For the scorecard plus coaching period, significantly more residents prescribed appropriate prophylaxis for every patient (78% vs 45%, P = 0.0017). Preventable VTE was eliminated in both intervention periods (0% vs 0.35%, P = 0.046). After providing feedback, significantly more residents reported receiving data about practice habits on the Accreditation Council for Graduate Medical Education resident survey (87% vs 38%, P < 0.001). Providing personal clinical effectiveness feedback including data and peer-to-peer coaching improves resident performance, and results in a significant reduction in harm for patients.

Using technology to enhance the quality of home health care: three case studies of health information technology initiatives at the visiting nurse service of New York.

PubMed

Russell, David; Rosenfeld, Peri; Ames, Sylvia; Rosati, Robert J

2010-01-01

There is a growing recognition among health services researchers and policy makers that Health Information Technology (HIT) has the potential to address challenging issues that face patients and providers of healthcare. The Visiting Nurse Service of New York (VNSNY), a large not-for-profit home healthcare agency, has integrated technology applications into the service delivery model of several programs. Case studies, including the development and implementation, of three informatics initiatives at VNSNY are presented on: (1) Quality Scorecards that utilize process, outcomes, cost, and satisfaction measures to assess performance among clinical staff and programs; (2) a tool to identify patients at risk of being hospitalized, and (3) a predictive model that identifies patients who are eligible for physical rehabilitation services. Following a description of these initiatives, we discuss their impact on quality and process indicators, as well as the opportunities and challenges to implementation. © 2010 National Association for Healthcare Quality.

[The development and validation of two scales on retribution practices: PRG-13 and PRE-21].

PubMed

Boada-Grau, Joan; Costa-Solé, Jordi; Gil-Ripoll, Carme; Vigil-Colet, Andreu

2012-01-01

The present study outlines the development process of two scales that measure general and specific retribution practices in organisations. Historically, retribution has been the subject of research of other social sciences such as Sociology and Business Administration. In Psychology, and more specifically in Work and Organisational Psychology, there are hardly any studies or inventories designed to evaluate retribution practices. In order to accomplish the objectives, a sample of 237 employees was selected, 42.6% of whom were women and 57.4% were men. We performed and exploratory factorial analysis using principal axis factoring as extraction method and an oblique rotation (oblimin) to analyse the two scales. The former is made up of four factors and the latter is a two-factor scale. The reliability coefficients of the six subscales we obtained ranged between .72 and .89. External validity was analysed using the correlations obtained between the two inventories and the Balanced Scorecard. The two tools were found to be two potentially useful scales to evaluate retribution practices.

Strategic Planning as a Tool for Achieving Alignment in Academic Health Centers

PubMed Central

Higginbotham, Eve J.; Church, Kathryn C.

2012-01-01

After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare. PMID:23303997

Measuring comparative hospital performance.

PubMed

Griffith, John R; Alexander, Jeffrey A; Jelinek, Richard C

2002-01-01

Leading healthcare provider organizations now use a "balanced scorecard" of performance measures, expanding information reviewed at the governance level to include financial, customer, and internal performance information, as well as providing an opportunity to learn and grow to provide better strategic guidance. The approach, successfully used by other industries, uses competitor data and benchmarks to identify opportunities for improved mission achievement. This article evaluates one set of nine multidimensional hospital performance measures derived from Medicare reports (cash flow, asset turnover, mortality, complications, length of inpatient stay, cost per case, occupancy, change in occupancy, and percent of revenue from outpatient care). The study examines the content validity, reliability and sensitivity, validity of comparison, and independence and concludes that seven of the nine measures (all but the two occupancy measures) represent a potentially useful set for evaluating most U.S. hospitals. This set reflects correctable differences in performance between hospitals serving similar populations, that is, the measures reflect relative performance and identify opportunities to make the organization more successful.

Values based decision making: a tool for achieving the goals of healthcare.

PubMed

Mills, Anne E; Spencer, Edward M

2005-03-01

The recognition that the success of the healthcare organization depends on its achievement of two interrelated goals is a relatively recent phenomenon. In its mid-history the healthcare organization was largely able to ignore cost issues. In its latter history, many would argue that it ignored its quality goals as it pursued its cost goals (15). Either approach, given declining revenues and a competitive landscape, is incompatible with continued responsible operation. If this is true, then tools that were appropriate when the healthcare organization was focused on the achievement of one or another of these goals are not adequate as the healthcare organization seeks to achieve both goals together. Thus, new perspectives and new tools must be found that help the organization address two intimately related but sometimes conflicting goals. Values based decision-making can be the perspective needed, and organization ethics is one tool that can be of use in supporting it within the institution. But there are caveats. In order for values based decision-making to be effective, leadership must take an active role in promoting its use. It must relinquish a degree of control and it must begin to trust its stakeholders to make decisions within the context of the organization's values and goals. This can be extremely difficult, as control by senior management is often seen as the only effective means of ensuring that correct decisions are made. There are additional difficulties in the healthcare organization. Control rests within two groups and the healthcare organization is operating in an environment in which variance elimination is emphasized as a means of controlling costs. This may be an appealing notion for revenue strapped healthcare organization leaders, but it implies greater control exerted by managers, not less. Relinquishing any degree of control is a frightening prospect, but it has been done successfully. An excellent example of leadership encouraging decisions based on values was presented by a unit administrator frustrated by the hierarchical structure and ponderous rituals of a traditional intensive care unit. Invoking a management tool called "the balanced scorecard" (which recognizes the multiplicity of goals and values in any organization) he identified the goals and values of the unit, and with the help and input of his staff he restructured it into functional multidisciplinary "teams" organized around tasks and goals which were based on values. The transformation of identities of unit members from their job description to their accomplishments improved both the efficiency of the unit and its morale--as well as resulting in cost savings. In this example teams had to learn to work together, collaborate and disregard the fear of doing things differently. Staff had to be motivated and feedback was necessary to ensure goals rather then rules were being meet. The balanced scorecard was implemented with mechanisms to support the communication and collaboration necessary to achieve the goals of the unit. The experiment was successful, but only because leadership recognized that multiple goals and multiple values were involved, that were explicitly articulated with the priority of excellent care. But once leadership was sure that "shared vision" existed leadership was able to trust staff to make appropriate decisions to realize that vision.

Leveraging business intelligence to make better decisions: Part II.

PubMed

Reimers, Mona

2014-01-01

This article is the second in a series about business intelligence (BI) in a medical practice. The first article reviewed the evolution of data reporting within the industry and provided some examples of how BI concepts differ from the reports available in the menus of our software systems, or the dashboards and scorecards practices have implemented. This article will discuss how to begin a BI initiative for front-end medical practice staffers that will create tools they can use to reduce errors and increase efficiency throughout their workday. This type of BI rollout can allow practices to get started with very little financial investment, gain enthusiasm from end users, and achieve a quick return on investment. More examples of successful BI projects in medical practices are discussed to help illustrate BI concepts.

Evaluation and implementation of highly challenging balance training in clinical practice for people with Parkinson's disease: protocol for the HiBalance effectiveness-implementation trial.

PubMed

Leavy, Breiffni; Kwak, Lydia; Hagströmer, Maria; Franzén, Erika

2017-02-07

If people with progressive neurological diseases are to avail of evidence-based rehabilitation, programs found effective in randomized controlled trials (RCT's) must firstly be adapted and tested in clinical effectiveness studies as a means of strengthening their evidence base. This paper describes the protocol for an effectiveness-implementation trial that will assess the clinical effectiveness of a highly challenging balance training program (the HiBalance program) for people with mild-moderate Parkinson's disease (PD) while simultaneously collecting data concerning the way in which the program is implemented. The HiBalance program is systemically designed to target balance impairments in PD and has been shown effective at improving balance control and gait in a previous RCT. Study aims are to i) determine the effectiveness of the adapted HiBalance program on performance and self-rated outcomes such as balance control, gait and physical activity level ii) conduct a process evaluation of program implementation at the various clinics iii) determine barriers and facilitators to program implementation in these settings. This effectiveness-implementation type 1 hybrid study will use a non-randomized controlled design with consecutive inclusion of people with PD at multiple clinical sites. A mixed method approach will be used to collect clinical effectiveness data and process evaluation data which is both quantitative and qualitative in nature. The consolidated framework for implementation research (CFIR) will be used to guide the planning and collection of data concerning implementation barriers and facilitators. The HiBalance program will be provided by physical therapists as a part of standard rehabilitation care at the clinical sites, while the evaluation of the implementation process will be performed by the research group and funded by research grants. An effectiveness-implementation study design benefits patients by speeding up the process of translating findings from research settings to routine health care. Findings from this study will also be highly relevant for those working with neurological rehabilitation when faced with decisions concerning the translation of training programs from efficacy studies to everyday clinical practice. ClinicalTrials.gov march 2016, NCT02727478 .

Evaluating the sub-national fidelity of national Initiatives in decentralized health systems: Integrated Primary Health Care Governance in Nigeria.

PubMed

Eboreime, Ejemai Amaize; Abimbola, Seye; Obi, Felix Abrahams; Ebirim, Obinna; Olubajo, Olalekan; Eyles, John; Nxumalo, Nonhlanhla Lynette; Mambulu, Faith Nankasa

2017-03-21

Policy making, translation and implementation in politically and administratively decentralized systems can be challenging. Beyond the mere sub-national acceptance of national initiatives, adherence to policy implementation processes is often poor, particularly in low and middle-income countries. In this study, we explore the implementation fidelity of integrated PHC governance policy in Nigeria's decentralized governance system and its implications on closing implementation gaps with respect to other top-down health policies and initiatives. Having engaged policy makers, we identified 9 core components of the policy (Governance, Legislation, Minimum Service Package, Repositioning, Systems Development, Operational Guidelines, Human Resources, Funding Structure, and Office Establishment). We evaluated the level and pattern of implementation at state level as compared to the national guidelines using a scorecard approach. Contrary to national government's assessment of level of compliance, we found that sub-national governments exercised significant discretion with respect to the implementation of core components of the policy. Whereas 35 and 32% of states fully met national criteria for the structural domains of "Office Establishment" and Legislation" respectively, no state was fully compliant to "Human Resource Management" and "Funding" requirements, which are more indicative of functionality. The pattern of implementation suggests that, rather than implementing to improve outcomes, state governments may be more interested in executing low hanging fruits in order to access national incentives. Our study highlights the importance of evaluating implementation fidelity in providing evidence of implementation gaps towards improving policy execution, particularly in decentralized health systems. This approach will help national policy makers identify more effective ways of supporting lower tiers of governance towards improvement of health systems and outcomes.

Assessing the performance of centralized waiting lists for patients without a regular family physician using clinical-administrative data.

PubMed

Breton, Mylaine; Smithman, Mélanie Ann; Brousselle, Astrid; Loignon, Christine; Touati, Nassera; Dubois, Carl-Ardy; Nour, Kareen; Boivin, Antoine; Berbiche, Djamal; Roberge, Danièle

2017-01-05

With 4.6 million patients who do not have a regular family physician, Canada performs poorly compared to other OECD countries in terms of attachment to a family physician. To address this issue, several provinces have implemented centralized waiting lists to coordinate supply and demand for attachment to a family physician. Although significant resources are invested in these centralized waiting lists, no studies have measured their performance. In this article, we present a performance assessment of centralized waiting lists for unattached patients implemented in Quebec, Canada. We based our approach on the Balanced Scorecard method. A committee of decision-makers, managers, healthcare professionals, and researchers selected five indicators for the performance assessment of centralized waiting lists, including both process and outcome indicators. We analyzed and compared clinical-administrative data from 86 centralized waiting lists (GACOs) located in 14 regions in Quebec, from April 1, 2013, to March 31, 2014. During the study period, although over 150,000 patients were attached to a family physician, new requests resulted in a 30% median increase in patients on waiting lists. An inverse correlation of average strength was found between the rates of patients attached to a family physician and the proportion of vulnerable patients attached to a family physician meaning that as more patients became attached to an FP through GACOs, the proportion of vulnerable patients became smaller (r = -0.31, p < 0.005). The results showed very large performance variations both among GACOs of different regions and among those of a same region for all performance indicators. Centralized waiting lists for unattached patients in Quebec seem to be achieving their twofold objective of attaching patients to a family physician and giving priority to vulnerable patients. However, the demand for attachment seems to exceed the supply and there appears to be a tension between giving priority to vulnerable patients and attaching of a large number of patients. Results also showed heterogeneity in the performance of centralized waiting lists across Quebec. Finally, our findings suggest it is critical that similar mechanisms should use available data to identify the best strategies for reducing variations and improving performance.

Health and Well-Being Metrics in Business: The Value of Integrated Reporting.

PubMed

Pronk, Nicolaas P; Malan, Daniel; Christie, Gillian; Hajat, Cother; Yach, Derek

2018-01-01

Health and well-being (HWB) are material to sustainable business performance. Yet, corporate reporting largely lacks the intentional inclusion of HWB metrics. This brief report presents an argument for inclusion of HWB metrics into existing standards for corporate reporting. A Core Scorecard and a Comprehensive Scorecard, designed by a team of subject matter experts, based on available evidence of effectiveness, and organized around the categories of Governance, Management, and Evidence of Success, may be integrated into corporate reporting efforts. Pursuit of corporate integrated reporting requires corporate governance and ethical leadership and values that ultimately align with environmental, social, and economic performance. Agreement on metrics that intentionally include HWB may allow for integrated reporting that has the potential to yield significant value for business and society alike.

Strategic performance management: development of a performance measurement system at the Mayo Clinic.

PubMed

Curtright, J W; Stolp-Smith, S C; Edell, E S

2000-01-01

Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis.

Measuring nursing essential contributions to quality patient care outcomes.

PubMed

Wolgast, Kelly A; Taylor, Katherine; Garcia, Dawn; Watkins, Miko

2011-01-01

Workload Management System for Nursing (WMSN) is a core Army Medical Department business system that has provided near real-time, comprehensive nursing workload and manpower data for decision making at all levels for over 25 years. The Army Manpower Requirements and Documentation Agency populates data from WMSN into the Manpower Staffing Standards System (Inpatient module within Automated Staffing Assessment Model). The current system, Workload Management System for Nursing Internet (WMSNi), is an interim solution that requires additional functionalities for modernization and integration at the enterprise level. The expanding missions and approved requirements for WMSNi support strategic initiatives on the Army Medical Command balanced scorecard and require continued sustainment for multiple personnel and manpower business processes for both inpatient and outpatient nursing care. This system is currently being leveraged by the TRICARE Management Activity as an interim multiservice solution, and is being used at 24 Army medical treatment facilities. The evidenced-based information provided to Army decision makers through the methods used in the WMSNi will be essential across the Army Medical Command throughout the system's life cycle.

The imaging 3.0 informatics scorecard.

PubMed

Kohli, Marc; Dreyer, Keith J; Geis, J Raymond

2015-04-01

Imaging 3.0 is a radiology community initiative to empower radiologists to create and demonstrate value for their patients, referring physicians, and health systems. In image-guided health care, radiologists contribute to the entire health care process, well before and after the actual examination, and out to the point at which they guide clinical decisions and affect patient outcome. Because imaging is so pervasive, radiologists who adopt Imaging 3.0 concepts in their practice can help their health care systems provide consistently high-quality care at reduced cost. By doing this, radiologists become more valuable in the new health care setting. The authors describe how informatics is critical to embracing Imaging 3.0 and present a scorecard that can be used to gauge a radiology group's informatics resources and capabilities. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Perhaps I am one of the lucky ones.

PubMed

Heenan, Michael

2010-01-01

I recently participated in the Ontario Hospital Association (OHA) webinar on quality and safety, in which I was asked to address the topic of engaging physicians in performance measurement, quality and safety. I am not a physician, but much of my work in healthcare has involved working with clinical leaders in these areas. At St. Joseph's Healthcare Hamilton, we started our quality and safety journey by creating a medical quality scorecard specifically designed for physicians. The card, written in physician-friendly versus business language, enabled physicians to drop the traditional business quadrants of finance and human resources and select four quadrants focused on clinical process and outcome indicators that matched their daily practice. Quality improvement initiatives resulting from the scorecard included the launch of a sepsis-management campaign in the emergency room and a new approach to neonatal safety.

75 FR 32635 - Defense Acquisition Regulations System; Defense Federal Acquisition Regulation Supplement...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... Regulations System; Defense Federal Acquisition Regulation Supplement; Balance of Payments Program Exemption... implement the exemption from the Balance of Payments Program for construction material that is commercial... is proposing to amend the DFARS to implement in the clauses at 252.225-7044, Balance of Payments...

The ADE scorecards: a tool for adverse drug event detection in electronic health records.

PubMed

Chazard, Emmanuel; Băceanu, Adrian; Ferret, Laurie; Ficheur, Grégoire

2011-01-01

Although several methods exist for Adverse Drug events (ADE) detection due to past hospitalizations, a tool that could display those ADEs to the physicians does not exist yet. This article presents the ADE Scorecards, a Web tool that enables to screen past hospitalizations extracted from Electronic Health Records (EHR), using a set of ADE detection rules, presently rules discovered by data mining. The tool enables the physicians to (1) get contextualized statistics about the ADEs that happen in their medical department, (2) see the rules that are useful in their department, i.e. the rules that could have enabled to prevent those ADEs and (3) review in detail the ADE cases, through a comprehensive interface displaying the diagnoses, procedures, lab results, administered drugs and anonymized records. The article shows a demonstration of the tool through a use case.

Training Employers to Implement Health Promotion Programs: Results From the CDC Work@Health® Program.

PubMed

Cluff, Laurie A; Lang, Jason E; Rineer, Jennifer R; Jones-Jack, Nkenge H; Strazza, Karen M

2018-05-01

Centers for Disease Control and Prevention (CDC) initiated the Work@Health Program to teach employers how to improve worker health using evidence-based strategies. Program goals included (1) determining the best way(s) to deliver employer training, (2) increasing employers' knowledge of workplace health promotion (WHP), and (3) increasing the number of evidence-based WHP interventions at employers' worksites. This study is one of the few to examine the effectiveness of a program designed to train employers how to implement WHP programs. Pre- and posttest design. Training via 1 of 3 formats hands-on, online, or blended. Two hundred six individual participants from 173 employers of all sizes. Eight-module training curriculum to guide participants through building an evidence-based WHP program, followed by 6 to 10 months of technical assistance. The CDC Worksite Health ScoreCard and knowledge, attitudes, and behavior survey. Descriptive statistics, paired t tests, and mixed linear models. Participants' posttraining mean knowledge scores were significantly greater than the pretraining scores (61.1 vs 53.2, P < .001). A year after training, employers had significantly increased the number of evidence-based interventions in place (47.7 vs 35.5, P < .001). Employers' improvements did not significantly differ among the 3 training delivery formats. The Work@Health Program provided employers with knowledge to implement WHP interventions. The training and technical assistance provided structure, practical guidance, and tools to assess needs and select, implement, and evaluate interventions.

Comprehension Literacy Improvement Program Implementation and Balanced Literacy Impact on Elementary Students

ERIC Educational Resources Information Center

Gough, Timothy Jerome

2017-01-01

The purpose of this study was to determine how teachers in an urban school district implemented Comprehensive Literacy Improvement Program (CLIP) and balanced literacy framework in second through fifth grade classrooms by exploring the evidence of implementation of guided reading strategies. Instructional delivery, training methodology, phonemic…

For the last time: stock options are an expense.

PubMed

Bodie, Zvi; Kaplan, Robert S; Merton, Robert C

2003-03-01

Should stock options be recorded as an expense on a company's income statement and balance sheet, or should they remain where they are, relegated to footnotes? The extraordinary boom in share prices during the Internet bubble made critics of option expensing look like spoilsports. But since the crash, the debate has returned with a vengeance. And no wonder: The authors believe the case for expensing options is overwhelming. In this article, Nobel Iaureate Robert Merton, one of the inventors of the Black-Scholes option-pricing model; his coauthor on the classic textbook Finance, Zvi Bodie; and Robert Kaplan, creator of the Balanced Scorecard, examine and dismiss the principal claims put forward by those who continue to oppose options expensing. They demonstrate that stock-option grants do indeed have real cash-flow implications that need to be reported. They show that effective ways certainly exist to quantify those implications. They detail the distortions that relegating stock-option accounting to footnotes creates. And they show why reporting option costs should in no way hamper young companies in their efforts to provide incentives. Options are indeed a powerful incentive, the authors agree, and failing to record a transaction that creates such powerful effects is economically indefensible. Worse, it encourages companies to favor options over alternative incentive systems. It is not the proper role of accounting standards, the authors argue, to distort executive and employee compensation by subsidizing one particular form of compensation and no other. Companies should choose compensation methods according to their economic benefits--not the way they are reported.

Mastering the management system.

PubMed

Kaplan, Robert S; Norton, David P

2008-01-01

Companies have always found it hard to balance pressing operational concerns with long-term strategic priorities. The tension is critical: World-class processes won't lead to success without the right strategic direction, and the best strategy in the world will get nowhere without strong operations to execute it. In this article, Kaplan, of Harvard Business School, and Norton, founder and director of the Palladium Group, explain how to effectively manage both strategy and operations by linking them tightly in a closed-loop management system. The system comprises five stages, beginning with strategy development, which springs from a company's mission, vision, and value statements, and from an analysis of its strengths, weaknesses, and competitive environment. In the next stage, managers translate the strategy into objectives and initiatives with strategy maps, which organize objectives by themes, and balanced scorecards, which link objectives to performance metrics. Stage three involves creating an operational plan to accomplish the objectives and initiatives; it includes targeting process improvements and preparing sales, resource, and capacity plans and dynamic budgets. Managers then put plans into action, monitoring their effectiveness in stage four. They review operational, environmental, and competitive data; assess progress; and identify barriers to execution. In the final stage, they test the strategy, analyzing cost, profitability, and correlations between strategy and performance. If their underlying assumptions appear faulty, they update the strategy, beginning another loop. The authors present not only a comprehensive blueprint for successful strategy execution but also a managerial tool kit, illustrated with examples from HSBC Rail, Cigna Property and Casualty, and Store 24. The kit incorporates leading management experts' frameworks, outlining where they fit into the management cycle.

Evaluating the use of antibiotic prophylaxis during open reduction and internal fixation surgery in patients at low risk of surgical site infection.

PubMed

Xu, Sheng-Gen; Mao, Zhao-Guang; Liu, Bin-Sheng; Zhu, Hui-Hua; Pan, Hui-Lin

2015-02-01

Widespread overuse and inappropriate use of antibiotics contribute to increasingly antibiotic-resistant pathogens and higher health care costs. It is not clear whether routine antibiotic prophylaxis can reduce the rate of surgical site infection (SSI) in low-risk patients undergoing orthopaedic surgery. We designed a simple scorecard to grade SSI risk factors and determined whether routine antibiotic prophylaxis affects SSI occurrence during open reduction and internal fixation (ORIF) orthopaedic surgeries in trauma patients at low risk of developing SSI. The SSI risk scorecard (possible total points ranged from 5 to 25) was designed to take into account a patient's general health status, the primary cause of fractures, surgical site tissue condition or wound class, types of devices implanted, and surgical duration. Patients with a low SSI risk score (≤8 points) who were undergoing clean ORIF surgery were divided into control (routine antibiotic treatment, cefuroxime) and evaluation (no antibiotic treatment) groups and followed up for 13-17 months after surgery. The infection rate was much higher in patients with high SSI risk scores (≥9 points) than in patients with low risk scores assigned to the control group (10.7% vs. 2.2%, P<0.0001). SSI occurred in 11 of 499 patients in the control group and in 13 of 534 patients in the evaluation group during the follow-up period of 13-17 months. The SSI occurrence rate did not differ significantly (2.2% vs. 2.4%, P=0.97) between the control and evaluation groups. Routine antibiotic prophylaxis does not significantly decrease the rate of SSI in ORIF surgical patients with a low risk score. Implementation of this scoring system could guide the rational use of perioperative antibiotics and ultimately reduce antibiotic resistance, health care costs, and adverse reactions to antibiotics. Copyright © 2014 Elsevier Ltd. All rights reserved.

Predicting chemically-induced skin reactions. Part I: QSAR models of skin sensitization and their application to identify potentially hazardous compounds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alves, Vinicius M.; Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599; Muratov, Eugene

Repetitive exposure to a chemical agent can induce an immune reaction in inherently susceptible individuals that leads to skin sensitization. Although many chemicals have been reported as skin sensitizers, there have been very few rigorously validated QSAR models with defined applicability domains (AD) that were developed using a large group of chemically diverse compounds. In this study, we have aimed to compile, curate, and integrate the largest publicly available dataset related to chemically-induced skin sensitization, use this data to generate rigorously validated and QSAR models for skin sensitization, and employ these models as a virtual screening tool for identifying putativemore » sensitizers among environmental chemicals. We followed best practices for model building and validation implemented with our predictive QSAR workflow using Random Forest modeling technique in combination with SiRMS and Dragon descriptors. The Correct Classification Rate (CCR) for QSAR models discriminating sensitizers from non-sensitizers was 71–88% when evaluated on several external validation sets, within a broad AD, with positive (for sensitizers) and negative (for non-sensitizers) predicted rates of 85% and 79% respectively. When compared to the skin sensitization module included in the OECD QSAR Toolbox as well as to the skin sensitization model in publicly available VEGA software, our models showed a significantly higher prediction accuracy for the same sets of external compounds as evaluated by Positive Predicted Rate, Negative Predicted Rate, and CCR. These models were applied to identify putative chemical hazards in the Scorecard database of possible skin or sense organ toxicants as primary candidates for experimental validation. - Highlights: • It was compiled the largest publicly-available skin sensitization dataset. • Predictive QSAR models were developed for skin sensitization. • Developed models have higher prediction accuracy than OECD QSAR Toolbox. • Putative chemical hazards in the Scorecard database were found using our models.« less

Evidence-based emergency medicine. Creating a system to facilitate translation of evidence into standardized clinical practice: a preliminary report.

PubMed

Wright, Stewart W; Trott, Alexander; Lindsell, Christopher J; Smith, Carol; Gibler, W Brian

2008-01-01

The Institute of Medicine, through its landmark report concerning errors in medicine, suggests that standardization of practice through systematic development and implementation of evidence-based clinical pathways is an effective way of reducing errors in emergency systems. The specialty of emergency medicine is well positioned to develop a complete system of innovative quality improvement, incorporating best practice guidelines with performance measures and practitioner feedback mechanisms to reduce errors and therefore improve quality of care. This article reviews the construction, ongoing development, and initial impact of such a system at a large, urban, university teaching hospital and at 2 affiliated community hospitals. The Committee for Procedural Quality and Evidence-Based Practice was formed within the Department of Emergency Medicine to establish evidence-based guidelines for nursing and provider care. The committee measures the effect of such guidelines, along with other quality measures, through pre- and postguideline patient care medical record audits. These measures are fed back to the providers in a provider-specific, peer-matched "scorecard." The Committee for Procedural Quality and Evidence-Based Practice affects practice and performance within our department. Multiple physician and nursing guidelines have been developed and put into use. Using asthma as an example, time to first nebulizer treatment and time to disposition from the emergency department decreased. Initial therapeutic agent changed and documentation improved. A comprehensive, guideline-driven, evidence-based approach to clinical practice is feasible within the structure of a department of emergency medicine. High-level departmental support with dedicated personnel is necessary for the success of such a system. Internet site development (available at http://www.CPQE.com) for product storage has proven valuable. Patient care has been improved in several ways; however, consistent and complete change in provider behavior remains elusive. Physician scorecards may play a role in altering these phenomena. Emergency medicine can play a leadership role in the development of quality improvement, error reduction, and pay-for-performance systems.

The contributions of library and information services to hospitals and academic health sciences centers: a preliminary taxonomy

PubMed Central

Abels, Eileen G.; Cogdill, Keith W.; Zach, Lisl

2002-01-01

Objectives: This article presents a taxonomy of the contributions of library and information services (LIS) in hospitals and academic health sciences centers. The taxonomy emerges from a study with three objectives: to articulate the value of LIS for hospitals and academic health sciences centers in terms of contributions to organizational missions and goals, to identify measures and measurable surrogates associated with each LIS contribution, and to document best practices for communicating the value of LIS to institutional administrators. Methods: The preliminary taxonomy of LIS contributions in hospitals and academic health sciences centers is based on a review of the literature, twelve semi-structured interviews with LIS directors and institutional administrators, and a focus group of administrators from five academic, teaching, and nonteaching hospitals. Results: Derived from the balanced scorecard approach, the taxonomy of LIS contributions is organized on the basis of five mission-level concepts and fifteen organizational goals. LIS contributions are included only if they have measurable surrogates. Conclusions: The taxonomy of LIS contributions offers a framework for the collection of both quantitative and qualitative data in support of communicating the value of LIS in hospitals and academic health sciences centers. PMID:12113510

[On the ultimate goal of management in Spanish hospitals].

PubMed

Pastor Tejedor, Jesús

2009-01-01

The European Foundation for Quality Management (EFQM) is the most introduced model in Spanish hospitals. The main target of this model is the internal and external client's satisfaction. The model of strategic management Balanced Scorecard (BSC) facilitates the alignment between management and the mission and vision of hospitals. For this reason, we propose a model of integrated management: EFQM-BSC. In order to obtain the items of this research, a survey was conducted among managers of Spanish hospitals on a battery of 46 indicators, selected from the EFQM model, and prioritised and included in the four perspectives of the BSC model. The research shows two possible models of hypothesis: the client model, where the final effect would be the client perspective (patient, staff and society's satisfaction), or the financial model, where the final effect would be the economic and financial results. After a reliability, dimension analysis and a discriminant analysis, it was obtained more consistent indicators which better explain each perspective. The relationship among these perspectives are determined by structural equations based on methods of partial least squares. The research confirms that the client model reflects a better consistency in its hypothesis.

Competitiveness measurement system in the advertising sector.

PubMed

Poveda-Bautista, Rocío; García-Melón, Mónica; Baptista, Doris C

2013-01-01

In this paper a new approach to find indicators that can be used to measure companies' competitiveness and performance in an efficient and reliable way is presented. The aim is to assist managers of companies within a specific industrial sector by providing information about their relative position in the market so as to define better action plans that may improve the company's performance. The approach combines the use of the Analytic Network Process, a multicriteria decision method, with the Balanced Scorecard. It allows the definition of a number of competitiveness indicators based on the performance and setting of the advertising sector. In this way it is possible to obtain a Competitiveness Index that allows a company to know its relative position with respect to other companies in the sector, and establish a ranking of the companies ordered by their competitiveness level. A case study in the advertising industry of Venezuela is provided. Results show that improvement plans for the agencies analyzed should promote creativity, innovation and the use of new technologies, as a particular form of innovation. These factors were considered to be the most relevant indicators in the advertising sector. The participating experts agreed that the methodology is useful and an improvement over current competitiveness assessment methods.

Analyzing key performance indicators (KPIs) for E-commerce and Internet marketing of elderly products: a review.

PubMed

Tsai, Yuan-Cheng; Cheng, Yu-Tien

2012-01-01

With the transformation of its population structure and economic environment, Taiwan is rapidly becoming an aging society. There is a growing need for elderly products, and therefore the operation of web shops that sell elderly products is important. In an era which values performance management, searching for key performance indicators (KPIs) helps to reveal, if the goals of a web shop are achieved. In the current study, researchers adopted the constructs of the Balanced Scorecard (BSC) to evaluate web shop performance. Additionally, the Delphi method, along with questionnaires, was used to develop 29 indicators. Finally, the decision making trial and evaluation laboratory (DEMATEL) method assisted in identifying the level of importance of the constructs, in which "internal process" ranked top, followed by "learning and growth", "customer", and "financial". "Internal process" was the key construct that impacted other factors, while "customer" was an important construct affected by other factors. By understanding the influences and relationships among the constructs, enterprises can conduct additional monitoring and management to achieve functions of prevention, continuous improvement, and innovation in order to shape their core competence. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Failure by Fragmentation.

ERIC Educational Resources Information Center

Gardner, Sid

1990-01-01

Because of a lack of program coordination and community accountability, services to children and youth are failing to address the problems of young people at risk. Collaboration among agencies can help social services to bypass program mentality. Communitywide interagency cooperation will include local scorecards, program linkages, and strategic…

Detail view of part of east side of building showing ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Detail view of part of east side of building showing scorecard and pencil holder - Fitzsimons General Hospital, Golf Course Waiting Shelter, Southwest area of Golf Course, 700 feet Northeast of intersection of West Harlow Avenue & Peoria Street, Aurora, Adams County, CO

Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model.

PubMed

Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

2012-01-01

Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. This is a combination (quantitative-qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective.

Impact of Game-Inspired Infographics on User Engagement and Information Processing in an eHealth Program

PubMed Central

Qian, Xiaokun; Deal, Allison M; Ribisl, Kurt M; Linnan, Laura A; Tate, Deborah F

2016-01-01

Background Online interventions providing individual health behavior assessment should deliver feedback in a way that is both understandable and engaging. This study focused on the potential for infographics inspired by the aesthetics of game design to contribute to these goals. Objective We conducted formative research to test game-inspired infographics against more traditional displays (eg, text-only, column chart) for conveying a behavioral goal and an individual’s behavior relative to the goal. We explored the extent to which the display type would influence levels of engagement and information processing. Methods Between-participants experiments compared game-inspired infographics with traditional formats in terms of outcomes related to information processing (eg, comprehension, cognitive load) and engagement (eg, attitudes toward the information, emotional tone). We randomly assigned participants (N=1162) to an experiment in 1 of 6 modules (tobacco use, alcohol use, vegetable consumption, fruit consumption, physical activity, and weight management). Results In the tobacco module, a game-inspired format (scorecard) was compared with text-only; there were no differences in attitudes and emotional tone, but the scorecard outperformed text-only on comprehension (P=.004) and decreased cognitive load (P=.006). For the other behaviors, we tested 2 game-inspired formats (scorecard, progress bar) and a traditional column chart; there were no differences in comprehension, but the progress bar outperformed the other formats on attitudes and emotional tone (P<.001 for all contrasts). Conclusions Across modules, a game-inspired infographic showed potential to outperform a traditional format for some study outcomes while not underperforming on other outcomes. Overall, findings support the use of game-inspired infographics in behavioral assessment feedback to enhance comprehension and engagement, which may lead to greater behavior change. PMID:27658469

Evaluation of the ProPublica Surgeon Scorecard "Adjusted Complication Rate" Measure Specifications.

PubMed

Ban, Kristen A; Cohen, Mark E; Ko, Clifford Y; Friedberg, Mark W; Stulberg, Jonah J; Zhou, Lynn; Hall, Bruce L; Hoyt, David B; Bilimoria, Karl Y

2016-10-01

The ProPublica Surgeon Scorecard is the first nationwide, multispecialty public reporting of individual surgeon outcomes. However, ProPublica's use of a previously undescribed outcome measure (composite of in-hospital mortality or 30-day related readmission) and inclusion of only inpatients have been questioned. Our objectives were to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. Using ACS-NSQIP data (2012-2014) for 8 ProPublica procedures and for All Operations, the proportion of cases meeting all ProPublica inclusion criteria was determined. We assessed the proportion of complications occurring inpatient, and thus not considered by ProPublica's measure. Finally, we compared risk-adjusted performance based on ProPublica's measure specifications to established ACS-NSQIP outcome measure performance (eg, death/serious morbidity, mortality). ProPublica's inclusion criteria resulted in elimination of 82% of all operations from assessment (range: 42% for total knee arthroplasty to 96% for laparoscopic cholecystectomy). For all ProPublica operations combined, 84% of complications occur during inpatient hospitalization (range: 61% for TURP to 88% for total hip arthroplasty), and are thus missed by the ProPublica measure. Hospital-level performance on the ProPublica measure correlated weakly with established complication measures, but correlated strongly with readmission (R = 0.834, P < 0.001). ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes. Thus, the validity of the ProPublica Surgeon Scorecard is questionable.

Impact of Game-Inspired Infographics on User Engagement and Information Processing in an eHealth Program.

PubMed

Comello, Maria Leonora G; Qian, Xiaokun; Deal, Allison M; Ribisl, Kurt M; Linnan, Laura A; Tate, Deborah F

2016-09-22

Online interventions providing individual health behavior assessment should deliver feedback in a way that is both understandable and engaging. This study focused on the potential for infographics inspired by the aesthetics of game design to contribute to these goals. We conducted formative research to test game-inspired infographics against more traditional displays (eg, text-only, column chart) for conveying a behavioral goal and an individual's behavior relative to the goal. We explored the extent to which the display type would influence levels of engagement and information processing. Between-participants experiments compared game-inspired infographics with traditional formats in terms of outcomes related to information processing (eg, comprehension, cognitive load) and engagement (eg, attitudes toward the information, emotional tone). We randomly assigned participants (N=1162) to an experiment in 1 of 6 modules (tobacco use, alcohol use, vegetable consumption, fruit consumption, physical activity, and weight management). In the tobacco module, a game-inspired format (scorecard) was compared with text-only; there were no differences in attitudes and emotional tone, but the scorecard outperformed text-only on comprehension (P=.004) and decreased cognitive load (P=.006). For the other behaviors, we tested 2 game-inspired formats (scorecard, progress bar) and a traditional column chart; there were no differences in comprehension, but the progress bar outperformed the other formats on attitudes and emotional tone (P<.001 for all contrasts). Across modules, a game-inspired infographic showed potential to outperform a traditional format for some study outcomes while not underperforming on other outcomes. Overall, findings support the use of game-inspired infographics in behavioral assessment feedback to enhance comprehension and engagement, which may lead to greater behavior change.

Health care, an easy target, needs to get its guard up.

PubMed

Ladika, Susan

2016-12-01

Health care ranked ninth in terms of its cybersecurity in a recent report by SecurityScorecard, a company that provides risk monitoring and security ratings. The health care industry is widely infected with malware and has come under repeated ransomware attacks.

An empirical assessment of high-performing medical groups: results from a national study.

PubMed

Shortell, Stephen M; Schmittdiel, Julie; Wang, Margaret C; Li, Rui; Gillies, Robin R; Casalino, Lawrence P; Bodenheimer, Thomas; Rundall, Thomas G

2005-08-01

The performance of medical groups is receiving increased attention. Relatively little conceptual or empirical work exists that examines the various dimensions of medical group performance. Using a national database of 693 medical groups, this article develops a scorecard approach to assessing group performance and presents a theory-driven framework for differentiating between high-performing versus low-performing medical groups. The clinical quality of care, financial performance, and organizational learning capability of medical groups are assessed in relation to environmental forces, resource acquisition and resource deployment factors, and a quality-centered culture. Findings support the utility of the performance scorecard approach and identification of a number of key factors differentiating high-performing from low-performing groups including, in particular, the importance of a quality-centered culture and the requirement of outside reporting from third party organizations. The findings hold a number of important implications for policy and practice, and the framework presented provides a foundation for future research.

Making Health System Performance Measurement Useful to Policy Makers: Aligning Strategies, Measurement and Local Health System Accountability in Ontario

PubMed Central

Veillard, Jeremy; Huynh, Tai; Ardal, Sten; Kadandale, Sowmya; Klazinga, Niek S.; Brown, Adalsteinn D.

2010-01-01

This study examined the experience of the Ontario Ministry of Health and Long-Term Care in enhancing its stewardship and performance management role by developing a health system strategy map and a strategy-based scorecard through a process of policy reviews and expert consultations, and linking them to accountability agreements. An evaluation of the implementation and of the effects of the policy intervention has been carried out through direct policy observation over three years, document analysis, interviews with decision-makers and systematic discussion of findings with other authors and external reviewers. Cascading strategies at health and local health system levels were identified, and a core set of health system and local health system performance indicators was selected and incorporated into accountability agreements with the Local Health Integration Networks. despite the persistence of such challenges as measurement limitations and lack of systematic linkage to decision-making processes, these activities helped to strengthen substantially the ministry's performance management function. PMID:21286268

A validity assessment of the Progress out of Poverty Index (PPI)™.

PubMed

Desiere, Sam; Vellema, Wytse; D'Haese, Marijke

2015-04-01

Development organisations need easy-to-use and quick-to-implement indicators to quantify poverty when requested to measure program impact. In this paper we assess the validity of the Progress out of Poverty Index (PPI)™, a country-specific indicator based on ten closed questions on directly observable household characteristics, by its compliance to the SMART criteria. Each response receives a pre-determined score, such that the sum of these scores can be converted into the likelihood the household is living below the poverty line. We focus on the PPI scorecard for Rwanda, which was validated using two national household surveys conducted in 2005/06 and 2010/11. The PPI is Specific, Measurable, Available cost effectively, and Timely available. Yet, its Relevance depends on the way it is used. Although it accurately distinguishes poor from non-poor households, making it a useful reporting tool, its limited sensitivity to changes in poverty status restricts its usefulness for evaluating the impact of development projects. Copyright © 2014 Elsevier Ltd. All rights reserved.

Perceptions of Nebraska Teachers Regarding the Transition from STARS to NeSA and Its Perceived Influence on the Implementation of a Balanced Assessment System

ERIC Educational Resources Information Center

Isom, Jamie

2012-01-01

The purpose of this explanatory mixed methods study was to explore the perceptions of Nebraska teachers about their experiences in the transition from STARS to NeSA. The study explored their perceptions of the influence of the transition on implementation of a balanced assessment system. As defined by NDE, a balanced system included NeSA testing,…

75 FR 72611 - Assessments, Large Bank Pricing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... the worst risk ranking and are included in the statistical analysis. Appendix 1 to the NPR describes the statistical analysis in detail. \\12\\ The percentage approximated by factors is based on the statistical model for that particual year. Actual weights assigned to each scorecard measure are largely based...

China's Efforts on Management, Surveillance, and Research of Noncommunicable Diseases: NCD Scorecard Project.

PubMed

Zhu, Xiao-Lei; Luo, Jie-Si; Zhang, Xiao-Chang; Zhai, Yi; Wu, Jing

The incidence of noncommunicable diseases (NCDs) is rising dramatically throughout the world. Aspects of researches concerned with the improvement and development of prevention and control of NCDs have been conducted. Furthermore, the influence of most determinants of the major NCDs has showed that a broad and deep response involving stakeholders in different sectors is required in the prevention and control of NCDs. China has experienced an increase in NCDs in a short period compared with many countries. To address the burden of NCDs in China, it is important to learn about the progress that has been made in prevention and control of NCDs in China and worldwide, informed by opinions of stakeholders in different areas. In 2014, GRAND South developed the NCD Scorecard instrument to evaluate progress of NCD prevention and control in 23 countries through a 2-round Delphi process. The scorecard included 51 indicators in 4 domains: governance, surveillance and research, prevention and risk factors, and health system response. Stakeholders were then selected in the areas of government, nongovernmental organizations, private sectors, and academia to join the NCD Scorecard survey. Indicators of progress were scored by stakeholders from 0 (no activity), 1 (present but not adequate), and 2 (adequate) to 3 (highly adequate) and then the percentage of progress in each domain was calculated, representing the current situation in each country. There were 14 indicators in the domains of governance and surveillance and research. Of 429 stakeholders worldwide, 41 in China participated in the survey. China scored in the top 5 out of all participating countries in those 2 domains, scoring 67% in governance and 64% in surveillance and research. Indicators on which China scored particularly well included having a well-resourced unit or department responsible for NCDs, having a strong national system for recording the cause of all deaths, and having a system of NCD surveillance. Areas where China had the greatest need for improvement included increasing taxes on tobacco and addressing the needs of the population older than age 70 dying from major NCDs. In China the burden of disease of NCDs and disabilities remains serious, although China has put significant efforts into its governance and surveillance and research. To improve, further action is needed on reducing tobacco consumption, increasing investment in the national health budget, and increasing the focus on system construction. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Virtual Environment TBI Screen (VETS)

DTIC Science & Technology

2014-10-01

balance challenges performed on a modified Wii Balance Board . Implementation of this device will enhance current approaches in TBI and mild TBI (i.e...TBI) screen (VETS) device in measuring standing balance . This system consists of software, a Wii balance board , and a large screen television that...Validate Wii ™ Balance Board relative to NeuroCom forceplate ! Running Wii Balance Board validation protocol. ! Milestone Achieved:

DistributedFBA.jl: High-level, high-performance flux balance analysis in Julia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heirendt, Laurent; Thiele, Ines; Fleming, Ronan M. T.

Flux balance analysis and its variants are widely used methods for predicting steady-state reaction rates in biochemical reaction networks. The exploration of high dimensional networks with such methods is currently hampered by software performance limitations. DistributedFBA.jl is a high-level, high-performance, open-source implementation of flux balance analysis in Julia. It is tailored to solve multiple flux balance analyses on a subset or all the reactions of large and huge-scale networks, on any number of threads or nodes. DistributedFBA.jl is a high-level, high-performance, open-source implementation of flux balance analysis in Julia. It is tailored to solve multiple flux balance analyses on amore » subset or all the reactions of large and huge-scale networks, on any number of threads or nodes.« less

DistributedFBA.jl: High-level, high-performance flux balance analysis in Julia

DOE PAGES

Heirendt, Laurent; Thiele, Ines; Fleming, Ronan M. T.

2017-01-16

Flux balance analysis and its variants are widely used methods for predicting steady-state reaction rates in biochemical reaction networks. The exploration of high dimensional networks with such methods is currently hampered by software performance limitations. DistributedFBA.jl is a high-level, high-performance, open-source implementation of flux balance analysis in Julia. It is tailored to solve multiple flux balance analyses on a subset or all the reactions of large and huge-scale networks, on any number of threads or nodes. DistributedFBA.jl is a high-level, high-performance, open-source implementation of flux balance analysis in Julia. It is tailored to solve multiple flux balance analyses on amore » subset or all the reactions of large and huge-scale networks, on any number of threads or nodes.« less

76 FR 67764 - Finance, Budget & Program Committee Board of Directors Meeting; Sunshine Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... NEIGHBORHOOD REINVESTMENT CORPORATION Finance, Budget & Program Committee Board of Directors..., Assistant Corporate Secretary (202) 220-2376; [email protected] . Agenda: I. Call To Order II. Executive Session III. Financial Report III. Budget Report IV. Lease Update V. Corporate Scorecard VI. NFMC & EHLP VII...

78 FR 53790 - Sunshine Act Meeting; Finance, Budget and Program Committee Meeting of the Board of Directors

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... NEIGHBORHOOD REINVESTMENT CORPORATION Sunshine Act Meeting; Finance, Budget and Program Committee... PERSON FOR MORE INFORMATION: Erica Hall, Assistant Corporate Secretary (202) 220-2376; [email protected] Education & Counseling VII. Quarterly Program Reports VIII. Financial Report IX. FY13 Corporate Scorecard...

76 FR 55125 - Finance, Budget & Program Committee Meeting of the Board of Directors; Sunshine Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... NEIGHBORHOOD REINVESTMENT CORPORATION Finance, Budget & Program Committee Meeting of the Board of..., Assistant Corporate Secretary, (202) 220-2376; [email protected] . AGENDA: I. CALL TO ORDER II. Financial Report III. Budget Report IV. Lease Update V. Corporate Scorecard VI. National Foreclosure Mitigation...

78 FR 65716 - Sunshine Act Meeting; Finance, Budget & Program Committee Meeting of the Board of Directors

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... NEIGHBORHOOD REINVESTMENT CORPORATION Sunshine Act Meeting; Finance, Budget & Program Committee Meeting of the Board of Directors TIME & DATE: 2:00 p.m., Thursday, November 7, 2013. PLACE: Telephonic.... Quarterly Program Reports C. Corporate Scorecard Report D. HUD Counseling Rule E. Grants Report VIII...

Impact of Competency-Based Education and Assessment on Program Outcomes

ERIC Educational Resources Information Center

Konkoth, Shanthi

2016-01-01

Since the publication of the "College Scorecard" by The U.S. Department of Education in 2015, comparisons between college attendance costs and institutional outcomes (i.e., graduation rates, post-graduation earnings) have come into sharp focus. This increased scrutiny requires institutions of higher learning to be more transparent about…

77 FR 15022 - Presidential Memorandum of February 21, 2012; Driving Innovation and Creating Jobs in Rural...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-14

...;and investigations, committee meetings, agency decisions and rulings, #0;delegations of authority... Affirmative Procurement Programs and Preferable Purchasing Programs, as applicable (as originally required by... emphasize biobased purchasing in the fiscal year 2012 and 2013 Sustainability/ Energy scorecard, which is...

75 FR 7513 - Notice of Proposed Information Collection: Comment Request; FHA TOTAL (Technology Open to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-19

... Information Collection: Comment Request; FHA TOTAL (Technology Open to Approved Lenders) Mortgage Scorecard... information collection requirement described below will be submitted to the Office of Management and Budget...-mail [email protected] or telephone (202) 402-8048 or the number for the Federal Information...

78 FR 24226 - Notice of Proposed Information Collection: Comment Request; FHA TOTAL (Technology Open to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... Information Collection: Comment Request; FHA TOTAL (Technology Open to Approved Lenders) Mortgage Scorecard... proposed information collection requirement described below will be submitted to the Office of Management... Information Service (1-800-877-8339). FOR FURTHER INFORMATION CONTACT: Karin B. Hill, Director, Office of...

Widening Participation: A Post-War Scorecard

ERIC Educational Resources Information Center

Tight, Malcolm

2012-01-01

Widening participation--though it has only recently been labelled as such--has been a continuing concern for policy makers and higher education institutions in the United Kingdom since 1945 (and before). This article reviews the evidence for four key target groups--women, lower socio-economic groups, mature adults and ethnic minorities--to produce…

Customer service: moving from slogan to point of differentiation.

PubMed

Thies, S

1999-01-01

To make its commitment to customer-centered care real, Dean Medical Center interviewed patients and created a "Vital Signs" scorecard. Performance is now measured according to those key areas specified by patients. Face-to-face communication from upper management to all employees and employee training has facilitated the program.

Charter School Laws: Ranking Scorecard.

ERIC Educational Resources Information Center

Center for Education Reform, Washington, DC.

This is the fifth report prepared by the Center for Education Reform (CER) evaluating the capacity and flexibility of state laws promoting charter schools. Three primary factors were evaluated in preparing charter-school quality rankings by state. The center finds that the establishment of multiple sponsoring authorities, in addition to local…

75 FR 22418 - FHA TOTAL Mortgage Scorecard

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-28

... and requirements to provide reports and loan samples at FHA's request, and appeals in writing for loss... requirements to provide reports and loan samples at FHA's request, and appeals in writing for loss of privilege... INFORMATION CONTACT: Leroy McKinney, Jr., Reports Management Officer, QDAM, Department of Housing and Urban...

The Balanced Reading Program: Helping All Students Achieve Success.

ERIC Educational Resources Information Center

Blair-Larsen, Susan M., Ed.; Williams, Kathryn A., Ed.

This book explains the methodologies, techniques, strategies, and knowledge base necessary to achieve a balanced reading program. The book's contributors define the key elements in a balanced reading program and provide guidelines for implementing a balanced instructional program in the classroom. Following an introduction which addresses…

Using Multithreading for the Automatic Load Balancing of 2D Adaptive Finite Element Meshes

NASA Technical Reports Server (NTRS)

Heber, Gerd; Biswas, Rupak; Thulasiraman, Parimala; Gao, Guang R.; Bailey, David H. (Technical Monitor)

1998-01-01

In this paper, we present a multi-threaded approach for the automatic load balancing of adaptive finite element (FE) meshes. The platform of our choice is the EARTH multi-threaded system which offers sufficient capabilities to tackle this problem. We implement the question phase of FE applications on triangular meshes, and exploit the EARTH token mechanism to automatically balance the resulting irregular and highly nonuniform workload. We discuss the results of our experiments on EARTH-SP2, an implementation of EARTH on the IBM SP2, with different load balancing strategies that are built into the runtime system.

Using Multi-threading for the Automatic Load Balancing of 2D Adaptive Finite Element Meshes

NASA Technical Reports Server (NTRS)

Heber, Gerd; Biswas, Rupak; Thulasiraman, Parimala; Gao, Guang R.; Saini, Subhash (Technical Monitor)

1998-01-01

In this paper, we present a multi-threaded approach for the automatic load balancing of adaptive finite element (FE) meshes The platform of our choice is the EARTH multi-threaded system which offers sufficient capabilities to tackle this problem. We implement the adaption phase of FE applications oil triangular meshes and exploit the EARTH token mechanism to automatically balance the resulting irregular and highly nonuniform workload. We discuss the results of our experiments oil EARTH-SP2, on implementation of EARTH on the IBM SP2 with different load balancing strategies that are built into the runtime system.

Impact of star performance ratings in English acute hospital trusts.

PubMed

Mannion, Russell; Davies, Huw; Marshall, Martin

2005-01-01

To explore some of the impacts of star performance ratings in acute hospital trusts in England. A multiple case study design was used which incorporated purposeful sampling of 'low' and 'high' performing trusts using the star rating system. In each case study site, data collection comprised semi-structured interviews and documentary analysis. Between eight and 12 senior managers and senior clinicians were interviewed in each organisation. There was a general view that the star ratings as presently constituted did not represent a rounded or balanced scorecard of their own organisation's performance and a widespread belief that the information used to calculate the ratings was often incomplete and inaccurate. The star ratings were viewed by some managers as useful, in that they gave added weight to their trust's modernisation agenda. In addition to driving beneficial change, the ratings were also sometimes reported to have inadvertently induced a range of unintended and dysfunctional consequences, including tunnel vision and a distortion of clinical priorities, bullying and intimidation, erosion of public trust and reduced staff morale, and ghettoisation. Set in the context of an international body of research, this study highlights some important gaps in knowledge and failings in current policy and practice. In particular, the many dysfunctional consequences of publishing star ratings indicate a need for a re-examination of performance management policies.

Service quality in contracted facilities.

PubMed

Rabbani, Fauziah; Pradhan, Nousheen Akber; Zaidi, Shehla; Azam, Syed Iqbal; Yousuf, Farheen

2015-01-01

The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework. Using a cross-sectional study design, two rural health centers (RHCs) contracted out to Aga Khan Health Service, Pakistan were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson χ2, Fisher's Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities. Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients' inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p=0.006). The study shows that contracting out initiatives have the potential to improve MNH care. This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.

A decision support tool to determine cost-to-benefit of a family-centered in-home program for at-risk adolescents.

PubMed

Wilson, Fernando A; Araz, Ozgur M; Thompson, Ronald W; Ringle, Jay L; Mason, W Alex; Stimpson, Jim P

2016-06-01

Family-centered program research has demonstrated its effectiveness in improving adolescent outcomes. However, given current fiscal constraints faced by governmental agencies, a recent report from the Institute of Medicine and National Research Council highlighted the need for cost-benefit analyses to inform decision making by policymakers. Furthermore, performance management tools such as balanced scorecards and dashboards do not generally include cost-benefit analyses. In this paper, we describe the development of an Excel-based decision support tool that can be used to evaluate a selected family-based program for at-risk children and adolescents relative to a comparison program or the status quo. This tool incorporates the use of an efficient, user-friendly interface with results provided in concise tabular and graphical formats that may be interpreted without need for substantial training in economic evaluation. To illustrate, we present an application of this tool to evaluate use of Boys Town's In-Home Family Services (IHFS) relative to detention and out-of-home placement in New York City. Use of the decision support tool can help mitigate the need for programs to contract experts in economic evaluation, especially when there are financial or time constraints. Copyright © 2016 Elsevier Ltd. All rights reserved.

Applying a managerial approach to day surgery.

PubMed

Onetti, Alberto

2008-01-01

The present article explores the day surgery topic assuming a managerial perspective. If we assume such a perspective, day surgery can be considered as a business model decision care and not just a surgical procedure alternative to the traditional ones requiring patient hospitalization. In this article we highlight the main steps required to develop a strategic approach [Cotta Ramusino E, Onetti A. Strategia d'Impresa. Milano; Il Sole 24 Ore; Second Edition, 2007] at hospital level (Onetti A, Greulich A. Strategic management in hospitals: the balanced scorecard approach. Milano: Giuffé; 2003) and to make day surgery part of it. It means understanding: - how and when day surgery can improve the health care providers' overall performance both in terms of clinical effectiveness and financial results, and, - how to organize and integrate it with the other hospital activities in order to make it work. Approaching day surgery as a business model decision requires to address in advance a list of potential issues and necessitates of continued audit to verify the results. If it does happen, day surgery can be both safe and cost effective and impact positively on surgical patient satisfaction. We propose a sort of "check-up list" useful to hospital managers and doctors that are evaluating the option of introducing day surgery or are trying to optimize it.

Championship management for healthcare organizations.

PubMed

Griffith, J R

2000-01-01

Stakeholders will put increasing pressure on integrated health systems (IHS) for measured performance, demanding data on quality and patient satisfaction, while simultaneously pressing for lower cost. The changes to Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) and the growing importance of the National Committee on Quality Assurance (NCQA) are simply forerunners of an intensifying trend. Quality of care in particular will face increasing scrutiny. Achieving competitive targets in these areas will also require measures addressing demand and worker satisfaction. "Balanced scorecard" approaches will allow IHS and their accountable work groups to track performance on several dimensions and establish integrated goals or targets. Those with consistently good scores will be labeled "champions." Champions will support the multidimensional measures with improved decision processes. About eight major processes will be central--governance/strategic management, clinical quality, clinical organization, financial planning, planning and marketing, information services, human resources, and plant services. It is possible to map these processes to the criteria of the Joint Commission, NCQA, and Malcolm Baldrige Quality Award. The processes themselves can be measured and common weaknesses identified and corrected. Champions share some common characteristics that seem to arise from the combination of processes and measures. Among these characteristics are service line orientation, extensive partnering with other organizations, and the possibility of outsourcing organizational components.

Quality indicators in the treatment of patients with depression, bipolar disorder or schizophrenia. Consensus study.

PubMed

Bernardo, Miquel; de Dios, Consuelo; Pérez, Víctor; Ignacio, Emilio; Serrano, Manuel; Vieta, Eduard; Mira, José Joaquín; Guilabert, Mercedes; Roca, Miquel

To define a set of indicators for mental health care, monitoring quality assurance in schizophrenia, depression and bipolar disorders in Spain. Qualitative research. Consensus-based study involving 6 psychiatrists on the steering committee and a panel of 43 psychiatrists working in several health services in Spain. An initial proposal of 44 indicators for depression, 42 for schizophrenia and 58 for bipolar disorder was elaborated after reviewing the literature. This proposal was analysed by experts using the Delphi technique. The valuation of these indicators in successive rounds allowed those with less degree of consensus to be discarded. Feasibility, sensitivity and clinical relevance were considered. The study was carried out between July 2015 and March 2016. Seventy indicators were defined by consensus: 17 for major depression, 16 for schizophrenia, 17 for bipolar disorder and 20 common to all three pathologies. These indicators included measures related to adequacy, patient safety, exacerbation, mechanical restraint, suicidal behaviour, psychoeducation, adherence, mortality and physical health. This set of indicators allows quality monitoring in the treatment of patients with schizophrenia, depression or bipolar disorder. Mental health care authorities and professionals can use this proposal for developing a balanced scorecard adjusted to their priorities and welfare objectives. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Dynamic game balancing implementation using adaptive algorithm in mobile-based Safari Indonesia game

NASA Astrophysics Data System (ADS)

Yuniarti, Anny; Nata Wardanie, Novita; Kuswardayan, Imam

2018-03-01

In developing a game there is one method that should be applied to maintain the interest of players, namely dynamic game balancing. Dynamic game balancing is a process to match a player’s playing style with the behaviour, attributes, and game environment. This study applies dynamic game balancing using adaptive algorithm in scrolling shooter game type called Safari Indonesia which developed using Unity. The game of this type is portrayed by a fighter aircraft character trying to defend itself from insistent enemy attacks. This classic game is chosen to implement adaptive algorithms because it has quite complex attributes to be developed using dynamic game balancing. Tests conducted by distributing questionnaires to a number of players indicate that this method managed to reduce frustration and increase the pleasure factor in playing.

Implementation of GAMMON - An efficient load balancing strategy for a local computer system

NASA Technical Reports Server (NTRS)

Baumgartner, Katherine M.; Kling, Ralph M.; Wah, Benjamin W.

1989-01-01

GAMMON (Global Allocation from Maximum to Minimum in cONstant time), an efficient load-balancing algorithm, is described. GAMMON uses the available broadcast capability of multiaccess networks to implement an efficient search technique for finding hosts with maximal and minimal loads. The search technique has an average overhead which is independent of the number of participating stations. The transition from the theoretical concept to a practical, reliable, and efficient implementation is described.

78 FR 40312 - 30-Day Notice of Proposed Information Collection: FHA TOTAL (Technology Open to Approved Lenders...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... the FHA Transformation Program, Single Family Housing is moving the TOTAL Scorecard to the Mortgage... used throughout the industry and are therefore listed as industry standard business practice. The...-0059 will be affected in the two initial transformation phases and Informed Consumer Choice Notice and...

Target Report No. 4. Legislative Scorecard.

ERIC Educational Resources Information Center

Dudley, Jim, Comp.; Von Kennel, Tim, Comp.

Votes of the Senators and Representatives on selected bills deemed important to students covering late 1976 and all of 1977 are presented along with the National Student Association and the National Student Lobby (NSA-NSL) rating of each Congressman. The rating is based on the percentage of times the Congressman voted in favor of the position that…

A Quality Scorecard for the Administration of Online Education Programs: A Delphi Study

ERIC Educational Resources Information Center

Shelton, Kaye

2010-01-01

As the demands for public accountability increase for the higher education industry, institutions are seeking methods for continuous improvement in order to demonstrate quality within programs and processes, including those provided through online education. Because of the rapid growth of online education programs, institutions are further called…

Alternative Fuels Data Center: Plug-In Electric Vehicle Readiness Scorecard

Science.gov Websites

track progress toward PEV readiness. Get started evaluating your community. Create Account Log in to your account. Email Password Forgot your password? LOG IN Public reporting burden for this collection of information is estimated to average (20.5 hours) per response, including the time for reviewing

Adapting a Community-Based Physical Activity Promotion Program for Rural, Diverse Youth

ERIC Educational Resources Information Center

Colquitt, Gavin; Walker, Ashley; Alfonso, Moya

2014-01-01

With school-aged youth spending less time in physical education, school-community-university partnerships offer potential to promote physical activity among school-aged youth. The VERB™ Summer Scorecard (VSS) program was designed in Lexington, Kentucky, to promote physical activity among "tweens" (8- to 13-year-olds). VSS since has been…

Food Scorecard.

ERIC Educational Resources Information Center

Jacobson, Michael; Wilson, Wendy

The importance of establishing good eating habits in youth as a means for laying the foundation of health in later life is discussed. This booklet contains charts that list nutritional scores for many common foods. These scores are measures of the overall nutritional content and value of the foods. Foods receive points for protein; vitamins A, B-2…

A Way Forward: How Higher Education Can Learn from Health Care

ERIC Educational Resources Information Center

Brooks, Beth A.

2017-01-01

Despite vigorous lobbying by advocacy groups at the federal and state levels, policies, and practices that are structurally very similar to those being opposed currently by university presidents--health care scorecards, value-based payments, and risk-sharing (i.e., "skin in the game" initiatives) are now very much realities in health…

Evaluating Multisystemic Efforts to Impact Disproportionality through Key Decision Points

ERIC Educational Resources Information Center

Derezotes, Dennette; Richardson, Brad; King, Connie Bear; Kleinschmit-Rembert, Julia; Pratt, Betty

2008-01-01

Working in four communities, Casey Foundation/Center for the Study of Social Policy (CSSP) Alliance on Racial Equity (the Alliance) have developed a Racial Equity Scorecard for measuring disproportionality at key decision points for use in impacting disproportionality in the child welfare system. The four communities include King County,…

Two-Phase Item Selection Procedure for Flexible Content Balancing in CAT

ERIC Educational Resources Information Center

Cheng, Ying; Chang, Hua-Hua; Yi, Qing

2007-01-01

Content balancing is an important issue in the design and implementation of computerized adaptive testing (CAT). Content-balancing techniques that have been applied in fixed content balancing, where the number of items from each content area is fixed, include constrained CAT (CCAT), the modified multinomial model (MMM), modified constrained CAT…

Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model

PubMed Central

Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

2012-01-01

Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. Conclusion: One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective. PMID:23555104

Balancing measures or a balanced accounting of improvement impact: a qualitative analysis of individual and focus group interviews with improvement experts in Scotland.

PubMed

Toma, Madalina; Dreischulte, Tobias; Gray, Nicola M; Campbell, Diane; Guthrie, Bruce

2018-07-01

As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement. We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions. Data were analysed iteratively using the framework approach. Participants described the consequences of improvement in terms of desirability/undesirability and the extent to which they were expected/unexpected when planning improvement. Four types of consequences were defined: expected desirable consequences ( goals ); expected undesirable consequences ( trade-offs ); unexpected undesirable consequences ( unpleasant surprises ); and unexpected desirable consequences ( pleasant surprises ). Unexpected consequences were considered important but rarely measured in existing programmes, and an improvement pause to take stock after implementation would allow these to be more actively identified and managed. A balanced accounting of all consequences of improvement interventions can facilitate staff engagement and reduce resistance to change, but has to be offset against the cost of additional data collection. Improvement measurement is usually focused on measuring intended goals , with minimal use of balancing measures which when used, typically monitor trade-offs expected before implementation. This paper proposes that improvers and leaders should seek a balanced accounting of all consequences of improvement across the life of an improvement programme, including deliberately pausing after implementation to identify and quantitatively or qualitatively evaluate any pleasant or unpleasant surprises. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluating the Role and Contribution of Innovation to Health and Wealth in the UK: A Review of Innovation, Health and Wealth: Phase 1 Final Report.

PubMed

Bienkowska-Gibbs, Teresa; Exley, Josephine; Saunders, Catherine L; Marjanovic, Sonja; Chataway, Joanna; MacLure, Calum; McDonald, Ruth; Ling, Tom

2016-06-20

The Department of Health's Innovation, Health and Wealth (IHW) strategy aimed to introduce a more strategic approach to the spread of innovation across the NHS. This study represents the first phase of a three-year evaluation and aims to map progress towards the IHW strategy and its component actions. This evaluation used a combination of quantitative and qualitative methods: document review, key informant interviews and stakeholder survey. This study also forms the basis for selecting case studies for phase two of the evaluation. Our findings from the interviews and survey suggest broad stakeholder support for the overarching ambitions of the IHW strategy. However, we found variable progress towards the overarching objectives of the eight IHW themes and an ambiguous relationship between many of the themes' objectives and their actions. It was difficult to assess progress on IHW's actions as commitment to the actions, implementation guidance and expected outcomes of the actions were not clearly articulated. The Academic Health Science Networks (AHSNs) and the Small Business Research Initiative (SBRI) were reported to be working well, which may be attributed to their clear structures of accountability and earmarked budgets. However, survey respondents and interviewees raised concerns that budgetary pressures may limit the impact of both AHSNs and the SBRI. The main challenges identified for ongoing action were the resources available for their implementation (e.g. Medtech Briefings), lack of awareness of the initiative (e.g. the NICE Implementation Collaborative) and the design of the actions (e.g. the Innovation Scorecard, web portal and High Impact Innovations).

Toward an Economic Mobility Ranking of U.S. Colleges. Evidence Speaks Reports, Vol 1, #6

ERIC Educational Resources Information Center

Chingos, Matthew M.; Blagg, Kristin

2015-01-01

The release of institution-level earnings information as part of the Obama Administration's new College Scorecard data has already spawned new "value-added" rankings based on the economic outcomes of students who attended similar institutions. These emerging rankings are an improvement on simple unadjusted rankings, but the wide variance…

Sustainability Indicators for the Army Installation Management Command

DTIC Science & Technology

2011-03-01

of brownfields remediated (no further actions required) and/or (b) per- centage of eligible brownfields re- mediated using sustainable remed...Sustainable Communities Scorecard • The SERDP-funded report by Alan Atkinson, David Berry, and Lee Hatcher (2009) entitled Sustainability Assessment ...Fitness (CSF) initiative focuses on sustaining resilience in our Soldiers, Families and Civilians through individual assessment and planning across

"What Can I Do with This Degree?"

ERIC Educational Resources Information Center

Wartel, Max

2015-01-01

As long as the question of what recent graduates can do with their degree is being asked, the need for comprehensive and trustworthy data will exist. Between the White House College Scorecard, the Rubio-Wyden-Warner Student Right to Know Before You Go Act, the USDOE's Title IV Federal Student Aid Programs: Gainful Employment in a Recognized…

Adaptation: Planning for climate change and its effects on federal lands

Treesearch

Marie Oliver; David L. Peterson; Michael J. Furniss

2012-01-01

National forest managers are charged with tackling the effects of climate change on the natural resources under their care. The Forest Service National Roadmap for Responding to Climate Change and the Climate Change Performance Scorecard require managers to make significant progress in addressing climate change by 2015. To help land managers meet this challenge,...

Re-Mediating Practitioners' Practice for Equity in Higher Education: Evaluating the Effectiveness of Action Research

ERIC Educational Resources Information Center

Vines, Erin

2012-01-01

This study examines the influence of action research on California community college practitioners' attitudes, beliefs, and behavior using the Center for Urban Education's (CUE) Equity Scorecard tools and process. This developmental evaluation study began March 2011 and concluded April 2012. The pseudonym of the field site studied is Las Flores…

Evaluating the Impact of CUE's Equity Scorecard Tools on Practitioner Beliefs and Practices

ERIC Educational Resources Information Center

Aguirre, Tomas A.

2012-01-01

This study examines the experiences of a number of participants from urban community colleges with high percentages of students from underrepresented populations in Central California. The participants were involved in action research with the Center for Urban Education (CUE) at the University of Southern California. The purpose of the study is to…

Factors Associated with Tweens' Intentions to Sustain Participation in an Innovative Community-Based Physical Activity Intervention

ERIC Educational Resources Information Center

DeBate, Rita D.; McDermott, Robert J.; Baldwin, Julie A.; Bryant, Carol A.; Courtney, Anita H.; Hogeboom, David L.; Nickelson, Jen; Phiilips, Leah M.; Alfonso, Moya L.

2009-01-01

Background: Participation in free-time play, including individual and group activities, is important during youth as patterns of physical activity established then persist into adulthood. The VERB Summer Scorecard (VSS) intervention is an innovative physical activity promotion initiative that offers tweens (8-13 year-olds) opportunities to be…

Student Success Scorecard: 2014 State of the System Report

ERIC Educational Resources Information Center

California Community Colleges, Chancellor's Office, 2014

2014-01-01

Community colleges are the primary point of access to higher education in California and the nation. This report, which is part of the Student Success Initiative, aims to provide analysis on how to close achievement gaps, improve outcomes for the system's 2.1 million students and present an unprecedented level of transparency and accountability on…

Measuring health systems strength and its impact: experiences from the African Health Initiative.

PubMed

Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

2017-12-21

Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and health financing, were the building blocks reported to be of lower focus. The African Health Initiative experience furthers the science of evaluation for health systems strengthening, highlighting areas for further methodological development - including the development of valid, feasible measures sensitive to interventions in multiple contexts (particularly in leadership and governance) and describing interactions across building blocks; in developing summary statistics to facilitate testing intervention effects on health systems and associations with health status; and designing appropriate analytic models for complex, multi-level open health systems.

Leveraging information technology to drive improvement in patient satisfaction.

PubMed

Nash, Mary; Pestrue, Justin; Geier, Peter; Sharp, Karen; Helder, Amy; McAlearney, Ann Scheck

2010-01-01

A healthcare organization's commitment to quality and the patient experience requires senior leader involvement in improvement strategies, and accountability for goals. Further, improvement strategies are most effective when driven by data, and in the world of patient satisfaction, evidence is growing that nurse leader rounding and discharge calls are strategic tactics that can improve patient satisfaction. This article describes how The Ohio State University Medical Center (OSUMC) leveraged health information technology (IT) to apply a data-driven strategy execution to improve the patient experience. Specifically, two IT-driven approaches were used: (1) business intelligence reporting tools were used to create a meaningful reporting system including dashboards, scorecards, and tracking reports and (2) an improvement plan was implemented that focused on two high-impact tactics and data to hardwire accountability. Targeted information from the IT systems enabled clinicians and administrators to execute these strategic tactics, and senior leaders to monitor achievement of strategic goals. As a result, OSUMC's inpatient satisfaction scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey improved from 56% nines and tens in 2006 to 71% in 2009. © 2010 National Association for Healthcare Quality.

Physician performance assessment using a composite quality index.

PubMed

Liu, Kaibo; Jain, Shabnam; Shi, Jianjun

2013-07-10

Assessing physician performance is important for the purposes of measuring and improving quality of service and reducing healthcare delivery costs. In recent years, physician performance scorecards have been used to provide feedback on individual measures; however, one key challenge is how to develop a composite quality index that combines multiple measures for overall physician performance evaluation. A controversy arises over establishing appropriate weights to combine indicators in multiple dimensions, and cannot be easily resolved. In this study, we proposed a generic unsupervised learning approach to develop a single composite index for physician performance assessment by using non-negative principal component analysis. We developed a new algorithm named iterative quadratic programming to solve the numerical issue in the non-negative principal component analysis approach. We conducted real case studies to demonstrate the performance of the proposed method. We provided interpretations from both statistical and clinical perspectives to evaluate the developed composite ranking score in practice. In addition, we implemented the root cause assessment techniques to explain physician performance for improvement purposes. Copyright © 2012 John Wiley & Sons, Ltd.

Valiant load-balanced robust routing under hose model for WDM mesh networks

NASA Astrophysics Data System (ADS)

Zhang, Xiaoning; Li, Lemin; Wang, Sheng

2006-09-01

In this paper, we propose Valiant Load-Balanced robust routing scheme for WDM mesh networks under the model of polyhedral uncertainty (i.e., hose model), and the proposed routing scheme is implemented with traffic grooming approach. Our Objective is to maximize the hose model throughput. A mathematic formulation of Valiant Load-Balanced robust routing is presented and three fast heuristic algorithms are also proposed. When implementing Valiant Load-Balanced robust routing scheme to WDM mesh networks, a novel traffic-grooming algorithm called MHF (minimizing hop first) is proposed. We compare the three heuristic algorithms with the VPN tree under the hose model. Finally we demonstrate in the simulation results that MHF with Valiant Load-Balanced robust routing scheme outperforms the traditional traffic-grooming algorithm in terms of the throughput for the uniform/non-uniform traffic matrix under the hose model.

Dimensions of Balance in an Administrator's Life.

ERIC Educational Resources Information Center

Creswell, John W.; And Others

1991-01-01

This article presents a new model for viewing and implementing balance in the lives of higher education administrators derived from a review of the educational, psychological, and management literature. Rejecting the traditional, two dimensional model for balancing work with the rest of life, the new model envisions four concentric circles of…

Examining the Transition to a Four-Day School Week and Investigating Post-Change Faculty/Staff Work-Life Balance: A Community College Case Study

ERIC Educational Resources Information Center

Cardinale, Nelly

2013-01-01

This single descriptive embedded case study examined the process of implementing a four-day work/school week at a community college and investigated post-change faculty/staff work-life balance. All of the students attending this college live at home. The change was implemented due to state funding shortfalls, increasing college utility expenses…

Rating a Teacher Observation Tool: Five Ways to Ensure Classroom Observations are Focused and Rigorous

ERIC Educational Resources Information Center

New Teacher Project, 2011

2011-01-01

This "Rating a Teacher Observation Tool" identifies five simple questions and provides an easy-to-use scorecard to help policymakers decide whether an observation framework is likely to produce fair and accurate results. The five questions are: (1) Do the criteria and tools cover the classroom performance areas most connected to student outcomes?…

Creating a Sustainability Scorecard as a predictive tool for measuring the complex social, economic and environmental impacts of industries, a case study: assessing the viability and sustainability of the dairy industry.

PubMed

Buys, L; Mengersen, K; Johnson, S; van Buuren, N; Chauvin, A

2014-01-15

Sustainability is a key driver for decisions in the management and future development of industries. The World Commission on Environment and Development (WCED, 1987) outlined imperatives which need to be met for environmental, economic and social sustainability. Development of strategies for measuring and improving sustainability in and across these domains, however, has been hindered by intense debate between advocates for one approach fearing that efforts by those who advocate for another could have unintended adverse impacts. Studies attempting to compare the sustainability performance of countries and industries have also found ratings of performance quite variable depending on the sustainability indices used. Quantifying and comparing the sustainability of industries across the triple bottom line of economy, environment and social impact continues to be problematic. Using the Australian dairy industry as a case study, a Sustainability Scorecard, developed as a Bayesian network model, is proposed as an adaptable tool to enable informed assessment, dialogue and negotiation of strategies at a global level as well as being suitable for developing local solutions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Balanced detection for self-mixing interferometry.

PubMed

Li, Kun; Cavedo, Federico; Pesatori, Alessandro; Zhao, Changming; Norgia, Michele

2017-01-15

We propose a new detection scheme for self-mixing interferometry using two photodiodes for implementing a differential acquisition. The method is based on the phase opposition of the self-mixing signal measured between the two laser diode facet outputs. The subtraction of the two outputs implements a sort of balanced detection that improves the signal quality, and allows canceling of unwanted signals due to laser modulation and disturbances on laser supply and transimpedance amplifier. Experimental results demonstrate the benefits of differential acquisition in a system for both absolute distance and displacement-vibration measurement. This Letter provides guidance for the design of self-mixing interferometers using balanced detection.

Dynamic load balancing for petascale quantum Monte Carlo applications: The Alias method

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sudheer, C. D.; Krishnan, S.; Srinivasan, A.

Diffusion Monte Carlo is the most accurate widely used Quantum Monte Carlo method for the electronic structure of materials, but it requires frequent load balancing or population redistribution steps to maintain efficiency and avoid accumulation of systematic errors on parallel machines. The load balancing step can be a significant factor affecting performance, and will become more important as the number of processing elements increases. We propose a new dynamic load balancing algorithm, the Alias Method, and evaluate it theoretically and empirically. An important feature of the new algorithm is that the load can be perfectly balanced with each process receivingmore » at most one message. It is also optimal in the maximum size of messages received by any process. We also optimize its implementation to reduce network contention, a process facilitated by the low messaging requirement of the algorithm. Empirical results on the petaflop Cray XT Jaguar supercomputer at ORNL showing up to 30% improvement in performance on 120,000 cores. The load balancing algorithm may be straightforwardly implemented in existing codes. The algorithm may also be employed by any method with many near identical computational tasks that requires load balancing.« less

Scholastic Guide to Balanced Reading 3-6: Making It Work for You.

ERIC Educational Resources Information Center

Baltas, Joyce, Ed.; Shafer, Susan, Ed.

Suggesting the need for a balance between literature and intentional skills instruction, this book provides grade 3-6 teachers and administrators with a theoretical base for creating a balanced reading program and gives educators a chance to step into actual classrooms where teachers have successfully implemented effective programs. Each chapter…

76 FR 38997 - Approval and Promulgation of Implementation Plans; State of Oregon; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... economic blow that would result from an earlier closure and is an appropriate balance of environmental and... BART rules for the Boardman facility achieve the proper balance of environmental benefits, the cost to... secure greater environmental benefits with a better balance of cost and risk by transitioning the...

77 FR 50969 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Low Emission Vehicle...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... program has two objectives. The first is to reduce emissions of nitrogen oxides (NO X ) and volatile.... Maryland's regulations established initial NMOG credit balances for manufacturer credit account balances to... established ZEV credit account balances to provide parity between California and Maryland with respect to the...

75 FR 832 - Defense Federal Acquisition Regulation Supplement; Foreign Participation in Acquisitions in...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-06

... inapplicability of the Balance of Payments Program evaluation factor to offers of products (other than arms... that it would be inconsistent with the public interest to apply the provisions of the Balance of... services. In order to implement the determination of the inapplicability of the Balance of Payments Program...

Balancing ecosystem values: innovative experiments for sustainable forestry—proceedings of a conference.

Treesearch

Charles E. Peterson; Douglas Maguire

2005-01-01

Balancing Ecosystem Values: Innovative Experiments for Sustainable Forestry is a compendium of more than 40 contributions from Asia, Europe, and North America. The theme encompasses experiments implemented at an operational scale to test ecological, social, or economic responses to silvicultural treatments designed to balance the complex set of...

Cultures of Work-Life Balance in Higher Education: A Case of Fragmentation

ERIC Educational Resources Information Center

Lester, Jaime

2015-01-01

In response to demographic shifts, colleges and universities implemented new policies, adopted new practices, and created professional development opportunities to gain support for work-life balance. Research on work-life balance reveals gender disparities, lack of policy usage, and a lack of cultural change with little understanding of the ways…

Smarter Balanced and Higher Education: Preparing Young People for Postsecondary Success

ERIC Educational Resources Information Center

Smarter Balanced Assessment Consortium, 2012

2012-01-01

The Smarter Balanced Assessment Consortium is creating next-generation assessments aligned to the Common Core State Standards (CCSS) in English language arts/literacy and mathematics. With more than 40 states implementing the CCSS, the Smarter Balanced assessment system will allow states to certify that students have the knowledge and skills to…

The Evaluation of Hospital Performance in Iran: A Systematic Review Article

PubMed Central

BAHADORI, Mohammadkarim; IZADI, Ahmad Reza; GHARDASHI, Fatemeh; RAVANGARD, Ramin; HOSSEINI, Seyed Mojtaba

2016-01-01

Background: This research aimed to systematically study and outline the methods of hospital performance evaluation used in Iran. Methods: In this systematic review, all Persian and English-language articles published in the Iranian and non-Iranian scientific journals indexed from Sep 2004 to Sep 2014 were studied. For finding the related articles, the researchers searched the Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, as well as the non-Iranian electronic databases, including Medline, Embase, Scopus, and Google Scholar. For reviewing the selected articles, a data extraction form, developed by the researchers was used. Results: The entire review process led to the selection of 51 articles. The publication of articles on the hospital performance evaluation in Iran has increased considerably in the recent years. Besides, among these 51 articles, 38 articles (74.51%) had been published in Persian language and 13 articles (25.49%) in English language. Eight models were recognized as evaluation model for Iranian hospitals. Totally, in 15 studies, the data envelopment analysis model had been used to evaluate the hospital performance. Conclusion: Using a combination of model to integrate indicators in the hospital evaluation process is inevitable. Therefore, the Ministry of Health and Medical Education should use a set of indicators such as the balanced scorecard in the process of hospital evaluation and accreditation and encourage the hospital managers to use them. PMID:27516991

The Evaluation of Hospital Performance in Iran: A Systematic Review Article.

PubMed

Bahadori, Mohammadkarim; Izadi, Ahmad Reza; Ghardashi, Fatemeh; Ravangard, Ramin; Hosseini, Seyed Mojtaba

2016-07-01

This research aimed to systematically study and outline the methods of hospital performance evaluation used in Iran. In this systematic review, all Persian and English-language articles published in the Iranian and non-Iranian scientific journals indexed from Sep 2004 to Sep 2014 were studied. For finding the related articles, the researchers searched the Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, as well as the non-Iranian electronic databases, including Medline, Embase, Scopus, and Google Scholar. For reviewing the selected articles, a data extraction form, developed by the researchers was used. The entire review process led to the selection of 51 articles. The publication of articles on the hospital performance evaluation in Iran has increased considerably in the recent years. Besides, among these 51 articles, 38 articles (74.51%) had been published in Persian language and 13 articles (25.49%) in English language. Eight models were recognized as evaluation model for Iranian hospitals. Totally, in 15 studies, the data envelopment analysis model had been used to evaluate the hospital performance. Using a combination of model to integrate indicators in the hospital evaluation process is inevitable. Therefore, the Ministry of Health and Medical Education should use a set of indicators such as the balanced scorecard in the process of hospital evaluation and accreditation and encourage the hospital managers to use them.

Operating room metrics score card-creating a prototype for individualized feedback.

PubMed

Gabriel, Rodney A; Gimlich, Robert; Ehrenfeld, Jesse M; Urman, Richard D

2014-11-01

The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback. To accomplish this task, we identified key metrics that represented time and quality parameters. We collected these data for individual anesthesiologists and compared performance to the overall group average. Data were presented as an electronic score card and made available to individual clinicians on a real-time basis in an effort to provide effective feedback. These metrics included number of cancelled cases, average turnover time, average time to operating room ready and patient in room, number of delayed first case starts, average induction time, average extubation time, average time to recovery room arrival to discharge, performance feedback from other providers, compliance to various protocols, and total anesthetic costs. The concept we propose can easily be generalized to a variety of operating room settings, types of facilities and OR health care professionals. Such a scorecard can be created using content that is important for operating room efficiency, research, and practice improvement for anesthesia providers.

Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey.

PubMed

Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar

2013-01-01

This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data. Copyright © 2012 John Wiley & Sons, Ltd.

Measuring the strategic readiness of intangible assets.

PubMed

Kaplan, Robert S; Norton, David P

2004-02-01

Measuring the value of intangible assets such as company culture, knowledge management systems, and employees' skills is the holy grail of accounting. Executives know that these intangibles, being hard to imitate, are powerful sources of sustainable competitive advantage. If managers could measure them, they could manage the company's competitive position more easily and accurately. In one sense, the challenge is impossible. Intangible assets are unlike financial and physical resources in that their value depends on how well they serve the organizations that own them. But while this prevents an independent valuation of intangible assets, it also points to an altogether different approach for assessing their worth. In this article, the creators of the Balanced Scorecard draw on its tools and framework--in particular, a tool called the strategy map--to present a step-by-step way to determine "strategic readiness," which refers to the alignment of an organization's human, information, and organization capital with its strategy. In the method the authors describe, the firm identifies the processes most critical to creating and delivering its value proposition and determines the human, information, and organization capital the processes require. Some managers shy away from measuring intangible assets because they seem so subjective. But by using the systematic approaches set out in this article, companies can now measure what they want, rather than wanting only what they can currently measure.

An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

PubMed

Fitch, Dale

2014-01-01

This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

PID Controller Design for FES Applied to Ankle Muscles in Neuroprosthesis for Standing Balance

PubMed Central

Rouhani, Hossein; Same, Michael; Masani, Kei; Li, Ya Qi; Popovic, Milos R.

2017-01-01

Closed-loop controlled functional electrical stimulation (FES) applied to the lower limb muscles can be used as a neuroprosthesis for standing balance in neurologically impaired individuals. The objective of this study was to propose a methodology for designing a proportional-integral-derivative (PID) controller for FES applied to the ankle muscles toward maintaining standing balance for several minutes and in the presence of perturbations. First, a model of the physiological control strategy for standing balance was developed. Second, the parameters of a PID controller that mimicked the physiological balance control strategy were determined to stabilize the human body when modeled as an inverted pendulum. Third, this PID controller was implemented using a custom-made Inverted Pendulum Standing Apparatus that eliminated the effect of visual and vestibular sensory information on voluntary balance control. Using this setup, the individual-specific FES controllers were tested in able-bodied individuals and compared with disrupted voluntary control conditions in four experimental paradigms: (i) quiet-standing; (ii) sudden change of targeted pendulum angle (step response); (iii) balance perturbations that simulate arm movements; and (iv) sudden change of targeted angle of a pendulum with individual-specific body-weight (step response). In paradigms (i) to (iii), a standard 39.5-kg pendulum was used, and 12 subjects were involved. In paradigm (iv) 9 subjects were involved. Across the different experimental paradigms and subjects, the FES-controlled and disrupted voluntarily-controlled pendulum angle showed root mean square errors of <1.2 and 2.3 deg, respectively. The root mean square error (all paradigms), rise time, settle time, and overshoot [paradigms (ii) and (iv)] in FES-controlled balance were significantly smaller or tended to be smaller than those observed with voluntarily-controlled balance, implying improved steady-state and transient responses of FES-controlled balance. At the same time, the FES-controlled balance required similar torque levels (no significant difference) as voluntarily-controlled balance. The implemented PID parameters were to some extent consistent among subjects for standard weight conditions and did not require prolonged individual-specific tuning. The proposed methodology can be used to design FES controllers for closed-loop controlled neuroprostheses for standing balance. Further investigation of the clinical implementation of this approach for neurologically impaired individuals is needed. PMID:28676739

Digitally balanced detection for optical tomography.

PubMed

Hafiz, Rehan; Ozanyan, Krikor B

2007-10-01

Analog balanced Photodetection has found extensive usage for sensing of a weak absorption signal buried in laser intensity noise. This paper proposes schemes for compact, affordable, and flexible digital implementation of the already established analog balanced detection, as part of a multichannel digital tomography system. Variants of digitally balanced detection (DBD) schemes, suitable for weak signals on a largely varying background or weakly varying envelopes of high frequency carrier waves, are introduced analytically and elaborated in terms of algorithmic and hardware flow. The DBD algorithms are implemented on a low-cost general purpose reconfigurable hardware (field-programmable gate array), utilizing less than half of its resources. The performance of the DBD schemes compare favorably with their analog counterpart: A common mode rejection ratio of 50 dB was observed over a bandwidth of 300 kHz, limited mainly by the host digital hardware. The close relationship between the DBD outputs and those of known analog balancing circuits is discussed in principle and shown experimentally in the example case of propane gas detection.

The efficacy of treadmill training on balance dysfunction in individuals with chronic stroke: a systematic review.

PubMed

Tally, Zachary; Boetefuer, Laura; Kauk, Courtney; Perez, Gabriela; Schrand, Lorraine; Hoder, Jeffrey

2017-10-01

Physical activity and exercise interventions are useful in facilitating the functional recovery of those with chronic stroke and, routinely, are gait-specific. While treadmill training has proven useful in gait performance recovery post-stroke, its efficacy on balance dysfunction has not been  systematically reviewed. The purpose of this systematic review was to determine the effect of treadmill training (TT) interventions on balance dysfunction in individuals with chronic stroke. A systematic literature search of PubMed, EMBASE, and CINAHL was performed. Eligible randomized controlled trials were published between 2007 and 2016. Selected trials investigated TT interventions in persons with chronic stroke and implemented at least one objective balance measure. Methodological quality was assessed using PEDro criteria. Eight studies met eligibility criteria and were included in the qualitative analysis. Studies differed in TT implementation and use of adjunctive treatments; however, all trials demonstrated improvements in balance measures that were as effective, if not more so, than conventional physical therapy treatments, including targeted balance training. This review recognized moderate evidence in favor of TT interventions in balance and stroke rehabilitation programs. With TT, intensity may be a more critical factor than specificity and may offer additional carryover to recovery parameters of postural control and balance, beyond gait performance. It is recommended that clinicians utilizing TT incorporate objective measures of balance to assess the potential for skill transference and improvements in balance. Higher quality studies and additional research are needed to denote critical parameters by which improvements in balance may be optimized.

Defense AT and L. Volume 43, Number 1

DTIC Science & Technology

2014-02-01

community on the strategic direction of future space system acquisitions. Should we continue and/or improve aggregated space systems over time or move...desirable. Schedulers must have a firm command of project manage- ment theory and practice and possess leadership and communication skills. Scorecard...idea was recommended by the Defense Sci- ence Board’s Munitions System Reliability report. In the future, such systems conceivably could communicate

A Numeric Scorecard Assessing the Mental Health Preparedness for Large-Scale Crises at College and University Campuses: A Delphi Study

ERIC Educational Resources Information Center

Burgin, Rick A.

2012-01-01

Large-scale crises continue to surprise, overwhelm, and shatter college and university campuses. While the devastation to physical plants and persons is often evident and is addressed with crisis management plans, the number of emotional casualties left in the wake of these large-scale crises may not be apparent and are often not addressed with…

Scorecard on Colorado Public Higher Education. How the Public Higher Education System and Its Students Perform on Selected Measures. March 1995.

ERIC Educational Resources Information Center

Colorado Commission on Higher Education, Denver.

This report is the fifth in a series that measures performance of Colorado college students and the state's higher education system. The data are presented at the system level, and cover finances, students, and graduates, and are broken down into the following sectors: public institution totals; a state summary, and then separately by research…

Creation of a Scorecard to Predict In-Hospital Death in Patients Undergoing Operations for Acute Type A Aortic Dissection.

PubMed

Leontyev, Sergey; Légaré, Jean-Francois; Borger, Michael A; Buth, Karen J; Funkat, Anne K; Gerhard, Jochann; Mohr, Friedrich W

2016-05-01

This study evaluated preoperative predictors of in-hospital death for the surgical treatment of patients with acute type A aortic dissection (Type A) and created an easy-to-use scorecard to predict in-hospital death. We reviewed retrospectively all consecutive patients who underwent operations for acute Type A between 1996 and 2011 at 2 tertiary care institutions. A logistic regression model was created to identify independent preoperative predictors of in-hospital death. The results were used to create a scorecard predicting operative risk. Emergency operations were performed in 534 consecutive patients for acute Type A. Mean age was 61 ± 14 years and 36.3% were women. Critical preoperative state was present in 31% of patients and malperfusion of one or more end organs in 36%. Unadjusted in-hospital mortality was 18.7% and not significantly different between institutions. Independent predictors of in-hospital death were age 50 to 70 years (odds ratio [OR], 3.8; p = 0.001), age older than 70 years (OR, 2.8; p = 0.03), critical preoperative state (OR, 3.2; p < 0.001), visceral malperfusion (OR, 3.0; p = 0.003), and coronary artery disease (OR, 2.2; p = 0.006). Age younger than 50 years (OR, 0.3; p = 0.01) was protective for early survival. Using this information, we created an easily usable mortality risk score based on these variables. The patients were stratified into four risk categories predicting in-hospital death: less than 10%, 10% to 25%, 25% to 50%, and more than 50%. This represents one of the largest series of patients with Type A in which a risk model was created. Using our approach, we have shown that age, critical preoperative state, and malperfusion syndrome were strong independent risk factors for early death and could be used for the preoperative risk assessment. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Experience from a multi-country initiative to improve the monitoring of selected reproductive health indicators in Africa.

PubMed

Barreix, Maria; Tunçalp, Özge; Mutombo, Namuunda; Adegboyega, Ayotunde A; Say, Lale

2017-05-01

Universal access to sexual and reproductive health remains part of the unfinished business of global development in Africa. To achieve it, health interventions should be monitored using programmatic indicators. WHO's Strengthening Measurement of Reproductive Health Indicators in Africa initiative, implemented in Ghana, Nigeria, Kenya, Uganda, and Zimbabwe, aimed to improve national information systems for routine monitoring of reproductive health indicators. Participating countries developed action plans employing a two-pronged strategy: (1) revising, standardizing, and harmonizing existing reproductive health indicators captured through routine information-systems; and (2) building data-collection capacity through training and supervision at select pilot sites. Country teams evaluated existing and new indicators, and outlined barriers to strengthening routine measurement. Activities included updating abortion-care guidelines (spontaneous and induced abortions), providing training on laws surrounding induced abortions, and improving feedback mechanisms. The country teams updated monitoring and evaluation frameworks, and attempted to build recording/reporting capacity in selected pilot areas. Barriers to implementing the initiative that were encountered included restrictive induced-abortion laws, staff turn-over, and administrative delays, including low capacity among healthcare staff and competing priorities for staff time. The areas identified for further improvement were up-scaling programs to a national level, creating scorecards to record data, increasing collaborations with the private sector, conducting related costing exercises, and performing ex-post evaluations. © 2017 World Health Organization; licensed by Wiley on behalf of International Federation of Gynecology and Obstetrics.

Unstructured Adaptive Grid Computations on an Array of SMPs

NASA Technical Reports Server (NTRS)

Biswas, Rupak; Pramanick, Ira; Sohn, Andrew; Simon, Horst D.

1996-01-01

Dynamic load balancing is necessary for parallel adaptive methods to solve unsteady CFD problems on unstructured grids. We have presented such a dynamic load balancing framework called JOVE, in this paper. Results on a four-POWERnode POWER CHALLENGEarray demonstrated that load balancing gives significant performance improvements over no load balancing for such adaptive computations. The parallel speedup of JOVE, implemented using MPI on the POWER CHALLENCEarray, was significant, being as high as 31 for 32 processors. An implementation of JOVE that exploits 'an array of SMPS' architecture was also studied; this hybrid JOVE outperformed flat JOVE by up to 28% on the meshes and adaption models tested. With large, realistic meshes and actual flow-solver and adaption phases incorporated into JOVE, hybrid JOVE can be expected to yield significant advantage over flat JOVE, especially as the number of processors is increased, thus demonstrating the scalability of an array of SMPs architecture.

DNS load balancing in the CERN cloud

NASA Astrophysics Data System (ADS)

Reguero Naredo, Ignacio; Lobato Pardavila, Lorena

2017-10-01

Load Balancing is one of the technologies enabling deployment of large-scale applications on cloud resources. A DNS Load Balancer Daemon (LBD) has been developed at CERN as a cost-effective way to balance applications accepting DNS timing dynamics and not requiring persistence. It currently serves over 450 load-balanced aliases with two small VMs acting as master and slave. The aliases are mapped to DNS subdomains. These subdomains are managed with DDNS according to a load metric, which is collected from the alias member nodes with SNMP. During the last years, several improvements were brought to the software, for instance: support for IPv6, parallelization of the status requests, implementing the client in Python to allow for multiple aliases with differentiated states on the same machine or support for application state. The configuration of the Load Balancer is currently managed by a Puppet type. It discovers the alias member nodes and gets the alias definitions from the Ermis REST service. The Aiermis self-service GUI for the management of the LB aliases has been produced and is based on the Ermis service above that implements a form of Load Balancing as a Service (LBaaS). The Ermis REST API has authorisation based in Foreman hostgroups. The CERN DNS LBD is Open Software with Apache 2 license.

Development of a Pattern Recognition Methodology for Determining Operationally Optimal Heat Balance Instrumentation Calibration Schedules

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurt Beran; John Christenson; Dragos Nica

2002-12-15

The goal of the project is to enable plant operators to detect with high sensitivity and reliability the onset of decalibration drifts in all of the instrumentation used as input to the reactor heat balance calculations. To achieve this objective, the collaborators developed and implemented at DBNPS an extension of the Multivariate State Estimation Technique (MSET) pattern recognition methodology pioneered by ANAL. The extension was implemented during the second phase of the project and fully achieved the project goal.

Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk.

PubMed

Tisher, Kristen; Mann, Kimberly; VanDyke, Sarah; Johansson, Charity; Vallabhajosula, Srikant

2018-03-05

Supervised balance training shows immediate benefit for older adults at fall risk. The long-term effectiveness of such training can be enhanced by implementing a safe and simple home exercise program (HEP). We investigated the effects of a12-week unsupervised HEP following supervised clinic-based balance training on functional mobility, balance, fall risk, and gait. Six older adults with an elevated fall risk obtained an HEP and comprised the HEP group (HEPG) and five older adults who were not given an HEP comprised the no HEP group (NoHEPG). The HEP consisted of three static balance exercises: feet-together, single-leg stance, and tandem. Each exercise was to be performed twice for 30-60 s, once per day, 3 days per week for 12 weeks. Participants were educated on proper form, safety, and progression of exercises. Pre- and post-HEP testing included Berg Balance Scale (BBS), Timed Up and Go, Short Physical Performance Battery (SPPB) assessments, Activities-Balance Confidence, Late-Life Functional Disability Instrument and instrumented assessments of balance and gait (Limits of Stability, modified Clinical Test of Sensory Interaction on Balance, Gait). A healthy control group (HCG; n = 11) was also tested. For most of the measures, the HEPG improved to the level of HCG. Though task-specific improvements like BBS and SPPB components were seen, the results did not carry over to more dynamic assessments. Results provide proof of concept that a simple HEP can be independently implemented and effective for sustaining and/or improving balance in older adults at elevated fall-risk after they have undergone a clinic-based balance intervention.

From the front line to the bottom line: building revenue integrity.

PubMed

Britt, John; Adams, Shawn; Snow, Trevor

2015-07-01

To improve trends in accounts receivable and a hospital's bottom line without fear of penalty or repayment, organizations should expand the definition of the revenue cycle team by: Engaging front-line clinical and business personnel. Training personnel to understand the roles they play in revenue integrity. Creating scorecards with measurable goals to promote accountability. Monitoring the outcomes and defining real-time, actionable responses to negative variances.

Facilitating process changes in meal delivery and radiological testing to improve inpatient insulin timing using six sigma method.

PubMed

Yamamoto, J Jay; Malatestinic, Bill; Lehman, Angela; Juneja, Rattan

2010-01-01

The objective of this project was to improve the timing of inpatient insulin administration related to meal delivery and the scheduling of radiology tests by Lean Six Sigma method. A multidisciplinary hospital team and a Six Sigma team from a pharmaceutical manufacturer collaborated to evaluate food delivery and radiology scheduling processes related to the timing of insulin administration. Key factors leading to problems within each system were addressed to improve the efficiency of each process while improving the timeliness of glucose testing and insulin administration. Standardizing the food delivery schedule and utilizing scorecards to track on-time meal deliveries to the floor enabled nursing to more accurately administer insulin in coordination with the delivery of meals. Increasing communication and restricting the scheduling of inpatient procedures during mealtimes reduced disruptions to insulin administration. Data at 6 months postimplementation demonstrated that the institution met goals for most primary outcome metrics including increasing on-time meal delivery and the proportion of patients taking insulin scheduled for radiology tests during appropriate times. By implementing the recommendations identified via Lean Six Sigma, this collaborative effort improved the timing of inpatient insulin administration related to meal delivery and radiology testing.

Battery voltage-balancing applications of disk-type radial mode Pb(Zr • Ti)O3 ceramic resonator

NASA Astrophysics Data System (ADS)

Thenathayalan, Daniel; Lee, Chun-gu; Park, Joung-hu

2017-10-01

In this paper, we propose a novel technique to build a charge-balancing circuit for series-connected battery strings using various kinds of disk-type ceramic Pb(Zr • Ti)O3 piezoelectric resonators (PRs). The use of PRs replaces the whole external battery voltage-balancer circuit, which consists mainly of a bulky magnetic element. The proposed technique is validated using different ceramic PRs and the results are analyzed in terms of their physical properties. A series-connected battery string with a voltage rating of 61.5 V is set as a hardware prototype under test, then the power transfer efficiency of the system is measured at different imbalance voltages. The performance of the proposed battery voltage-balancer circuit employed with a PR is also validated through hardware implementation. Furthermore, the temperature distribution image of the PR is obtained to compare power transfer efficiency and thermal stress under different operating conditions. The test results show that the battery voltage-balancer circuit can be successfully implemented using PRs with the maximum power conversion efficiency of over 96% for energy storage systems.

T55 power turbine rotor multiplane-multispeed balancing study

NASA Technical Reports Server (NTRS)

Martin, M. R.

1982-01-01

A rotordynamic analysis of the T55-L-11C engine was used to evaluate the balancing needs of the power turbine and to optimize the balancing procedure. As a result, recommendations were made for implementation of a multiplane-multispeed balancing plan. Precision collars for the attachment of trial weights to a slender rotor were designed enabling demonstration balancing on production hardware. The quality of the balance was then evaluated by installing a high speed balanced power turbine in an engine and running in a test cell at the Corpus Christi Army depot. The engine used had been tested prior to the turbine changeout and showed acceptable overall vibration levels for the engine were significantly reduced, demonstrating the ability of multiplane-multispeed balancing to control engine vibration.

A balanced Kalman filter ocean data assimilation system with application to the South Australian Sea

NASA Astrophysics Data System (ADS)

Li, Yi; Toumi, Ralf

2017-08-01

In this paper, an Ensemble Kalman Filter (EnKF) based regional ocean data assimilation system has been developed and applied to the South Australian Sea. This system consists of the data assimilation algorithm provided by the NCAR Data Assimilation Research Testbed (DART) and the Regional Ocean Modelling System (ROMS). We describe the first implementation of the physical balance operator (temperature-salinity, hydrostatic and geostrophic balance) to DART, to reduce the spurious waves which may be introduced during the data assimilation process. The effect of the balance operator is validated in both an idealised shallow water model and the ROMS model real case study. In the shallow water model, the geostrophic balance operator eliminates spurious ageostrophic waves and produces a better sea surface height (SSH) and velocity analysis and forecast. Its impact increases as the sea surface height and wind stress increase. In the real case, satellite-observed sea surface temperature (SST) and SSH are assimilated in the South Australian Sea with 50 ensembles using the Ensemble Adjustment Kalman Filter (EAKF). Assimilating SSH and SST enhances the estimation of SSH and SST in the entire domain, respectively. Assimilation with the balance operator produces a more realistic simulation of surface currents and subsurface temperature profile. The best improvement is obtained when only SSH is assimilated with the balance operator. A case study with a storm suggests that the benefit of the balance operator is of particular importance under high wind stress conditions. Implementing the balance operator could be a general benefit to ocean data assimilation systems.

Tai Chi and balance control.

PubMed

Wong, Alice M K; Lan, Ching

2008-01-01

Balance function begins to decline from middle age on, and poor balance function increases the risk of fall and injury. Suitable exercise training may improve balance function and prevent accidental falls. The coordination of visual, proprioceptive, vestibular and musculoskeletal system is important to maintain balance. Balance function can be evaluated by functional balance testing and sensory organization testing. Tai Chi Chuan (TC) is a popular conditioning exercise in the Chinese community, and recent studies substantiate that TC is effective in balance function enhancement and falls prevention. In studies utilizing functional balance testing, TC may increase the duration of one-leg standing and the distance of functional reach. In studies utilizing sensory organization testing, TC improves static and dynamic balance, especially in more challenging sensory perturbed condition. Therefore, TC may be prescribed as an alternative exercise program for elderly subjects or balance-impaired patients. Participants can choose to perform a complete set of TC or selected movements according to their needs. In conclusion, TC may improve balance function and is appropriate for implementation in the community.

Investigation of the applicability of a functional programming model to fault-tolerant parallel processing for knowledge-based systems

NASA Technical Reports Server (NTRS)

Harper, Richard

1989-01-01

In a fault-tolerant parallel computer, a functional programming model can facilitate distributed checkpointing, error recovery, load balancing, and graceful degradation. Such a model has been implemented on the Draper Fault-Tolerant Parallel Processor (FTPP). When used in conjunction with the FTPP's fault detection and masking capabilities, this implementation results in a graceful degradation of system performance after faults. Three graceful degradation algorithms have been implemented and are presented. A user interface has been implemented which requires minimal cognitive overhead by the application programmer, masking such complexities as the system's redundancy, distributed nature, variable complement of processing resources, load balancing, fault occurrence and recovery. This user interface is described and its use demonstrated. The applicability of the functional programming style to the Activation Framework, a paradigm for intelligent systems, is then briefly described.

The Circle of Collaboration.

ERIC Educational Resources Information Center

Burnham, Jacki; Discher, Stephanie; Ingle, Krista

This brief paper describes the Circle of Collaboration approach at one elementary school in Utah that is focusing on development of an inclusive school for all students and implementation of a program (Balance Literacy) to enhance students' reading skills. Balance Literacy incorporates phonemic awareness, phonic instruction, fluency, vocabulary,…

Soil carbon and soil respiration in conservation agriculture with vegetables in Siem Reap, Cambodia

USDA-ARS?s Scientific Manuscript database

A balance between food production and environmental protection is required to sustainably feed a growing population. The resource saving concept of conservation agriculture aims to achieve this balance through implementing simultaneously three conservation practices; no-till, continuous soil cover, ...

[A Matter of Balance: strategy for implementation in Dutch homecare organizations].

PubMed

de Jonge, M C; van der Poel, A; van Haastregt, J C M; Du Moulin, M F T M; Zijlstra, G A R; Voordouw, I

2013-02-01

The Dutch version of A Matter of Balance (AMB-NL) is a cognitive behavioral group program to reduce fear of falling and related activity avoidance in community-living older persons. This paper presents the strategy for implementation of AMB-NL in Dutch homecare organizations and the outcomes of this implementation. The aim was to implement AMB-NL in at least 50 % of 64 homecare organizations in The Netherlands in 2009 and 2010. The implementation strategy was based on the four phases of the Replicating Effective Interventions: pre-conditions, pre-implementation, implementation, and maintenance and evolution. After preparing the implementation activities, such as identifying implementation barriers, consulting stakeholders, preparing the materials involved in the implementation, and training the facilitators of the program (n = 53), AMB-NL was implemented in 16 of the 64 homecare organizations (25 %). Another five homecare organizations indicated that they would shortly include AMB-NL in their care program. These organizations conducted the intervention 19 times to a total of 178 participants. After the implementation phase another 16 facilitators were trained, and program materials were successfully disseminated. The implementation of AMB-NL was well performed. The targeted aim is not fully reached within the two-year timeframe, but the program is well received by participants, trainers and homecare organizations. Further implementation and maintenance of AMB-NL in primary health care is recommended.

The Role of Deformation Energetics in Long-Term Tectonic Modeling

NASA Astrophysics Data System (ADS)

Ahamed, S.; Choi, E.

2017-12-01

The deformation-related energy budget is usually considered in the simplest form or even entirely omitted from the energy balance equation. We derive a full energy balance equation that accounts not only for heat energy but also for mechanical (elastic, plastic and viscous) work. The derived equation is implemented in DES3D, an unstructured finite element solver for long-term tectonic deformation. We verify the implementation by comparing numerical solutions to the corresponding semi-analytic solutions in three benchmarks extended from the classical oedometer test. We also investigate the long-term effects of deformation energetics on the evolution of large offset normal faults. We find that the models considering the full energy balance equation tend to produce more secondary faults and an elongated core complex. Our results for the normal fault system confirm that persistent inelastic deformation has a significant impact on the long-term evolution of faults, motivating further exploration of the role of the full energy balance equation in other geodynamic systems.

Causality analysis in business performance measurement system using system dynamics methodology

NASA Astrophysics Data System (ADS)

Yusof, Zainuridah; Yusoff, Wan Fadzilah Wan; Maarof, Faridah

2014-07-01

One of the main components of the Balanced Scorecard (BSC) that differentiates it from any other performance measurement system (PMS) is the Strategy Map with its unidirectional causality feature. Despite its apparent popularity, criticisms on the causality have been rigorously discussed by earlier researchers. In seeking empirical evidence of causality, propositions based on the service profit chain theory were developed and tested using the econometrics analysis, Granger causality test on the 45 data points. However, the insufficiency of well-established causality models was found as only 40% of the causal linkages were supported by the data. Expert knowledge was suggested to be used in the situations of insufficiency of historical data. The Delphi method was selected and conducted in obtaining the consensus of the causality existence among the 15 selected expert persons by utilizing 3 rounds of questionnaires. Study revealed that only 20% of the propositions were not supported. The existences of bidirectional causality which demonstrate significant dynamic environmental complexity through interaction among measures were obtained from both methods. With that, a computer modeling and simulation using System Dynamics (SD) methodology was develop as an experimental platform to identify how policies impacting the business performance in such environments. The reproduction, sensitivity and extreme condition tests were conducted onto developed SD model to ensure their capability in mimic the reality, robustness and validity for causality analysis platform. This study applied a theoretical service management model within the BSC domain to a practical situation using SD methodology where very limited work has been done.

Employee reactions to the use of management control systems in hospitals: motivation vs. threat.

PubMed

Lopez-Valeiras, Ernesto; Gomez-Conde, Jacobo; Lunkes, Rogerio Joao

Management control systems (such as budgets or balanced scorecards) are formal procedures used by managers to promote employee behavior aligned with organisational objectives. Employees may react to these control systems by either becoming more motivated or perceiving them as a threat. The aim of this paper is to determine the extent to which hospital ownership (public or private), professional group (physician, nurse, pharmacist or administrative employee), type of contract (fixed or temporary), gender and tenure can condition employee reaction to management control systems. We conducted the study in the three largest hospitals in the State of Santa Catarina (Brazil), two public (federal and state-owned) and one private (non-profit organisation). Physicians, nurses, pharmacists and administrative employees received a questionnaire between October 2013 and January 2014 concerning their current perceptions. We obtained 100 valid responses and conducted an ANOVA variance analysis. Our results show that the effect of management control systems on employees differs according to hospital ownership, professional group and type of contract. However, no significant evidence was found concerning gender or tenure. The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Developing an evaluation framework for clinical redesign programs: lessons learnt.

PubMed

Samaranayake, Premaratne; Dadich, Ann; Fitzgerald, Anneke; Zeitz, Kathryn

2016-09-19

Purpose The purpose of this paper is to present lessons learnt through the development of an evaluation framework for a clinical redesign programme - the aim of which was to improve the patient journey through improved discharge practices within an Australian public hospital. Design/methodology/approach The development of the evaluation framework involved three stages - namely, the analysis of secondary data relating to the discharge planning pathway; the analysis of primary data including field-notes and interview transcripts on hospital processes; and the triangulation of these data sets to devise the framework. The evaluation framework ensured that resource use, process management, patient satisfaction, and staff well-being and productivity were each connected with measures, targets, and the aim of clinical redesign programme. Findings The application of business process management and a balanced scorecard enabled a different way of framing the evaluation, ensuring measurable outcomes were connected to inputs and outputs. Lessons learnt include: first, the importance of mixed-methods research to devise the framework and evaluate the redesigned processes; second, the need for appropriate tools and resources to adequately capture change across the different domains of the redesign programme; and third, the value of developing and applying an evaluative framework progressively. Research limitations/implications The evaluation framework is limited by its retrospective application to a clinical process redesign programme. Originality/value This research supports benchmarking with national and international practices in relation to best practice healthcare redesign processes. Additionally, it provides a theoretical contribution on evaluating health services improvement and redesign initiatives.

[Impact and state of the art of regional healthcare planning and management guidelines in a local health authority of the Lazio region (Italy)].

PubMed

Priori, Maria Rosaria; Barbato, Angelo

2007-01-01

The aim of this study was to evaluate the impact of health care planning and management guidelines, elaborated by the Lazio regional healthcare authority, on the organizational structure and operational processes of local health authorities and, more specifically, of the Roma C local health authority. The guidelines are made up of three volumes and mainly describe an operational model, rather than being a set of standard references aimed at standardizing the quality of information low systems in local healthcare authorities. The guidelines are essentially a didactic text, and were elaborated by a consulting firm, Engineering Management Consulting, on behalf of the Lazio regional authority. In the first section, the main concepts are defined, while in subsequent sections, detailed models regarding the specific subject matter are described. Although the guidelines represent a useful tool in the process of converting local health authorities of the Lazio region into "business" organizations, so far they have been of use only in the first phase of assessment of different organizational models for healthcare planning and management. There is still a long way ahead towards defining standard procedures and references for describing activities and costs. This is what should hopefully be achieved briefly and which will necessarily require the introduction of a data warehouse and business intelligence software that will allow monitoring of activities and making short term predictions through the use balanced scorecards and data mining.

Evaluating the Implementation of the Empowering Coaching™ Programme: Balancing Fidelity and Adaptation

ERIC Educational Resources Information Center

Søvik, Margaret L.; Larsen, Torill; Tjomsland, Hege; Samdal, Oddrun

2016-01-01

Purpose: The purpose of this paper is to explore the implementation of a theoretically grounded coach education training programme for youth football coaches in Norway, through observational methods. In particular, it focuses on implementation fidelity and programme adaptation, and possible differences between the coach educators (CEs) according…

Adaptive Load-Balancing Algorithms using Symmetric Broadcast Networks

NASA Technical Reports Server (NTRS)

Das, Sajal K.; Harvey, Daniel J.; Biswas, Rupak; Biegel, Bryan A. (Technical Monitor)

2002-01-01

In a distributed computing environment, it is important to ensure that the processor workloads are adequately balanced, Among numerous load-balancing algorithms, a unique approach due to Das and Prasad defines a symmetric broadcast network (SBN) that provides a robust communication pattern among the processors in a topology-independent manner. In this paper, we propose and analyze three efficient SBN-based dynamic load-balancing algorithms, and implement them on an SGI Origin2000. A thorough experimental study with Poisson distributed synthetic loads demonstrates that our algorithms are effective in balancing system load. By optimizing completion time and idle time, the proposed algorithms are shown to compare favorably with several existing approaches.

Adaptive Load-Balancing Algorithms Using Symmetric Broadcast Networks

NASA Technical Reports Server (NTRS)

Das, Sajal K.; Biswas, Rupak; Chancellor, Marisa K. (Technical Monitor)

1997-01-01

In a distributed-computing environment, it is important to ensure that the processor workloads are adequately balanced. Among numerous load-balancing algorithms, a unique approach due to Dam and Prasad defines a symmetric broadcast network (SBN) that provides a robust communication pattern among the processors in a topology-independent manner. In this paper, we propose and analyze three novel SBN-based load-balancing algorithms, and implement them on an SP2. A thorough experimental study with Poisson-distributed synthetic loads demonstrates that these algorithms are very effective in balancing system load while minimizing processor idle time. They also compare favorably with several other existing load-balancing techniques. Additional experiments performed with real data demonstrate that the SBN approach is effective in adaptive computational science and engineering applications where dynamic load balancing is extremely crucial.

Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool

DTIC Science & Technology

2016-10-01

AWARD NUMBER: W81XWH-14-2-0150 TITLE: Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool PRINCIPAL...AND SUBTITLE Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH...Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The proposed study will implement and evaluate a novel, low-cost, Virtual Reality (VR

Tips for School Districts: GASB's New Fund Balance Standards

ERIC Educational Resources Information Center

Mead, Dean Michael

2010-01-01

In March 2009, the Governmental Accounting Standards Board (GASB) issued Statement No. 54, "Fund Balance Reporting and Governmental Fund Type Definitions." School districts that prepare financial reports based on generally accepted accounting principles are required to implement this standard no later than the first fiscal year that starts after…

It's Time to Implement GASB Statement 54

ERIC Educational Resources Information Center

Heinfeld, Gary; Nuehring, Bert

2012-01-01

In February 2009, the Governmental Accounting Standards Board (GASB) issued Statement No. 54, "Find Balance Reporting and Governmental Fund Type Definitions." This statement changes how a fund balance is classified on the face of the government fund financial statements and refines the definitions for government fund types. The statement's…