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…

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…

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.

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.

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.

Issues for academic health centers to consider before implementing a balanced-scorecard effort.

PubMed

Zelman, W N; Blazer, D; Gower, J M; Bumgarner, P O; Cancilla, L M

1999-12-01

Because of changes in the health care environment, it is likely that strategic planning and management will become much more important to academic health centers (AHCs) than in the past. One approach to strategic planning and management that is gaining the considerable interest of health care organizations is the balanced scorecard. Based on a year's experience in examining this management tool, and on early implementation efforts, the authors critically evaluate the applicability of the balanced-scorecard approach at AHCs in relation to two fundamental questions: Does the decentralized nature of most AHCs mitigate the potential usefulness of the balanced-scorecard approach? Are the balanced scorecard's four perspectives (learning and growth, internal; customer; and financial) appropriate for AHCs, which are neither for-profit nor manufacturing organizations? The authors conclude that (1) the unique characteristics of AHCs may mitigate the full benefit of the balanced-scorecard approach, and (2) in cases where it is used, some key modifications must be made in the balanced-scorecard approach to account for those unique characteristics. For example, in a corporation, the key question from the financial perspective is "To succeed financially, how should we appear to our stockholders?" But in an AHC, this question must be revised to "What financial condition must we achieve to allow us to accomplish our mission?"

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.

The Balanced Scorecard as a management tool for assessing and monitoring strategy implementation in health care organizations.

PubMed

Bisbe, Josep; Barrubés, Joan

2012-10-01

Both prior literature and reported managerial practices have claimed that the Balanced Scorecard is a management tool that can help organizations to effectively implement strategies. In this article, we examine some of the contributions, dilemmas, and limitations of Balanced Scorecards in health care organizations. First, we describe the evolution of Balanced Scorecards from multidimensional performance measurement systems to causal representations of formulated strategies, and analyze the applicability of Balanced Scorecards in health care settings. Next, we discuss several issues under debate regarding Balanced Scorecard adoption in health care organizations. We distinguish between issues related to the design of Balanced Scorecards and those related to the use of these tools. We conclude that the Balanced Scorecard has the potential to contribute to the implementation of strategies through the strategically-oriented performance measurement systems embedded within it. However, effective adoption requires the adaptation of the generic instrument to the specific realities of health care organizations. Full English text available from:www.revespcardiol.org. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Designing and implementing a balanced scorecard: lessons learned in nonprofit implementation.

PubMed

Gumbus, Andra; Wilson, Tom

2004-01-01

The balanced scorecard has been referred to as the management innovation of the century, and extensive articles have been written using case studies of organizations that use this performance measurement system. This article addresses the key issues of design and implementation with a step-by-step guide to how to design a balanced scorecard and lessons to avoid implementation problems in government and nonprofit settings.

Teaching the Balanced Scorecard through Simulation

ERIC Educational Resources Information Center

Capelo, Carlos; Lopes, Ana Isabel; Mata, Ana

2012-01-01

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

Cultural Change and a Balanced Scorecard. Does Your Organization Measure Up?

ERIC Educational Resources Information Center

McAlary, Chris K.

2001-01-01

Discusses the balanced scorecard concept, a customer-based planning and process improvement system for measuring the success of campus business enterprises and helping to better achieve organizational goals. Scorecard design and implementation are described as are selected success stories. (GR)

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…

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 balanced scorecard: a potent tool for energizing and focusing healthcare organization management.

PubMed

Chow, C W; Ganulin, D; Teknika, O; Haddad, K; Williamson, J

1998-01-01

The current environment for healthcare organizations contains many forces demanding unprecedented levels of change. These forces include changing demographics, increased customer expectations, increased competition, and intensified governmental pressure. Meeting these challenges will require healthcare organizations to undergo fundamental changes and to continuously seek new ways to create future value. This article provides explanation of a potent new management tool-the balanced scorecard-that can be used by healthcare organizations to meet these challenges. The article also presents the opinions of many high-level healthcare administrators that the balanced scorecard can be highly beneficial to healthcare organizations. It also summarizes these administrators' suggestions regarding the goals and measures that can make up an effective scorecard for a hospital as a whole, as well as for a specific subunit of a hospital. Interestingly, while no published report of balanced scorecard implementations in healthcare organizations exists, a number of administrators stated that they had fully implemented systems similar to the scorecard. These actions can be considered support for the scorecard's potential usefulness; at the same time, they suggest that some sharing of experiences will likely be available in the future. As all administrators are well aware, moving from concept to practice is often difficult. While the article includes some suggestions for scorecard development and implementation, each organization must engage in the full range of activities, from defining its mission to the selection of goals and strategies, and develop its own unique scorecard to assist progress toward the selected goals. As a starting point, Table 3 provides a timeline of some general events that may be common to all organizations during this process.

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.

Implementing a balanced scorecard as a strategic management tool in a long-term care organization.

PubMed

Schalm, Corinne

2008-01-01

The Capital Care Group, the largest public sector continuing care organization in Canada, had no ready access to information on its own performance and therefore was limited in its pursuit of evidence-informed decision-making. To remedy this, it was decided to introduce a balanced scorecard. A literature review was conducted together with interviews with 10 other health care organizations which had implemented balanced scorecards. With this information, a workshop was held that resulted in a framework and about 120 potential indicators. Subsequently the number of indicators was reduced to 29, using pre-determined criteria. Development of a corporate balanced scorecard facilitated executive strategic thinking and clarified the organization's strategic direction. In parallel, scorecards were developed at the level of care centres. These had a common core of indicators, plus some site-specific ones. Development of the corporate scorecard took three years and an additional six months for the care centre scorecards. A formal implementation plan has been accepted by the executive team. Key to this is communicating to staff the role of scorecards for strategic management and not just performance measurement. Traditional thinking needs to change from a short-term operational focus to long-term strategy. In addition, champions need to be identified in each care centre and they need to be networked together. Finally, the scorecard is being integrated into existing operational management as a routine component together with resources to support its use. The balanced scorecard has focused on its role as a strategic management tool. The indicators and dimensions need to be customized to the organization. Senior management must be seen to be driving its introduction. It is worth spending sufficient time developing and implementing a scorecard rather than trying to rush its introduction. The scorecard needs to be integrated with existing management processes and sufficient

Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

PubMed

Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

2016-06-01

This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases. © The Author(s) 2014.

[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.

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: 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…

Using a balanced scorecard to improve the performance of an emergency department.

PubMed

Huang, Shu-Hsin; Chen, Ping-Ling; Yang, Ming-Chin; Chang, Wen-Yin; Lee, Haw-Jenn

2004-01-01

The performance of the emergency department significantly improved after implementing the balanced scorecard including hours of continuing education attended by the staff, staff job satisfaction, the rate of incomplete laboratory tests within 30 minutes, the average monthly inappropriate return rate, and hospital profit. The results can assist administrators plan for the future. Although this was a pilot program for implementing a balanced scorecard in an emergency department, the indicators used in this study may also be reasonable for a hospital that has limited resources.

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.

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…

The Balanced Scorecard of acute settings: development process, definition of 20 strategic objectives and implementation.

PubMed

Groene, Oliver; Brandt, Elimer; Schmidt, Werner; Moeller, Johannes

2009-08-01

Strategy development and implementation in acute care settings is often restricted by competing challenges, the pace of policy reform and the existence of parallel hierarchies. To describe a generic approach to strategy development, illustrate the use of the Balanced Scorecard as a tool to facilitate strategy implementation and demonstrate how to break down strategic goals into measurable elements. Multi-method approach using three different conceptual models: Health Promoting Hospitals Standards and Strategies, the European Foundation for Quality Management (EFQM) Model and the Balanced Scorecard. A bundle of qualitative and quantitative methods were used including in-depth interviews, standardized organization-wide surveys on organizational values, staff satisfaction and patient experience. Three acute care hospitals in four different locations belonging to a German holding group. Chief executive officer, senior medical officers, working group leaders and hospital staff. Development and implementation of the Balanced Scorecard. Twenty strategic objectives with corresponding Balanced Scorecard measures. A stepped approach from strategy development to implementation is presented to identify key themes for strategy development, drafting a strategy map and developing strategic objectives and measures. The Balanced Scorecard, in combination with the EFQM model, is a useful tool to guide strategy development and implementation in health care organizations. As for other quality improvement and management tools not specifically developed for health care organizations, some adaptations are required to improve acceptability among professionals. The step-wise approach of strategy development and implementation presented here may support similar processes in comparable organizations.

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…

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.

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…

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)

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

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.

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.

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.

[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.

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…

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…

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.

[The use of the balanced scorecard and the budget in the strategic management of public hospitals].

PubMed

Naranjo Gil, David

2010-01-01

To analyze the relationship between hospital managers' characteristics and the use of the balanced scorecard and the budget. A further aim was to analyze how these two techniques influence strategic goals aimed at cost reduction and enhancing service flexibility. Data were collected through a questionnaire sent to 884 members of top management teams in 218 public hospitals in Spain. The response rate was 53.51% with 473 useful questionnaires. Structural equation techniques were used to validate the metric scales and the model used. Younger managers and less tenured managers were more likely to use the balanced scorecard than the budget. Diversity in the top management team was related to the use of distinct management control techniques. The use of the balanced scorecard was positively associated with the implementation of healthcare strategies focused on enhancing service flexibility and reducing healthcare cost. The adoption of management control systems is not only a function of the outcome of a rational decision-making process and institutional pressures but also crucially depends on the characteristics of the individuals ultimately responsible for such decisions. The use of the balanced scorecard facilitates hospitals' implementation of plans with multiple strategic goals. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

Implementation and Performance Evaluation Using the Fuzzy Network Balanced Scorecard

ERIC Educational Resources Information Center

Tseng, Ming-Lang

2010-01-01

The balanced scorecard (BSC) is a multi-criteria evaluation concept that highlights the importance of performance measurement. However, although there is an abundance of literature on the BSC framework, there is a scarcity of literature regarding how the framework with dependence and interactive relationships should be properly implemented in…

Introduction of the Balanced Scorecard into an academic department of medicine: creating a road map to success.

PubMed

Bouland, Daniel L; Fink, Ed; Fontanesi, John

2011-01-01

In this paper, we describe: 1) the environmental forces driving performance measurement and management in the University of California San Diego Department of Medicine; 2) the systematic process used by the department to implement a Balanced Scorecard; 3) the initial direct and indirect outcomes of this effort; 4) the opportunities and challenges to the Balanced Scorecard as a management directive; and 5) future directions.

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.

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

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.

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…

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.

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.

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

[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.

[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.

Hands-on Scorecarding in the Higher Education Sector

ERIC Educational Resources Information Center

Scholey, Cam; Armitage, Howard

2006-01-01

The balanced scorecard, introduced by Robert Kaplan and David Norton, has evolved from an improved performance measurement system to an integrated strategic planning, implementation, and scorecarding system. Simple yet powerful second-generation balanced scorecards depict the organization's strategy through a series of strategy maps and scorecards…

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.

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…

[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.

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

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…

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

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

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.

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…

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

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.

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.

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.

[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.

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.

[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.

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…

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.

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.

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.

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…

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.

[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.

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…

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.

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

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.

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…

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…

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

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

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.

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

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,…

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.

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.

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.

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.

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.

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…

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.

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.

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

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…

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.

[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.

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.

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.

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.

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

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

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.

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.

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.

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".

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.

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.

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.

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.

[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.

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.

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.

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.

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

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

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

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.

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.

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.

[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.

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.

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.

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.

Balanced performance measurement in research hospitals: the participative case study of a haematology department.

PubMed

Catuogno, Simona; Arena, Claudia; Saggese, Sara; Sarto, Fabrizia

2017-08-03

The paper aims to review, design and implement a multidimensional performance measurement system for a public research hospital in order to address the complexity of its multifaceted stakeholder requirements and its double institutional aim of care and research. The methodology relies on a participative case study performed by external researchers in close collaboration with the staff of an Italian research hospital. The paper develops and applies a customized version of balanced scorecard based on a new set of performance measures. Our findings suggest that it can be considered an effective framework for measuring the research hospital performance, thanks to a combination of generalizable and context-specific factors. By showing how the balanced scorecard framework can be customized to research hospitals, the paper is especially of interest for complex healthcare organizations that are implementing management accounting practices. The paper contributes to the body of literature on the application of the balanced scorecard in healthcare through an examination of the challenges in designing and implementing this multidimensional performance tool. This is one of the first papers that show how the balanced scorecard model can be adapted to fit the specific requirements of public research hospitals.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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).

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.

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

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

[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.

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

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

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...

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…

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.

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.

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

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

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

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.

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.

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.

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.

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.

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.

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

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…

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.

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

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

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.

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.

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.

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 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

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

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.

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…

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…

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…

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

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.

Bridge Building for the Future of the Finnish Polytechnics

ERIC Educational Resources Information Center

Kettunen, Juha

2004-01-01

This study presents the strategy process of Finnish polytechnics using the balanced scorecard approach. The study extends the balanced scorecard from the communication and implementation of this strategy to the planning of the strategy. Stakeholders formulated a strategic managerial plan for the network of all polytechnics in Finland by applying…

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…

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…

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…

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."…

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.

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

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.

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...

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

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

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.

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

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.

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…

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…

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.

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…

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

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.

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.

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

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

Association Between Surgeon Scorecard Use and Operating Room Costs.

PubMed

Zygourakis, Corinna C; Valencia, Victoria; Moriates, Christopher; Boscardin, Christy K; Catschegn, Sereina; Rajkomar, Alvin; Bozic, Kevin J; Soo Hoo, Kent; Goldberg, Andrew N; Pitts, Lawrence; Lawton, Michael T; Dudley, R Adams; Gonzales, Ralph

2017-03-01

Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting. Intervention participants were attending surgeons in orthopedic surgery, otolaryngology-head and neck surgery, and neurological surgery (n = 63). Control participants were attending surgeons in cardiothoracic surgery, general surgery, vascular surgery, pediatric surgery, obstetrics/gynecology, ophthalmology, and urology (n = 186). From January 1 to December 31, 2015, each surgeon in the intervention group received standardized monthly scorecards showing the median surgical supply direct cost for each procedure type performed in the prior month compared with the surgeon's baseline (July 1, 2012, to November 30, 2014) and compared with all surgeons at the institution performing the same procedure at baseline. All surgical departments were eligible for a financial incentive if they met a 5% cost reduction goal. The primary outcome was each group's median surgical supply cost per case. Secondary outcome measures included total departmental surgical supply costs, case mix index-adjusted median surgical supply costs, patient outcomes (30-day readmission, 30-day mortality, and discharge status), and surgeon responses to a postintervention study-specific health care value survey. The median surgical supply direct costs per case decreased 6.54% in the intervention group, from $1398 (interquartile range [IQR], $316-$5181) (10 637 cases) in 2014 to $1307 (IQR, $319-$5037) (11 820 cases) in 2015. In contrast, the median surgical supply direct cost increased 7.42% in the control group, from $712 (IQR, $202-$1602) (16 441 cases

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.

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.

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.

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

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…

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.

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

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.

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)

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.

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.

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…

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…

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)

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

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.

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

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…

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…

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…

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.

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,…

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…

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…

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.

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…

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…

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…

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.

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…

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,…

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.

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.…

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…

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.

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 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 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…

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…

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…

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.

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.

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.

BALANCE

DOEpatents

Carmichael, H.

1953-01-01

A torsional-type analytical balance designed to arrive at its equilibrium point more quickly than previous balances is described. In order to prevent external heat sources creating air currents inside the balance casing that would reiard the attainment of equilibrium conditions, a relatively thick casing shaped as an inverted U is placed over the load support arms and the balance beam. This casing is of a metal of good thernnal conductivity characteristics, such as copper or aluminum, in order that heat applied to one portion of the balance is quickly conducted to all other sensitive areas, thus effectively preventing the fornnation of air currents caused by unequal heating of the balance.

[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.

Typical balance exercises or exergames for balance improvement?

PubMed

Gioftsidou, Asimenia; Vernadakis, Nikolaos; Malliou, Paraskevi; Batzios, Stavros; Sofokleous, Polina; Antoniou, Panagiotis; Kouli, Olga; Tsapralis, Kyriakos; Godolias, George

2013-01-01

Balance training is an effective intervention to improve static postural sway and balance. The purpose of the present study was to investigate the effectiveness of the Nintendo Wii Fit Plus exercises for improving balance ability in healthy collegiate students in comparison with a typical balance training program. Forty students were randomly divided into two groups, a traditional (T group) and a Nintendo Wii group (W group) performed an 8 week balance program. The "W group" used the interactive games as a training method, while the "T group" used an exercise program with mini trampoline and inflatable discs (BOSU). Pre and Post-training participants completed balance assessments. Two-way repeated measures analyses of variance (ANOVAs) were conducted to determine the effect of training program. Analysis of the data illustrated that both training program groups demonstrated an improvement in Total, Anterior-posterior and Medial Lateral Stability Index scores for both limbs. Only at the test performed in the balance board with anterior-posterior motion, the improvement in balance ability was greater in the "T group" than the "W group", when the assessment was performed post-training (p=0.023). Findings support the effectiveness of using the Nintendo Wii gaming console as a balance training intervention tool.

Prenatal diagnosis of de novo t(2;18;14)(q33.1;q12.2;q31.2), dup(5)(q34q34), del(7)(p21.1p21.1), and del(10)(q25.3q25.3) and a review of the prenatally ascertained de novo apparently balanced complex and multiple chromosomal rearrangements.

PubMed

Chen, Chih-Ping; Chern, Schu-Rern; Lee, Chen-Chi; Lin, Chyi-Chyang; Li, Yueh-Chun; Hsieh, Lie-Jiau; Chen, Wen-Lin; Wang, Wayseen

2006-02-01

To present the prenatal diagnosis of a de novo complex chromosomal rearrangement (CCR) associated with de novo interstitial deletions and duplication and to review the literature. Amniocentesis was performed at 18 weeks' gestation because of an increased risk for Down syndrome based on maternal serum alpha-fetoprotein and human chorionic gonadotrophin screening. Amniocentesis revealed a karyotype of 46,XY,t(2;18;14)(q33.1;q12.2;q31.2),dup(5)(q34q34),del(7)(p21.1p21.1), del(10)(q25.3q25.3). The parental karyotypes were normal. The pregnancy was terminated. The fetus manifested facial dysmorphism, clinodactyly of both hands, and hypoplasia of the left great toe. Spectral karyotyping (SKY), cytogenetic polymorphism, and polymorphic DNA markers were used to investigate the imbalances and the origin of the de novo aberrant chromosomes. SKY showed a three-way CCR. Cytogenetic polymorphism investigation of the derivative chromosome 14 of the fetus and the parental chromosomes 14 determined the maternal origin of the translocation. Polymorphic DNA marker analysis confirmed the maternal origin of the de novo interstitial deletions and duplication. No cryptic imbalance at or near the breakpoints of the CCR was detected by the molecular analysis. De novo apparently balanced CCRs may be associated with imbalances in other chromosomes. We suggest further investigation and re-evaluation of cryptic or subtle imbalances in all cases classified as de novo apparently balanced CCRs. Copyright 2006 John Wiley & Sons, Ltd.

Interchangeability of the Wii Balance Board for Bipedal Balance Assessment.

PubMed

Bonnechère, Bruno; Jansen, Bart; Omelina, Lubos; Rooze, Marcel; Van Sint Jan, Serge

2015-08-27

Since 2010, an increasing interest in more portable and flexible hardware for balance and posture assessment led to previously published studies determining whether or not the Wii Balance Board could be used to assess balance and posture, both scientifically and clinically. However, no previous studies aimed at comparing results from different Wii Balance Boards for clinical balance evaluation exist. The objective of this crossover study is to assess the interchangeability of the Wii Balance Board. A total of 6 subjects participated in the study and their balance was assessed using 4 different Wii Balance Boards. Trials were recorded simultaneously with Wii Balance Boards and with a laboratory force plate. Nine relevant clinical parameters were derived from center of pressure displacement data obtained from Wii Balance Board and force plate systems. Intraclass correlation coefficients (ICC), F tests, and Friedman tests were computed to assess the agreement between trials and to compare the Wii Balance Board and force plate results. Excellent correlations were found between the Wii Balance Board and force plate (mean ρ =.83). With the exception of 2 parameters, strong to excellent agreements were found for the 7 remaining parameters (ICC=.96). No significant differences were found between trials recorded with different Wii Balance Boards. Our results indicate that for most of the parameters analyzed, balance and posture assessed with one Wii Balance Board were statistically similar to results obtained from another. Furthermore, the good correlation between the Wii Balance Board and force plate results shows that Wii Balance Boards can be reliably used for scientific assessment using most of the parameters analyzed in this study. These results also suggest that the Wii Balance Board could be used in multicenter studies and therefore, would allow for the creation of larger populations for clinical studies. Ethical Committee of the Erasme Hospital (CCB B406201215142

Interchangeability of the Wii Balance Board for Bipedal Balance Assessment

PubMed Central

Jansen, Bart; Omelina, Lubos; Rooze, Marcel; Van Sint Jan, Serge

2015-01-01

Background Since 2010, an increasing interest in more portable and flexible hardware for balance and posture assessment led to previously published studies determining whether or not the Wii Balance Board could be used to assess balance and posture, both scientifically and clinically. However, no previous studies aimed at comparing results from different Wii Balance Boards for clinical balance evaluation exist. Objective The objective of this crossover study is to assess the interchangeability of the Wii Balance Board. Methods A total of 6 subjects participated in the study and their balance was assessed using 4 different Wii Balance Boards. Trials were recorded simultaneously with Wii Balance Boards and with a laboratory force plate. Nine relevant clinical parameters were derived from center of pressure displacement data obtained from Wii Balance Board and force plate systems. Intraclass correlation coefficients (ICC), F tests, and Friedman tests were computed to assess the agreement between trials and to compare the Wii Balance Board and force plate results. Results Excellent correlations were found between the Wii Balance Board and force plate (mean ρ =.83). With the exception of 2 parameters, strong to excellent agreements were found for the 7 remaining parameters (ICC=.96). No significant differences were found between trials recorded with different Wii Balance Boards. Conclusions Our results indicate that for most of the parameters analyzed, balance and posture assessed with one Wii Balance Board were statistically similar to results obtained from another. Furthermore, the good correlation between the Wii Balance Board and force plate results shows that Wii Balance Boards can be reliably used for scientific assessment using most of the parameters analyzed in this study. These results also suggest that the Wii Balance Board could be used in multicenter studies and therefore, would allow for the creation of larger populations for clinical studies. Trial

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

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.

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 ...

Reconceptualizing Balance: Attributes associated with balance performance

PubMed Central

Thomas, Julia C.; Odonkor, Charles; Griffith, Laura; Holt, Nicole; Percac-Lima, Sanja; Leveille, Suzanne; Ni, Pensheng; Latham, Nancy K.; Jette, Alan M.; Bean, Jonathan F.

2014-01-01

Balance tests are commonly used to screen for impairments that put older adults at risk for falls. The purpose of this study was to determine the attributes that were associated with balance performance as measured by the The Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) balance test. This study was a cross-sectional secondary analysis of baseline data from a longitudinal cohort study, the Boston Rehabilitative Impairment Study of the Elderly (Boston RISE). Boston RISE was performed in an outpatient rehabilitation research center and evaluated Boston area primary care patients aged 65 to 96 (N=364) with self-reported difficulty or task-modification climbing a flight of stairs or walking ½ of a mile. The outcome measure was standing balance as measured by the FICSIT-4 balance assessment. Other measures included: self-efficacy, pain, depression, executive function, vision, sensory loss, reaction time, kyphosis, leg range of motion, trunk extensor muscle endurance, leg strength and leg velocity at peak power. Participants were 67% female, had an average age of 76.5 (± 7.0) years, an average of 4.1 (± 2.0) chronic conditions, and an average FICSIT-4 score of 6.7 (± 2.2) out of 9. After adjusting for age and gender, attributes significantly associated with balance performance were falls self-efficacy, trunk extensor muscle endurance, sensory loss, and leg velocity at peak power. FICSIT-4 balance performance is associated with a number of behavioral and physiologic attributes, many of which are amenable to rehabilitative treatment. Our findings support a consideration of balance as multidimensional activity as proposed by the current International Classification of Functioning, Disability, and Health (ICF) model. PMID:24952097

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.

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

Efficacy of virtual reality-based balance training versus the Biodex balance system training on the body balance of adults

PubMed Central

Ibrahim, Manal S.; Mattar, Ayman G.; Elhafez, Salam M.

2016-01-01

[Purpose] This study investigated efficacy of virtual reality (VR)-based balance training on enhancing balance and postural reactions of adults as a low-cost new modality compared to the established Biodex Balance System (BBS). [Subjects] Thirty normal adults of both genders were divided randomly into two equal-sized experimental groups of 15: BBS balance training and VR balance training. [Methods] The training programmes were conducted in 12 sessions, three 15-min sessions per week. The Nintendo® Wii Fit Plus (NWFP) and its balance board were used to train of the VR group. Each participant answered a questionnaire concerning usability, enjoyment, balance improvement, and fatigue at the end of the training programs. [Results] The study found a significant increase the measure of mean overall balance (OLB) in both groups. No significant difference was found between the groups, but a significant decrease in the mean balance-test time was found for both groups, with no significant difference between the two training methods. The VR programme was rated highly enjoyable by 81.8% of the group. [Conclusion] The Wii Fit Plus system with the balance board as a new VR balance-training technique, can be considered an effective and enjoyable tool for the training of adults’ body balance. PMID:26957722

The Digital Health Scorecard: A New Health Literacy Metric for NCD Prevention and Care.

PubMed

Ratzan, Scott C; Weinberger, Michael B; Apfel, Franklin; Kocharian, Gary

2013-06-01

According to the World Health Organization, 3 out of 5 deaths worldwide are due to common, chronic conditions, such as heart and respiratory diseases, cancer, and diabetes. These noncommunicable diseases (NCDs) are linked to multiple lifestyle risk factors, including smoking, the harmful use of alcohol, and physical inactivity. They are associated with other "intermediate" risk factors, such as elevated body mass index (BMI), hypertension, hyperlipidemia, and hyperglycemia. Taking action to reduce these 7 risk factors can help people protect themselves against leading causes of death. All of these risk factors are measurable and modifiable, but globally available, cost-effective, and easy-to-use outcome metrics that can drive action on all levels do not yet exist. The Digital Health Scorecard is being proposed as a dynamic, globally available digital tool to raise public, professional, and policy maker NCD health literacy (the motivation and ability to access, understand, communicate, and use information to improve health and reduce the incidence of NCD). Its aim is to motivate and empower individuals to make the behavioral and choice changes needed to improve their health and reduce NCD risk factors by giving unprecedented access to global data intelligence, creating awareness, making links to professional and community-based support services and policies, and providing a simple way to measure and track risk changes. Moreover, it provides health care professionals, communities, institutions, workplaces, and nations with a simple metric to monitor progress toward agreed local, national, and global NCD targets. Copyright © 2013 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

Life Balancing -- A Better Way to Balance Large Batteries

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

Anderson, R. Dyche; Zane, Regan; Plett, Gregory

2017-03-28

A new cell balancing technology was developed under a Department of Energy contract which merges the DC/DC converter function into cell balancing. Instead of conventional passive cell balancing technology which bypasses current through a resistor, or active cell balancing which moves current from one cell to another, with significant cost and additional inefficiencies, this concept takes variable amount of current from each cell or small group of cells and converts it to current for the low voltage system.

Characteristics of 'tween' participants and non-participants in the VERB™ summer scorecard physical activity promotion program.

PubMed

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

2011-04-01

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™ summer scorecard (VSS)', leveraging the brand equity of the national VERB™--It's What You Do! campaign. Key elements of VSS subsequently were adopted in Sarasota County, FL. This study identified characteristics of Sarasota's VSS participants and non-participants. Students in Grades 5-8 from six randomly selected public schools completed a survey assessing VSS participation, physical activity level, psychosocial variables, parental support for physical activity and demographics. Logistic regression showed that VSS participants were more likely to be from Grades 5 to 6 versus Grades 7 and 8 [odds ratio (OR) = 6.055] and perceive high versus low parental support for physical activity (OR = 4.627). Moreover, for each unit rise in self-efficacy, the odds of VSS participation rose by 1.839. Chi-squared automatic interaction detector (CHAID) analysis suggested an interaction effect between grade and school socioeconomic status (SES), with a large proportion of seventh and eighth graders from high SES schools being non-participants (76.6%). A VSS-style program can be expected to be more effective with tweens who are younger, in a middle SES school, having high self-efficacy and high parental support for physical activity.

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.

Biomechanical assessment of dynamic balance: Specificity of different balance tests.

PubMed

Ringhof, Steffen; Stein, Thorsten

2018-04-01

Dynamic balance is vitally important for most sports and activities of daily living, so the assessment of dynamic stability has become an important issue. In consequence, a large number of balance tests have been developed. However, it is not yet known whether these tests (i) measure the same construct and (ii) can differentiate between athletes with different balance expertise. We therefore studied three common dynamic balance tests: one-leg jump landings, Posturomed perturbations and simulated forward falls. Participants were 24 healthy young females in regular training in either gymnastics (n = 12) or swimming (n = 12). In each of the tests, the participants were instructed to recover balance as quickly as possible. Dynamic stability was computed by time to stabilization and margin of stability, deduced from force plates and motion capture respectively. Pearson's correlations between the dynamic balance tests found no significant associations between the respective dynamic stability measures. Furthermore, independent t-tests indicated that only jump landings could properly distinguish between both groups of athletes. In essence, the different dynamic balance tests applied did not measure the same construct but rather task-specific skills, each of which depends on multifactorial internal and external constraints. Our study therefore contradicts the traditional view of considering balance as a general ability, and reinforces that dynamic balance measures are not interchangeable. This highlights the importance of selecting appropriate balance tests. Copyright © 2018 Elsevier B.V. All rights reserved.

Balancing Vanguard Satellites

NASA Technical Reports Server (NTRS)

Simkovich, A.; Baumann, Robert C.

1961-01-01

The Vanguard satellites and component parts were balanced within the specified limits by using a Gisholt Type-S balancer in combination with a portable International Research and Development vibration analyzer and filter, with low-frequency pickups. Equipment and procedures used for balancing are described; and the determination of residual imbalance is accomplished by two methods: calculation, and graphical interpretation. Between-the-bearings balancing is recommended for future balancing of payloads.

[Balance trainability using the Nintendo Wii balance board in sportive people].

PubMed

Paukowits, S; Stöggl, T

2014-03-01

A multivariable training has a positive impact on balance skills and risk of injury. To date the effect of this training using the Nintendo Wii balance board in sportive people has not yet been investigated. The aim of this study was to investigate whether training with the Nintendo Wii balance board can improve balance skills. 20 people were randomized into a control and an intervention group each with 10 people who performed a unilateral stance test with eyes open and closed as well as the star excursion balance test before and after the intervention. The control group completed their usual sports and the intervention group an adjunct training with the Nintendo Wii balance board for 4 weeks. Adjunct Training using the Nintendo Wii Balance Board did not improve sportive people's balance skills significantly. The intervention group, however, attained better results in the star excursion balance test, whereas the control group did not show any changes. The unilateral stance tests did not provide significant differences before and after training within both groups. The use of the Nintendo Wii balance board should be further investigated by employing individual difficulty levels. © Georg Thieme Verlag KG Stuttgart · New York.

Balance in Assessment

ERIC Educational Resources Information Center

White, Richard

2007-01-01

The review by Black and Wiliam of national systems makes clear the complexity of assessment, and identifies important issues. One of these is "balance": balance between local and central responsibilities, balance between the weights given to various purposes of schooling, balance between weights for various functions of assessment, and balance…

Rotor balance system

NASA Technical Reports Server (NTRS)

Novotny, Rudolph J. (Inventor)

1989-01-01

A balance ring (18) which is shrunk fit within each disk (12) of a rotor is selectively ground for detail balance. A plurality of openings (20) through the outer edge of the balance ring receive weights during the asssembly balance of the rotor. A snap ring (42) retains the weights within the openings.

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.

Surface Mass Balance of the Columbia Glacier, Alaska, 1978 and 2010 Balance Years

USGS Publications Warehouse

O'Neel, Shad

2012-01-01

Although Columbia Glacier is one of the largest sources of glacier mass loss in Alaska, surface mass balance measurements are sparse, with only a single data set available from 1978. The dearth of surface mass-balance data prohibits partitioning of the total mass losses between dynamics and surface forcing; however, the accurate inclusion of calving glaciers into predictive models requires both dynamic and climatic forcing of total mass balance. During 2010, the U.S. Geological Survey collected surface balance data at several locations distributed over the surface of Columbia Glacier to estimate the glacier-wide annual balance for balance year 2010 using the 2007 area-altitude distribution. This report also summarizes data collected in 1978, calculates the 1978 annual surface balance, and uses these observations to constrain the 2010 values, particularly the shape of the balance profile. Both years exhibit balances indicative of near-equilibrium surface mass-balance conditions, and demonstrate the importance of dynamic processes during the rapid retreat.

Skylab water balance analysis

NASA Technical Reports Server (NTRS)

Leonard, J. I.

1977-01-01

The water balance of the Skylab crew was analyzed. Evaporative water loss using a whole body input/output balance equation, water, body tissue, and energy balance was analyzed. The approach utilizes the results of several major Skylab medical experiments. Subsystems were designed for the use of the software necessary for the analysis. A partitional water balance that graphically depicts the changes due to water intake is presented. The energy balance analysis determines the net available energy to the individual crewman during any period. The balances produce a visual description of the total change of a particular body component during the course of the mission. The information is salvaged from metabolic balance data if certain techniques are used to reduce errors inherent in the balance method.

A balancing act: physical balance, through arousal, influences size perception.

PubMed

Geuss, Michael N; Stefanucci, Jeanine K; de Benedictis-Kessner, Justin; Stevens, Nicholas R

2010-10-01

Previous research has demonstrated that manipulating vision influences balance. Here, we question whether manipulating balance can influence vision and how it may influence vision--specifically, the perception of width. In Experiment 1, participants estimated the width of beams while balanced and unbalanced. When unbalanced, participants judged the widths to be smaller. One possible explanation is that unbalanced participants did not view the stimulus as long as when balanced because they were focused on remaining balanced. In Experiment 2, we tested this notion by limiting viewing time. Experiment 2 replicated the findings of Experiment 1, but viewing time had no effect on width judgments. In Experiment 3, participants' level of arousal was manipulated, because the balancing task likely produced arousal. While jogging, participants judged the beams to be smaller. In Experiment 4, participants completed another arousing task (counting backward by sevens) that did not involve movement. Again, participants judged the beams to be smaller when aroused. Experiment 5A raised participants' level of arousal before estimating the board widths (to control for potential dual-task effects) and showed that heightened arousal still influenced perceived width of the boards. Collectively, heightened levels of arousal, caused by multiple manipulations (including balance), influenced perceived width.

Wii Fit Balance Board Playing Improves Balance and Gait in Parkinson Disease

PubMed Central

Mhatre, Priya V.; Vilares, Iris; Stibb, Stacy M.; Albert, Mark V.; Pickering, Laura; Marciniak, Christina M.; Kording, Konrad; Toledo, Santiago

2014-01-01

Objective To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance board system on balance and gait in adults with Parkinson disease (PD). Design A prospective interventional cohort study. Setting An outpatient group exercise class. Participants Ten subjects with PD, Hoehn and Yahr stages 2.5 or 3, with a mean age of 67.1 years; 4 men, 6 women. Interventions The subjects participated in supervised group exercise sessions 3 times per week for 8 weeks by practicing 3 different Wii balance board games (marble tracking, skiing, and bubble rafting) adjusted for their individualized function level. The subjects trained for 10 minutes per game, a total of 30 minutes training per session. Main Outcome Measurements Pre-and postexercise training, a physical therapist evaluated subjects’ function by using the Berg Balance Scale, Dynamic Gait Index, and Sharpened Romberg with eyes open and closed. Postural sway was assessed at rest and with tracking tasks by using the Wii balance board. The subjects rated their confidence in balance by using the Activities-specific Balance Confidence scale and depression on the Geriatric Depression Scale. Results Balance as measured by the Berg Balance Scale improved significantly, with an increase of 3.3 points (P = .016). The Dynamic Gait Index improved as well (mean increase, 2.8; P = .004), as did postural sway measured with the balance board (decreased variance in stance with eyes open by 31%; P = .049). Although the Sharpened Romberg with eyes closed increased by 6.85 points and with eyes opened by 3.3 points, improvements neared significance only for eyes closed (P = .07 versus P = .188). There were no significant changes on patient ratings for the Activities-specific Balance Confidence (mean decrease, −1%; P = .922) or the Geriatric Depression Scale (mean increase, 2.2; P = .188). Conclusions An 8-week exercise training class by using the Wii Fit balance board improved selective measures of

Polarization-balanced beamsplitter

DOEpatents

Decker, D.E.

1998-02-17

A beamsplitter assembly is disclosed that includes several beamsplitter cubes arranged to define a plurality of polarization-balanced light paths. Each polarization-balanced light path contains one or more balanced pairs of light paths, where each balanced pair of light paths includes either two transmission light paths with orthogonal polarization effects or two reflection light paths with orthogonal polarization effects. The orthogonal pairing of said transmission and reflection light paths cancels polarization effects otherwise caused by beamsplitting. 10 figs.

Coaching for Balance.

ERIC Educational Resources Information Center

Larson, Bonnie

2001-01-01

Discusses coaching for balance the integration of the whole self: physical (body), intellectual (mind), spiritual (soul), and emotional (heart). Offers four ways to identify problems and tell whether someone is out of balance and four coaching techniques for creating balance. (Contains 11 references.) (JOW)

Work-life balance: history, costs, and budgeting for balance.

PubMed

Raja, Siva; Stein, Sharon L

2014-06-01

The concept and difficulties of work-life balance are not unique to surgeons, but professional responsibilities make maintaining a work-life balance difficult. Consequences of being exclusively career focused include burn out, physical, and mental ailments. In addition, physician burn out may hinder optimal patient care and incur significant costs on health care in general. Assessing current uses of time, allocating goals catered to an individual surgeon, and continual self-assessment may help balance time, and ideally will help prevent burn out.

Wii Fit balance board playing improves balance and gait in Parkinson disease.

PubMed

Mhatre, Priya V; Vilares, Iris; Stibb, Stacy M; Albert, Mark V; Pickering, Laura; Marciniak, Christina M; Kording, Konrad; Toledo, Santiago

2013-09-01

To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance board system on balance and gait in adults with Parkinson disease (PD). A prospective interventional cohort study. An outpatient group exercise class. Ten subjects with PD, Hoehn and Yahr stages 2.5 or 3, with a mean age of 67.1 years; 4 men, 6 women. The subjects participated in supervised group exercise sessions 3 times per week for 8 weeks by practicing 3 different Wii balance board games (marble tracking, skiing, and bubble rafting) adjusted for their individualized function level. The subjects trained for 10 minutes per game, a total of 30 minutes training per session. Pre-and postexercise training, a physical therapist evaluated subjects' function by using the Berg Balance Scale, Dynamic Gait Index, and Sharpened Romberg with eyes open and closed. Postural sway was assessed at rest and with tracking tasks by using the Wii balance board. The subjects rated their confidence in balance by using the Activities-specific Balance Confidence scale and depression on the Geriatric Depression Scale. Balance as measured by the Berg Balance Scale improved significantly, with an increase of 3.3 points (P = .016). The Dynamic Gait Index improved as well (mean increase, 2.8; P = .004), as did postural sway measured with the balance board (decreased variance in stance with eyes open by 31%; P = .049). Although the Sharpened Romberg with eyes closed increased by 6.85 points and with eyes opened by 3.3 points, improvements neared significance only for eyes closed (P = .07 versus P = .188). There were no significant changes on patient ratings for the Activities-specific Balance Confidence (mean decrease, -1%; P = .922) or the Geriatric Depression Scale (mean increase, 2.2; P = .188). An 8-week exercise training class by using the Wii Fit balance board improved selective measures of balance and gait in adults with PD. However, no significant changes were seen in mood or

Differential Sensitivity Between a Virtual Reality Balance Module and Clinically Used Concussion Balance Modalities.

PubMed

Teel, Elizabeth F; Gay, Michael R; Arnett, Peter A; Slobounov, Semyon M

2016-03-01

Balance assessments are part of the recommended clinical concussion evaluation, along with computerized neuropsychological testing and self-reported symptoms checklists. New technology has allowed for the creation of virtual reality (VR) balance assessments to be used in concussion care, but there is little information on the sensitivity and specificity of these evaluations. The purpose of this study is to establish the sensitivity and specificity of a VR balance module for detecting lingering balance deficits clinical concussion care. Retrospective case-control study. Institutional research laboratory. Normal controls (n = 94) and concussed participants (n = 27). All participants completed a VR balance assessment paradigm. Concussed participants were diagnosed by a Certified Athletic Trainer or physician (with 48 hours postinjury) and tested in the laboratory between 7 and 10 days postinjury. Receiver operating characteristic curves were performed to establish the VR module's sensitivity and specificity for detecting lingering balance deficits. Final balance score. For the VR balance module, a cutoff score of 8.25 was established to maximize sensitivity at 85.7% and specificity at 87.8%. The VR balance module has high sensitivity and specificity for detecting subacute balance deficits after concussive injury. The VR balance has a high subacute sensitivity and specificity as a stand-alone balance assessment tool and may detect ongoing balance deficits not readily detectable by the Balance Error Scoring System or Sensory Organization Test. Virtual reality balance modules may be a beneficial addition to the current clinical concussion diagnostic battery.

AN INITIAL EVALUATION OF THE BTRACKS BALANCE PLATE AND SPORTS BALANCE SOFTWARE FOR CONCUSSION DIAGNOSIS

PubMed Central

Manyak, Kristin A.; Abdenour, Thomas E.; Rauh, Mitchell J.; Baweja, Harsimran S.

2016-01-01

Background As recently dictated by the American Medical Society, balance testing is an important component in the clinical evaluation of concussion. Despite this, previous research on the efficacy of balance testing for concussion diagnosis suggests low sensitivity (∼30%), based primarily on the popular Balance Error Scoring System (BESS). The Balance Tracking System (BTrackS, Balance Tracking Systems Inc., San Diego, CA, USA) consists of a force plate (BTrackS Balance Plate) and software (BTrackS Sport Balance) which can quickly (<2 min) perform concussion balance testing with gold standard accuracy. Purpose The present study aimed to determine the sensitivity of the BTrackS Balance Plate and Sports Balance Software for concussion diagnosis. Study Design Cross-Sectional Study Methods Preseason baseline balance testing of 519 healthy Division I college athletes playing sports with a relatively high risk for concussions was performed with the BTrackS Balance Test. Testing was administered by certified athletic training staff using the BTrackS Balance Plate and Sport Balance software. Of the baselined athletes, 25 later experienced a concussion during the ensuing sport season. Post-injury balance testing was performed on these concussed athletes within 48 of injury and the sensitivity of the BTrackS Balance Plate and Sport Balance software was estimated based on the number of athletes showing a balance decline according to the criteria specified in the Sport Balance software. This criteria is based on the minimal detectable change statistic with a 90% confidence level (i.e. 90% specificity). Results Of 25 athletes who experienced concussions, 16 had balance declines relative to baseline testing results according to the BTrackS Sport Balance software criteria. This corresponds to an estimated concussion sensitivity of 64%, which is twice as great as that reported previously for the BESS. Conclusions The BTrackS Balance Plate and Sport Balance software has the

[Seventy years of medicine in the Instituto Mexicano del Seguro Social].

PubMed

Fajardo-Ortiz, Guillermo

2014-01-01

The purpose of these lines is to remember and refer some of the historical landmarks in the evolution of the medical services of the Instituto Mexicano del Seguro Social (IMSS, according to its initials in Spanish) since it was founded, in 1943. We also want to bring to the reader's attention that the dimensions and impacts on health that IMSS has achieved, throughout its history, have strengthened the citizenship, as well as social sustainability. Also, those impacts have determined the creation and the reinforcement of human capital in México. Throughout this concise balance, all the controversy surrounding the foundation of the Institute is being recalled (the protest in the Mexico City Zócalo, or the attack to an hospital in San Ángel -a neighborhood located in the Southwest of Mexico City-), as well as the way the IMSS incorporated several words into the vocabulary of Mexicans. We also remember the previous antecedent of the Revista Médica del Instituto Mexicano del Seguro Social, as well as the Revista de Enfermería, and the emblematic Archives of Medical Research. The IMSS has 70 years of achievements, seven decades covered.

Work–Life Balance: History, Costs, and Budgeting for Balance

PubMed Central

Raja, Siva; Stein, Sharon L.

2014-01-01

The concept and difficulties of work–life balance are not unique to surgeons, but professional responsibilities make maintaining a work–life balance difficult. Consequences of being exclusively career focused include burn out, physical, and mental ailments. In addition, physician burn out may hinder optimal patient care and incur significant costs on health care in general. Assessing current uses of time, allocating goals catered to an individual surgeon, and continual self-assessment may help balance time, and ideally will help prevent burn out. PMID:25067921

Laser Balancing

NASA Technical Reports Server (NTRS)

1981-01-01

Mechanical Technology, Incorporated developed a fully automatic laser machining process that allows more precise balancing removes metal faster, eliminates excess metal removal and other operator induced inaccuracies, and provides significant reduction in balancing time. Manufacturing costs are reduced as a result.

Balancing Act

Cancer.gov

Part of being an Active, More Powerful You means finding balance in your daily life: taking on the Must-dos and finding time for some Should Dos and Want-to-Dos. Sometimes, emotions and commitments can come into play and upset the balance.

A Question of Balance

ERIC Educational Resources Information Center

Claxton, David B.; Troy, Maridy; Dupree, Sarah

2006-01-01

Most authorities consider balance to be a component of skill-related physical fitness. Balance, however, is directly related to health, especially for older adults. Falls are a leading cause of injury and death among the elderly. Improved balance can help reduce falls and contribute to older people remaining physically active. Balance is a…

Balance and Self-Efficacy of Balance in Children with CHARGE Syndrome

ERIC Educational Resources Information Center

Haibach, Pamela S.; Lieberman, Lauren J.

2013-01-01

Introduction: Balance is a critical component of daily living, because it affects all movements and the ability to function independently. Children with CHARGE syndrome have sensory and motor impairments that could negatively affect their balance and postural control. The purpose of the study presented in this article was to assess the balance and…

Balance Assessment Practices and Use of Standardized Balance Measures Among Ontario Physical Therapists

PubMed Central

Sibley, Kathryn M.; Straus, Sharon E.; Inness, Elizabeth L.; Salbach, Nancy M.

2011-01-01

Background Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. Objective The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. Design This was a cross-sectional study. Methods A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. Results Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed “Up & Go” Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. Limitations The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. Conclusions Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall. PMID:21868613

DEL phenotype.

PubMed

Kwon, Dong H; Sandler, S G; Flegel, Willy A

2017-09-01

DEL red blood cells (RBCs) type as D- by routine serologic methods and are transfused routinely, without being identified as expressing a very weak D antigen, to D- recipients. DEL RBCs are detected only by adsorption and elution of anti-D or by molecular methods. Most DEL phenotypes have been reported in population studies conducted in East Asia, although DEL phenotypes have been detected also among Caucasian individuals. Approximately 98 percent of DEL phenotypes in East Asians are associated with the RHD*DEL1 or RHD*01EL.01 allele. The prevalence of DEL phenotypes has been reported among D- Han Chinese (30%), Japanese (28%), and Korean (17%) populations. The prevalence of DEL phenotypes is significantly lower among D- Caucasian populations (0.1%). Among the 3-5 percent of African individuals who are D-, there are no reports of the DEL phenotype. Case reports from East Asia indicate that transfusion of DEL RBCs to D- recipients has been associated with D alloimmunization. East Asian immigrants constitute 2.1 percent of the 318.9 million persons residing in the United States, and an estimated 2.8 percent are blood donors. Using these statistics, we estimate that 68-683 units of DEL RBCs from donors of East Asian ancestry are transfused as D- annually in the United States. Given the reports from East Asia of D alloimmunization attributed to transfusion of DEL RBCs, one would expect an occasional report of D alloimmunization in the United States following transfusion of DEL RBCs to a D- recipient. If such cases do occur, the most likely reason that they are not detected is the absence of active post-transfusion monitoring for formation of anti-D.

The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson's Patients: A Report of Four Cases.

PubMed

Balci, Nilay Çömük; Tonga, Eda; Gülşen, Mustafa

2013-09-01

This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson's disease. Four patients with Parkinson's disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson's Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson's patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson's disease patients.

Automatic force balance calibration system

NASA Technical Reports Server (NTRS)

Ferris, Alice T. (Inventor)

1995-01-01

A system for automatically calibrating force balances is provided. The invention uses a reference balance aligned with the balance being calibrated to provide superior accuracy while minimizing the time required to complete the calibration. The reference balance and the test balance are rigidly attached together with closely aligned moment centers. Loads placed on the system equally effect each balance, and the differences in the readings of the two balances can be used to generate the calibration matrix for the test balance. Since the accuracy of the test calibration is determined by the accuracy of the reference balance and current technology allows for reference balances to be calibrated to within +/-0.05% the entire system has an accuracy of +/-0.2%. The entire apparatus is relatively small and can be mounted on a movable base for easy transport between test locations. The system can also accept a wide variety of reference balances, thus allowing calibration under diverse load and size requirements.

Automatic force balance calibration system

NASA Technical Reports Server (NTRS)

Ferris, Alice T. (Inventor)

1996-01-01

A system for automatically calibrating force balances is provided. The invention uses a reference balance aligned with the balance being calibrated to provide superior accuracy while minimizing the time required to complete the calibration. The reference balance and the test balance are rigidly attached together with closely aligned moment centers. Loads placed on the system equally effect each balance, and the differences in the readings of the two balances can be used to generate the calibration matrix for the test balance. Since the accuracy of the test calibration is determined by the accuracy of the reference balance and current technology allows for reference balances to be calibrated to within .+-.0.05%, the entire system has an accuracy of a .+-.0.2%. The entire apparatus is relatively small and can be mounted on a movable base for easy transport between test locations. The system can also accept a wide variety of reference balances, thus allowing calibration under diverse load and size requirements.

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…

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.…

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…

Dynamic balance improvement program

NASA Technical Reports Server (NTRS)

Butner, M. F.

1983-01-01

The reduction of residual unbalance in the space shuttle main engine (SSME) high pressure turbopump rotors was addressed. Elastic rotor response to unbalance and balancing requirements, multiplane and in housing balancing, and balance related rotor design considerations were assessed. Recommendations are made for near term improvement of the SSME balancing and for future study and development efforts.

Balance and flexibility.

PubMed

2003-12-01

The 'work-life balance' and flexible working are currently key buzz terms in the NHS. Those looking for more information on these topics should visit Flexibility at www.flexibility.co.uk for a host of resources designed to support new ways of working, including information on flexible workers and flexible rostering, the legal balancing act for work-life balance and home working.

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.

Balance Food and Activity

MedlinePlus

... eNewsletters Calendar Balance Food and Activity What is Energy Balance? Energy is another word for "calories." Your ... adults, fewer calories are needed at older ages. Energy Balance in Real Life Think of it as ...

The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson’s Patients: A Report of Four Cases

PubMed Central

BALCI, Nilay Çömük; TONGA, Eda; GÜLŞEN, Mustafa

2013-01-01

This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson’s disease. Four patients with Parkinson’s disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson’s Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson’s patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson’s disease patients. PMID:28360557

Atypical E2F transcriptional repressor DEL1 acts at the intersection of plant growth and immunity by controlling the hormone salicylic acid.

PubMed

Chandran, Divya; Rickert, Joshua; Huang, Yingxiang; Steinwand, Michael A; Marr, Sharon K; Wildermuth, Mary C

2014-04-09

In plants, the activation of immunity is often inversely correlated with growth. Mechanisms that control plant growth in the context of pathogen challenge and immunity are unclear. Investigating Arabidopsis infection with the powdery mildew fungus, we find that the Arabidopsis atypical E2F DEL1, a transcriptional repressor known to promote cell proliferation, represses accumulation of the hormone salicylic acid (SA), an established regulator of plant immunity. DEL1-deficient plants are more resistant to pathogens and slightly smaller than wild-type. The resistance and size phenotypes of DEL1-deficient plants are due to the induction of SA and activation of immunity in the absence of pathogen challenge. Moreover, Enhanced Disease Susceptibility 5 (EDS5), a SA transporter required for elevated SA and immunity, is a direct repressed target of DEL1. Together, these findings indicate that DEL1 control of SA levels contributes to regulating the balance between growth and immunity in developing leaves. Copyright © 2014 Elsevier Inc. All rights reserved.

Balance confidence is related to features of balance and gait in individuals with chronic stroke

PubMed Central

Schinkel-Ivy, Alison; Wong, Jennifer S.; Mansfield, Avril

2016-01-01

Reduced balance confidence is associated with impairments in features of balance and gait in individuals with sub-acute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke. Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months post-discharge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable and quiet standing, walking, and reactive stepping outcome measures as the dependent variables. Walking velocity was positively correlated with balance confidence, while medio-lateral centre of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence. This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs. PMID:27955809

Balance ability and athletic performance.

PubMed

Hrysomallis, Con

2011-03-01

The relationship between balance ability and sport injury risk has been established in many cases, but the relationship between balance ability and athletic performance is less clear. This review compares the balance ability of athletes from different sports, determines if there is a difference in balance ability of athletes at different levels of competition within the same sport, determines the relationship of balance ability with performance measures and examines the influence of balance training on sport performance or motor skills. Based on the available data from cross-sectional studies, gymnasts tended to have the best balance ability, followed by soccer players, swimmers, active control subjects and then basketball players. Surprisingly, no studies were found that compared the balance ability of rifle shooters with other athletes. There were some sports, such as rifle shooting, soccer and golf, where elite athletes were found to have superior balance ability compared with their less proficient counterparts, but this was not found to be the case for alpine skiing, surfing and judo. Balance ability was shown to be significantly related to rifle shooting accuracy, archery shooting accuracy, ice hockey maximum skating speed and simulated luge start speed, but not for baseball pitching accuracy or snowboarding ranking points. Prospective studies have shown that the addition of a balance training component to the activities of recreationally active subjects or physical education students has resulted in improvements in vertical jump, agility, shuttle run and downhill slalom skiing. A proposed mechanism for the enhancement in motor skills from balance training is an increase in the rate of force development. There are limited data on the influence of balance training on motor skills of elite athletes. When the effectiveness of balance training was compared with resistance training, it was found that resistance training produced superior performance results for

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.

Effect of Selected Balance Exercises on the Dynamic Balance of Children with Visual Impairments

ERIC Educational Resources Information Center

Jazi, Shirin Davarpanah; Purrajabi, Fatemeh; Movahedi, Ahmadreza; Jalali, Shahin

2012-01-01

Introduction: Maintaining balance while walking is of utmost importance for individuals with visual impairments because deficits in dynamic balance have been associated with a high risk of falling. Thus, the primary aim of the study presented here was to determine whether balance training effects the dynamic balance of children with visual…

Loss of balance during balance beam walking elicits a multifocal theta band electrocortical response

PubMed Central

Gwin, Joseph T.; Makeig, Scott; Ferris, Daniel P.

2013-01-01

Determining the neural correlates of loss of balance during walking could lead to improved clinical assessment and treatment for individuals predisposed to falls. We used high-density electroencephalography (EEG) combined with independent component analysis (ICA) to study loss of balance during human walking. We examined 26 healthy young subjects performing heel-to-toe walking on a treadmill-mounted balance beam as well as walking on the treadmill belt (both at 0.22 m/s). ICA identified clusters of electrocortical EEG sources located in or near anterior cingulate, anterior parietal, superior dorsolateral-prefrontal, and medial sensorimotor cortex that exhibited significantly larger mean spectral power in the theta band (4–7 Hz) during walking on the balance beam compared with treadmill walking. Left and right sensorimotor cortex clusters produced significantly less power in the beta band (12–30 Hz) during walking on the balance beam compared with treadmill walking. For each source cluster, we also computed a normalized mean time/frequency spectrogram time locked to the gait cycle during loss of balance (i.e., when subjects stepped off the balance beam). All clusters except the medial sensorimotor cluster exhibited a transient increase in theta band power during loss of balance. Cluster spectrograms demonstrated that the first electrocortical indication of impending loss of balance occurred in the left sensorimotor cortex at the transition from single support to double support prior to stepping off the beam. These findings provide new insight into the neural correlates of walking balance control and could aid future studies on elderly individuals and others with balance impairments. PMID:23926037

Loss of balance during balance beam walking elicits a multifocal theta band electrocortical response.

PubMed

Sipp, Amy R; Gwin, Joseph T; Makeig, Scott; Ferris, Daniel P

2013-11-01

Determining the neural correlates of loss of balance during walking could lead to improved clinical assessment and treatment for individuals predisposed to falls. We used high-density electroencephalography (EEG) combined with independent component analysis (ICA) to study loss of balance during human walking. We examined 26 healthy young subjects performing heel-to-toe walking on a treadmill-mounted balance beam as well as walking on the treadmill belt (both at 0.22 m/s). ICA identified clusters of electrocortical EEG sources located in or near anterior cingulate, anterior parietal, superior dorsolateral-prefrontal, and medial sensorimotor cortex that exhibited significantly larger mean spectral power in the theta band (4-7 Hz) during walking on the balance beam compared with treadmill walking. Left and right sensorimotor cortex clusters produced significantly less power in the beta band (12-30 Hz) during walking on the balance beam compared with treadmill walking. For each source cluster, we also computed a normalized mean time/frequency spectrogram time locked to the gait cycle during loss of balance (i.e., when subjects stepped off the balance beam). All clusters except the medial sensorimotor cluster exhibited a transient increase in theta band power during loss of balance. Cluster spectrograms demonstrated that the first electrocortical indication of impending loss of balance occurred in the left sensorimotor cortex at the transition from single support to double support prior to stepping off the beam. These findings provide new insight into the neural correlates of walking balance control and could aid future studies on elderly individuals and others with balance impairments.

Balancing

NASA Astrophysics Data System (ADS)

Harteveld, Casper

At many occasions we are asked to achieve a “balance” in our lives: when it comes, for example, to work and food. Balancing is crucial in game design as well as many have pointed out. In games with a meaningful purpose, however, balancing is remarkably different. It involves the balancing of three different worlds, the worlds of Reality, Meaning, and Play. From the experience of designing Levee Patroller, I observed that different types of tensions can come into existence that require balancing. It is possible to conceive of within-worlds dilemmas, between-worlds dilemmas, and trilemmas. The first, the within-world dilemmas, only take place within one of the worlds. We can think, for example, of a user interface problem which just relates to the world of Play. The second, the between-worlds dilemmas, have to do with a tension in which two worlds are predominantly involved. Choosing between a cartoon or a realistic style concerns, for instance, a tension between Reality and Play. Finally, the trilemmas are those in which all three worlds play an important role. For each of the types of tensions, I will give in this level a concrete example from the development of Levee Patroller. Although these examples come from just one game, I think the examples can be exemplary for other game development projects as they may represent stereotypical tensions. Therefore, to achieve harmony in any of these forthcoming games, it is worthwhile to study the struggles we had to deal with.

Cavendish Balance Automation

NASA Technical Reports Server (NTRS)

Thompson, Bryan

2000-01-01

This is the final report for a project carried out to modify a manual commercial Cavendish Balance for automated use in cryostat. The scope of this project was to modify an off-the-shelf manually operated Cavendish Balance to allow for automated operation for periods of hours or days in cryostat. The purpose of this modification was to allow the balance to be used in the study of effects of superconducting materials on the local gravitational field strength to determine if the strength of gravitational fields can be reduced. A Cavendish Balance was chosen because it is a fairly simple piece of equipment for measuring gravity, one the least accurately known and least understood physical constants. The principle activities that occurred under this purchase order were: (1) All the components necessary to hold and automate the Cavendish Balance in a cryostat were designed. Engineering drawings were made of custom parts to be fabricated, other off-the-shelf parts were procured; (2) Software was written in LabView to control the automation process via a stepper motor controller and stepper motor, and to collect data from the balance during testing; (3)Software was written to take the data collected from the Cavendish Balance and reduce it to give a value for the gravitational constant; (4) The components of the system were assembled and fitted to a cryostat. Also the LabView hardware including the control computer, stepper motor driver, data collection boards, and necessary cabling were assembled; and (5) The system was operated for a number of periods, data collected, and reduced to give an average value for the gravitational constant.

Balance Calibration – A Method for Assigning a Direct-Reading Uncertainty to an Electronic Balance.

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

Mike Stears

2010-07-01

Paper Title: Balance Calibration – A method for assigning a direct-reading uncertainty to an electronic balance. Intended Audience: Those who calibrate or use electronic balances. Abstract: As a calibration facility, we provide on-site (at the customer’s location) calibrations of electronic balances for customers within our company. In our experience, most of our customers are not using their balance as a comparator, but simply putting an unknown quantity on the balance and reading the displayed mass value. Manufacturer’s specifications for balances typically include specifications such as readability, repeatability, linearity, and sensitivity temperature drift, but what does this all mean when themore » balance user simply reads the displayed mass value and accepts the reading as the true value? This paper discusses a method for assigning a direct-reading uncertainty to a balance based upon the observed calibration data and the environment where the balance is being used. The method requires input from the customer regarding the environment where the balance is used and encourages discussion with the customer regarding sources of uncertainty and possible means for improvement; the calibration process becomes an educational opportunity for the balance user as well as calibration personnel. This paper will cover the uncertainty analysis applied to the calibration weights used for the field calibration of balances; the uncertainty is calculated over the range of environmental conditions typically encountered in the field and the resulting range of air density. The temperature stability in the area of the balance is discussed with the customer and the temperature range over which the balance calibration is valid is decided upon; the decision is based upon the uncertainty needs of the customer and the desired rigor in monitoring by the customer. Once the environmental limitations are decided, the calibration is performed and the measurement data is entered into

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.

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.

Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial.

PubMed

Yatar, Gozde Iyigun; Yildirim, Sibel Aksu

2015-04-01

[Purpose] The aim of this study was to compare the effects of Wii Fit balance training (WBT) and progressive balance training (PBT) approaches on balance functions, balance confidence, and activities of daily living in chronic stroke patients. [Subjects] A total of 30 patients were randomized into the WBT (n=15) and PBT (n=15) groups. [Methods] All of the subjects received exercise training based on a neurodevelopemental approach in addition to either Wii Fit or progressive balance training for total of 1 hour a day, 3 days per week for 4 weeks. Primary measurements were static balance function measured with a Wii Balance Board and dynamic balance function assessed with the Berg Balance Scale, Timed Up and Go test, Dynamic Gait Index, and Functional Reach Test. Secondary measures were balance confidence assessed with the Activities-specific Balance Confidence scale and activities of daily living evaluated with the Frenchay Activity Index. [Results] There was not remarkable difference between the two treatments in dynamic balance functions, balance confidence, and activities of daily living. [Conclusion] Although both of the approaches were found to be effective in improving the balance functions, balance confidence, and activities of daily living, neither of them were more preferable than the other for the treatment of balance in patients with chronic stroke.

Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial

PubMed Central

Yatar, Gozde Iyigun; Yildirim, Sibel Aksu

2015-01-01

[Purpose] The aim of this study was to compare the effects of Wii Fit balance training (WBT) and progressive balance training (PBT) approaches on balance functions, balance confidence, and activities of daily living in chronic stroke patients. [Subjects] A total of 30 patients were randomized into the WBT (n=15) and PBT (n=15) groups. [Methods] All of the subjects received exercise training based on a neurodevelopemental approach in addition to either Wii Fit or progressive balance training for total of 1 hour a day, 3 days per week for 4 weeks. Primary measurements were static balance function measured with a Wii Balance Board and dynamic balance function assessed with the Berg Balance Scale, Timed Up and Go test, Dynamic Gait Index, and Functional Reach Test. Secondary measures were balance confidence assessed with the Activities-specific Balance Confidence scale and activities of daily living evaluated with the Frenchay Activity Index. [Results] There was not remarkable difference between the two treatments in dynamic balance functions, balance confidence, and activities of daily living. [Conclusion] Although both of the approaches were found to be effective in improving the balance functions, balance confidence, and activities of daily living, neither of them were more preferable than the other for the treatment of balance in patients with chronic stroke. PMID:25995576

Effects of DanceSport on walking balance and standing balance among the elderly.

PubMed

Sohn, Jeehoon; Park, Sung-Ha; Kim, Sukwon

2018-05-04

Dancesport is a popular activity among older adults who look for fun and fitness in Korea. Studies reported positive sociological and psychological effects of dancesport. But, little studies were performed to evaluate the effects of dancesport on balance performances. The objective of the present study was to evaluate the effects of dancesport for 15 weeks on walking balance and standing balance of older adults. Older adults regularly participated in the dancesport program 3 times a week for 15 weeks. The program included Rumba, Cha-cha-cha, and Jive. They exercised the prescribed dancesport at intermediate level for 50-60 mins for each time. A total 22 reflective markers were placed on the anatomical landmarks and 8 cameras were used to measure 3-D positions of participants. Also, center of pressure (COP) data were measured to analyze standing balance using a ground reaction board at 1200 Hz for 30 seconds. One-way analysis of variance (ANOVA) was performed to test the effects of 15 weeks of dancesport on walking balance and standing balance. The results suggested that, after 15 weeks of dancesport participation, older adults' walking balance (48.3 ± 20.3 cm2 vs 38.2 ± 18.2 cm2) and standing balance (COP area: 189.4 ± 85.4 mm2 vs 103.5 ± 55.4mm2, COP distance: 84.2 ± 34.4 cm vs 76.5 ± 21.4 cm) were significantly improved. Performing dancesport would require moving center of mass rapidly and frequently while maintaining posture. This may result in improving walking balance and standing balance in the present study. The study concluded that dancesport would be an effective exercise method in enhancing postural stability of older adults.

Balance evaluation in haemophilic preadolescent patients using Nintendo Wii Balance Board®.

PubMed

Pérez-Alenda, S; Carrasco, J J; Aguilar-Rodríguez, M; Martínez-Gómez, L; Querol-Giner, M; Cuesta-Barriuso, R; Torres-Ortuño, A; Querol, F

2017-01-01

Alterations in the musculoskeletal system, especially in the lower limbs, limit physical activity and affect balance and walking. Postural impairments in haemophilic preteens could increase the risk of bleeding events and deteriorate the physical condition, promoting the progression of haemophilic arthropathy. This study aims to evaluate static postural balance in haemophilic children, assessed by means of the Wii Balance Board ® (WBB). Nineteen children with haemophilia and 19 without haemophilia aged 9-10 years, have participated in this study. Postural balance was assessed by performing four tests, each one lasting 15 s: bipodal eyes open (BEO), bipodal eyes closed (BEC), monopodal dominant leg (MD) and monopodal non-dominant leg (MND). Two balance indices, standard deviation of amplitude (SDA) and standard deviation of velocity (SDV) were calculated in the anterior-posterior (AP) and medial-lateral (ML) directions. Index values were higher in haemophilic group and the differences were statistically significant (P < 0.05) in only six (SDAAP in BEO, BEC and MD conditions, SDAML in BEO, SDVAP in BEO and SDVML in MND condition) of 16 parameters analysed. Tests performed indicate a poorer static postural balance in the haemophilic cohort compared to the control group. Accordingly, physiotherapy programmes, physical activity and sports should be designed to improve the postural balance with the aim of preventing joint deterioration and improving quality of life. © 2016 John Wiley & Sons Ltd.

Balance Evaluation Systems

NASA Technical Reports Server (NTRS)

1996-01-01

NeuroCom's Balance Master is a system to assess and then retrain patients with balance and mobility problems and is used in several medical centers. NeuroCom received assistance in research and funding from NASA, and incorporated technology from testing mechanisms for astronauts after shuttle flights. The EquiTest and Balance Master Systems are computerized posturography machines that measure patient responses to movement of a platform on which the subject is standing or sitting, then provide assessments of the patient's postural alignment and stability.

Predicting prolonged intensive care unit length of stay in patients undergoing coronary artery bypass surgery--development of an entirely preoperative scorecard.

PubMed

Herman, Christine; Karolak, Wojtek; Yip, Alexandra M; Buth, Karen J; Hassan, Ansar; Légaré, Jean-Francois

2009-10-01

We sought to develop a predictive model based exclusively on preoperative factors to identify patients at risk for PrlICULOS following coronary artery bypass grafting (CABG). Retrospective analysis was performed on patients undergoing isolated CABG at a single center between June 1998 and December 2002. PrlICULOS was defined as initial admission to ICU exceeding 72 h. A parsimonious risk-predictive model was constructed on the basis of preoperative factors, with subsequent internal validation. Of 3483 patients undergoing isolated CABG between June 1998 and December 2002, 411 (11.8%) experienced PrlICULOS. Overall in-hospital mortality was higher among these patients (14.4% vs. 1.2%, Pscorecard was developed allowing identification of these patients prior to surgery and allowing for strategies aimed at optimizing hospital resources.

Differential sensitivity between a virtual reality (VR) balance module and clinically used concussion balance modalities

PubMed Central

Teel, Elizabeth F; Gay, Michael R; Arnett, Peter A; Slobounov, Semyon M

2015-01-01

Objective Balance assessments are part of the recommended clinical concussion evaluation, along with computerized neuropsychological testing and self-reported symptoms checklists. New technology has allowed for the creation of virtual reality (VR) balance assessments to be used in concussion care, but there is little information on the sensitivity and specificity of these evaluations. The purpose of this study is to establish the sensitivity and specificity of a VR balance module for detecting lingering balance deficits clinical concussion care. Design Retrospective, case-control study Setting Institutional research laboratory Participants Normal controls (n=94) and concussed participants (n=27) Interventions All participants completed a VR balance assessment paradigm. Concussed participants were diagnosed by a Certified Athletic Trainer or physician (with 48 hours post-injury) and tested in the lab between 7-10 days post-injury. ROC curves were performed in order to establish the VR module’s sensitivity and specificity for detecting lingering balance deficits. Main Outcome Measures Final balance score Results For the VR balance module, a cutoff score of 8.25 was established to maximize sensitivity at 85.7% and specificity at 87.8%. Conclusions The VR balance module has high sensitivity and specificity for detecting sub-acute balance deficits after concussive injury. PMID:26505696

Smarter Balanced Preliminary Performance Levels: Estimated MAP Scores Corresponding to the Preliminary Performance Levels of the Smarter Balanced Assessment Consortium (Smarter Balanced)

ERIC Educational Resources Information Center

Northwest Evaluation Association, 2015

2015-01-01

Recently, the Smarter Balanced Assessment Consortium (Smarter Balanced) released a document that established initial performance levels and the associated threshold scale scores for the Smarter Balanced assessment. The report included estimated percentages of students expected to perform at each of the four performance levels, reported by grade…

A balancing act? Work-life balance, health and well-being in European welfare states.

PubMed

Lunau, Thorsten; Bambra, Clare; Eikemo, Terje A; van der Wel, Kjetil A; Dragano, Nico

2014-06-01

Recent analyses have shown that adverse psychosocial working conditions, such as job strain and effort-reward imbalance, vary by country and welfare state regimes. Another work-related factor with potential impact on health is a poor work-life balance. The aims of this study are to determine the association between a poor work-life balance and poor health across a variety of European countries and to explore the variation of work-life balance between European countries. Data from the 2010 European Working Conditions Survey were used with 24,096 employees in 27 European countries. Work-life balance is measured with a question on the fit between working hours and family or social commitments. The WHO-5 well-being index and self-rated general health are used as health indicators. Logistic multilevel models were calculated to assess the association between work-life balance and health indicators and to explore the between-country variation of a poor work-life balance. Employees reporting a poor work-life balance reported more health problems (Poor well-being: OR = 2.06, 95% CI = 1.83-2.31; Poor self-rated health: OR = 2.00, 95% CI = 1.84-2.17). The associations were very similar for men and women. A considerable part of the between-country variation of work-life balance is explained by working hours, working time regulations and welfare state regimes. The best overall work-life balance is reported by Scandinavian men and women. This study provides some evidence on the public health impact of a poor work-life balance and that working time regulations and welfare state characteristics can influence the work-life balance of employees. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Get the Balance Right.

ERIC Educational Resources Information Center

Haddock, Rebecca Jaurigue

Today work goes on 24 hours a day, 7 days a week, and is about acceleration and access. Workers need balance more than ever. In fact, recent college graduates value work/life balance as their key factor in selecting employers. This paper, written for career counselors, defines balance as encompassing emotional, spiritual, physical, and…

26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Effect of prefunding balance and funding standard carryover balance. 1.430(f)-1 Section 1.430(f)-1 Internal Revenue INTERNAL REVENUE SERVICE... Effect of prefunding balance and funding standard carryover balance. (a) In general—(1) Overview. This...

Effects of circular gait training on balance, balance confidence in patients with stroke: a pilot study.

PubMed

Park, Shin-Kyu; Kim, Sung-Jin; Yoon, Tak Yong; Lee, Suk-Min

2018-05-01

[Purpose] This study aimed to investigate the effects of circular gait training on balance and balance confidence in patients with stroke. [Subjects and Methods] Fifteen patients with stroke were randomly divided into either the circular gait training (CGT) group (n=8) or the straight gait training (SGT) group (n=7). Both groups had conventional therapy that adhered to the neurodevelopmental treatment (NDT) approach, for 30 min. In addition, the CGT group performed circular gait training, and the SGT group practiced straight gait training for 30 min. Each intervention was applied for 1 h, 5 days a week, for 2 weeks. Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Activities-specific Balance Confidence (ABC) scale were used to test balance and balance confidence. [Results] After the intervention, both groups showed significant increases in balance and balance confidence. Significant improvements in the balance of the CGT group compared with the SGT group were observed at post-assessment. [Conclusion] This study showed that circular gait training significantly improves balance in patients with stroke.

Balancing with Vibration: A Prelude for “Drift and Act” Balance Control

PubMed Central

Milton, John G.; Ohira, Toru; Cabrera, Juan Luis; Fraiser, Ryan M.; Gyorffy, Janelle B.; Ruiz, Ferrin K.; Strauss, Meredith A.; Balch, Elizabeth C.; Marin, Pedro J.; Alexander, Jeffrey L.

2009-01-01

Stick balancing at the fingertip is a powerful paradigm for the study of the control of human balance. Here we show that the mean stick balancing time is increased by about two-fold when a subject stands on a vibrating platform that produces vertical vibrations at the fingertip (0.001 m, 15–50 Hz). High speed motion capture measurements in three dimensions demonstrate that vibration does not shorten the neural latency for stick balancing or change the distribution of the changes in speed made by the fingertip during stick balancing, but does decrease the amplitude of the fluctuations in the relative positions of the fingertip and the tip of the stick in the horizontal plane, A(x,y). The findings are interpreted in terms of a time-delayed “drift and act” control mechanism in which controlling movements are made only when controlled variables exceed a threshold, i.e. the stick survival time measures the time to cross a threshold. The amplitude of the oscillations produced by this mechanism can be decreased by parametric excitation. It is shown that a plot of the logarithm of the vibration-induced increase in stick balancing skill, a measure of the mean first passage time, versus the standard deviation of the A(x,y) fluctuations, a measure of the distance to the threshold, is linear as expected for the times to cross a threshold in a stochastic dynamical system. These observations suggest that the balanced state represents a complex time–dependent state which is situated in a basin of attraction that is of the same order of size. The fact that vibration amplitude can benefit balance control raises the possibility of minimizing risk of falling through appropriate changes in the design of footwear and roughness of the walking surfaces. PMID:19841741

Calcium Balance in Chronic Kidney Disease.

PubMed

Hill Gallant, Kathleen M; Spiegel, David M

2017-06-01

The kidneys play a critical role in the balance between the internal milieu and external environment. Kidney failure is known to disrupt a number of homeostatic mechanisms that control serum calcium and normal bone metabolism. However, our understanding of calcium balance throughout the stages of chronic kidney disease is limited and the concept of balance itself, especially with a cation as complex as calcium, is often misunderstood. Both negative and positive calcium balance have important implications in patients with chronic kidney disease, where negative balance may increase risk of osteoporosis and fracture and positive balance may increase risk of vascular calcification and cardiovascular events. Here, we examine the state of current knowledge about calcium balance in adults throughout the stages of chronic kidney disease and discuss recommendations for clinical strategies to maintain balance as well as future research needs in this area. Recent calcium balance studies in adult patients with chronic kidney disease show that neutral calcium balance is achieved with calcium intake near the recommended daily allowance. Increases in calcium through diet or supplements cause high positive calcium balance, which may put patients at risk for vascular calcification. However, heterogeneity in calcium balance exists among these patients. Given the available calcium balance data in this population, it appears clinically prudent to aim for recommended calcium intakes around 1000 mg/day to achieve neutral calcium balance and avoid adverse effects of either negative or positive calcium balance. Assessment of patients' dietary calcium intake could further equip clinicians to make individualized recommendations for meeting recommended intakes.

26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Effect of prefunding balance and funding standard carryover balance. 1.430(f)-1 Section 1.430(f)-1 Internal Revenue INTERNAL REVENUE SERVICE... § 1.430(f)-1 Effect of prefunding balance and funding standard carryover balance. (a) In general—(1...

Balance treatment ameliorates anxiety and increases self-esteem in children with comorbid anxiety and balance disorder.

PubMed

Bart, Orit; Bar-Haim, Yair; Weizman, Einat; Levin, Moran; Sadeh, Avi; Mintz, Matti

2009-01-01

Comorbidity between balance and anxiety disorders in adult population is a well-studied clinical entity. Children might be particularly prone to develop balance-anxiety comorbidity, but surprisingly they are practically neglected in this field of research. The consequence is that children are treated for what seems to be the primary disorder without noticing possible effects on the other disorder. In Study 1, children with balance dysfunction were compared to normally balanced controls on anxiety and self-esteem. In study 2, children with balance dysfunction were assigned to either balance training or a waiting-list control. Training consisted of 12 weekly sessions of balance treatment. Anxiety and self-esteem were tested before and after treatment/waiting. Study 1 confirmed significantly higher anxiety and lower self-esteem in the balance dysfunction group compared to the control group. Study 2 showed that treatment improved balance performance, reduced anxiety, and increased self-esteem relative to the control waiting list group. Taken together, the present findings are in accord with the observations of comorbidity between balance and anxiety disorders in adults and confirm their validity in children younger than 7 years of age. This profile of comorbidity between balance dysfunction and anxiety also include lower self-esteem.

Sport-specific balance.

PubMed

Zemková, Erika

2014-05-01

This review includes the latest findings based on experimental studies addressing sport-specific balance, an area of research that has grown dramatically in recent years. The main objectives of this work were to investigate the postural sway response to different forms of exercise under laboratory and sport-specific conditions, to examine how this effect can vary with expertise, and to provide examples of the association of impaired balance with sport performance and/or increasing risk of injury. In doing so, sports where body balance is one of the limiting factors of performance were analyzed. While there are no significant differences in postural stability between athletes of different specializations and physically active individuals during standing in a standard upright position (e.g., bipedal stance), they have a better ability to maintain balance in specific conditions (e.g., while standing on a narrow area of support). Differences in magnitude of balance impairment after specific exercises (rebound jumps, repeated rotations, etc.) and mainly in speed of its readjustment to baseline are also observed. Besides some evidence on an association of greater postural sway with the increasing risk of injuries, there are many myths related to the negative influence of impaired balance on sport performance. Though this may be true for shooting or archery, findings have shown that in many other sports, highly skilled athletes are able to perform successfully in spite of increased postural sway. These findings may contribute to better understanding of the postural control system under various performance requirements. It may provide useful knowledge for designing training programs for specific sports.

Load Balancing Scientific Applications

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

Pearce, Olga Tkachyshyn

2014-12-01

The largest supercomputers have millions of independent processors, and concurrency levels are rapidly increasing. For ideal efficiency, developers of the simulations that run on these machines must ensure that computational work is evenly balanced among processors. Assigning work evenly is challenging because many large modern parallel codes simulate behavior of physical systems that evolve over time, and their workloads change over time. Furthermore, the cost of imbalanced load increases with scale because most large-scale scientific simulations today use a Single Program Multiple Data (SPMD) parallel programming model, and an increasing number of processors will wait for the slowest one atmore » the synchronization points. To address load imbalance, many large-scale parallel applications use dynamic load balance algorithms to redistribute work evenly. The research objective of this dissertation is to develop methods to decide when and how to load balance the application, and to balance it effectively and affordably. We measure and evaluate the computational load of the application, and develop strategies to decide when and how to correct the imbalance. Depending on the simulation, a fast, local load balance algorithm may be suitable, or a more sophisticated and expensive algorithm may be required. We developed a model for comparison of load balance algorithms for a specific state of the simulation that enables the selection of a balancing algorithm that will minimize overall runtime.« less

Watt and joule balances

NASA Astrophysics Data System (ADS)

Robinson, Ian A.

2014-04-01

The time is fast approaching when the SI unit of mass will cease to be based on a single material artefact and will instead be based upon the defined value of a fundamental constant—the Planck constant—h . This change requires that techniques exist both to determine the appropriate value to be assigned to the constant, and to measure mass in terms of the redefined unit. It is important to ensure that these techniques are accurate and reliable to allow full advantage to be taken of the stability and universality provided by the new definition and to guarantee the continuity of the world's mass measurements, which can affect the measurement of many other quantities such as energy and force. Up to now, efforts to provide the basis for such a redefinition of the kilogram were mainly concerned with resolving the discrepancies between individual implementations of the two principal techniques: the x-ray crystal density (XRCD) method [1] and the watt and joule balance methods which are the subject of this special issue. The first three papers report results from the NRC and NIST watt balance groups and the NIM joule balance group. The result from the NRC (formerly the NPL Mk II) watt balance is the first to be reported with a relative standard uncertainty below 2 × 10-8 and the NIST result has a relative standard uncertainty below 5 × 10-8. Both results are shown in figure 1 along with some previous results; the result from the NIM group is not shown on the plot but has a relative uncertainty of 8.9 × 10-6 and is consistent with all the results shown. The Consultative Committee for Mass and Related Quantities (CCM) in its meeting in 2013 produced a resolution [2] which set out the requirements for the number, type and quality of results intended to support the redefinition of the kilogram and required that there should be agreement between them. These results from NRC, NIST and the IAC may be considered to meet these requirements and are likely to be widely debated

Chemical Equation Balancing.

ERIC Educational Resources Information Center

Blakley, G. R.

1982-01-01

Reviews mathematical techniques for solving systems of homogeneous linear equations and demonstrates that the algebraic method of balancing chemical equations is a matter of solving a system of homogeneous linear equations. FORTRAN programs using this matrix method to chemical equation balancing are available from the author. (JN)

Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

PubMed

Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

2018-04-01

The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

Human stick balancing: Tuning Lèvy flights to improve balance control

NASA Astrophysics Data System (ADS)

Cabrera, Juan Luis; Milton, John G.

2004-09-01

State-dependent, or parametric, noise is an essential component of the neural control mechanism for stick balancing at the fingertip. High-speed motion analysis in three dimensions demonstrates that the controlling movements made by the fingertip during stick balancing can be described by a Lévy flight. The Lévy index, α, is approximately 0.9; a value close to optimal for a random search. With increased skill, the index α does not change. However, the tails of the Lévy distribution become broader. These observations suggest a Lévy flight that is truncated by the properties of the nervous and musculoskeletal system; the truncation decreasing as skill level increases. Measurements of the cross-correlation between the position of the tip of the stick and the fingertip demonstrate that the role of closed-loop feedback changes with increased skill. Moreover, estimation of the neural latencies for stick balancing show that for a given stick length, the latency increases with skill level. It is suggested that the neural control for stick balancing involves a mechanism in which brief intervals of consciously generated, corrective movements alternate with longer intervals of prediction-free control. With learning the truncation of the Lévy flight becomes better optimized for balance control and hence the time between successive conscious corrections increases. These observations provide the first evidence that changes in a Lévy flight may have functional significance for the nervous system. This work has implications for the control of balancing problems ranging from falling in the elderly to the design of two-legged robots and earthquake proof buildings.

Balance disorders in the elderly and the benefit of balance exercise.

PubMed

Prasansuk, Suchitra; Siriyananda, Chana; Nakorn, Apinan Na; Atipas, Suvajana; Chongvisal, Samut

2004-10-01

Symptoms of balance disorders including 'unsteadiness', 'dizziness and vertigo' are common in the elderly and commonly found in general practice in medicine. There are many causes of balance disorders and vary from one person to another. Disorder of the internal ear or vestibular end-organ type is one cause. Unsteadiness of somato-sensory or proprioception is common in the elderly so is degenerative disorder of central control in brain. The elderly are prone to many chronic illnesses or disorders which are causes of balance disorder or give rise to more rapid degeneration of the central nervous system i.e. high blood pressure, diabetes mellitus, heart disease, proprioception and joint problems, arthritis and muscular weakness due to lack of good health and exercise. The objectives of this research study were to find the etiologies of balance disorders and how Balance Exercises and the 'National Health Service' can be of benefit in helping to prevent them. 1565 elderly inhabitants (age > or = 60 years) of 20 communities adjacent to Siriraj Hospital were selected for study. Among these, 625 persons had a history of balance disorders. Among those, 256 had symptoms during the week selected for examination. The average age was 66 years old, women outnumbered men with a ratio of 2.4:1. The common underlying causes were hypertension in 32.4%, diabetes mellitus 13.8%, arthritis 8.1%, and heart disease 4.4% respectively. All are still taking one or more types of drug. The subjects were randomly divided into two groups for the study purpose of effectiveness of balance exercise. Group 1 did not perform the head balance exercise and Group 2 performed the head balance exercise. Audiometric testing showed impaired hearing in 90% of the subjects. The majority slowed hearing loss in high frequencies. Testing of middle ear function found 75% of Group 1 to have normal middle ear function 77% of Group 2. Brainstem Electrical Response Audiometry (BERA) showed normal response latencies

Greenland Ice Sheet Mass Balance

NASA Technical Reports Server (NTRS)

Reeh, N.

1984-01-01

Mass balance equation for glaciers; areal distribution and ice volumes; estimates of actual mass balance; loss by calving of icebergs; hydrological budget for Greenland; and temporal variations of Greenland mass balance are examined.

Self-reported balance status is not a reliable indicator of balance performance in adolescents at one-month post-concussion.

PubMed

Rochefort, Coralie; Walters-Stewart, Coren; Aglipay, Mary; Barrowman, Nick; Zemek, Roger; Sveistrup, Heidi

2017-11-01

To determine if self-reported balance symptoms can be used as a proxy for measures of the center of pressure (COP) to identify balance deficits in a group of concussed adolescents. Case-control. Thirteen adolescents 1-month post-concussion who reported ongoing balance problems (Balance+), 20 adolescent 1-month post-concussion who reported no balance problems (Balance-), and 30 non-injured adolescents (control) completed a series of balance tests. Participants completed two 2-min trials standing on a Nintendo Wii Balance Board™ during which the COP under their feet was recorded: i) double-leg stance, eyes open; ii) double-leg stance, eyes closed. Participants also completed a dual-task condition combining a double-leg stance and a Stroop Colour-word test. Participants in both the Balance+ and Balance- group swayed over a larger ellipse area compared to the control group while completing the Eyes Closed (Balance+, p=0.002; Balance-, p=0.002) and Dual-Task (Balance+, p=0.001; Balance-, p=0.004) conditions and performed the Dual-Task condition with faster medio-lateral velocity (Balance+, p=0.003; Balance-, p=0.009). The participants in the Balance- group also swayed over a larger ellipse area compared to the control group while completing the Eyes Open condition (p=0.005). No significant differences were identified between the Balance+ and Balance- groups. At 1-month post-concussion, adolescents demonstrated balance deficits compared to non-injured adolescents regardless of whether they reported balance problems. These results suggest that self-reported balance status might not be an accurate reflection of balance performance following a concussion in adolescents. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

The balance principle in scientific research.

PubMed

Hu, Liang-ping; Bao, Xiao-lei; Wang, Qi

2012-05-01

The principles of balance, randomization, control and repetition, which are closely related, constitute the four principles of scientific research. The balance principle is the kernel of the four principles which runs through the other three. However, in scientific research, the balance principle is always overlooked. If the balance principle is not well performed, the research conclusion is easy to be denied, which may lead to the failure of the whole research. Therefore, it is essential to have a good command of the balance principle in scientific research. This article stresses the definition and function of the balance principle, the strategies and detailed measures to improve balance in scientific research, and the analysis of the common mistakes involving the use of the balance principle in scientific research.

Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson's Disease

PubMed Central

Giardini, Marica; Nardone, Antonio; Guglielmetti, Simone; Arcolin, Ilaria; Pisano, Fabrizio

2018-01-01

We hypothesised that rehabilitation specifically addressing balance in Parkinson's disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises) were assessed by assigning patients to two groups (Platform, n = 15, and Exercises, n = 17). The platform moved periodically in the anteroposterior, laterolateral, and oblique direction, with and without vision in different trials. Balance exercises were based on the Otago Exercise Program. Both platform and exercise sessions were administered from easy to difficult. Outcome measures were (a) balancing behaviour, assessed by both Index of Stability (IS) on platform and Mini-BESTest, and (b) gait, assessed by both baropodometry and Timed Up and Go (TUG) test. Falls Efficacy Scale-International (FES-I) and Parkinson's Disease Questionnaire (PDQ-8) were administered. Both groups exhibited better balance control, as assessed both by IS and by Mini-BESTest. Gait speed at baropodometry also improved in both groups, while TUG was less sensitive to improvement. Scores of FES-I and PDQ-8 showed a marginal improvement. A four-week treatment featuring no gait training but focused on challenging balance tasks produces considerable gait enhancement in mildly to moderately affected patients. Walking problems in PD depend on postural instability and are successfully relieved by appropriate balance rehabilitation. This trial is registered with ClinicalTrials.gov NCT03314597. PMID:29706993

Wii balance board exercise improves balance and lower limb muscle strength of overweight young adults.

PubMed

Siriphorn, Akkradate; Chamonchant, Dannaovarat

2015-01-01

[Purpose] The potential health benefits of the Nintendo Wii balance board exercise have been widely investigated. However, no study has been conducted to examine the benefits of Wii exercise for overweight young adults. The aim of this study was to investigate the effect of exercise performed on a Nintendo Wii balance board on the balance and lower limb muscle strength in overweight young adults. [Subjects and Methods] Within-subject repeated measures analysis was used. Sixteen young adults (aged 21.87±1.13 years, body mass index 24.15 ± 0.50 kg/m(2)) were recruited. All subjects performed an exercise program on a Wii balance board for 8 weeks (30 min/session, twice a week for 8 weeks). A NeuroCom Balance Master and a hand-held dynamometer were used to measure balance performance and lower limb muscle strength. [Results] According to the comparison of pre- and post-intervention measurements, the Wii balance board exercise program significantly improved the limit of stability parameters. There was also a significant increase in strength of four lower-limb muscle groups: the hip flexor, knee flexor, ankle dorsiflexor and ankle plantarflexor. [Conclusion] These findings suggest that a Wii balance board exercise program can be used to improve the balance and lower limb muscle strength of overweight young adults.

Assessment of postural balance function.

PubMed

Kostiukow, Anna; Rostkowska, Elzbieta; Samborski, Włodzimierz

2009-01-01

Postural balance is defined as the ability to stand unassisted without falling. Examination of the patient's postural balance function is a difficult diagnostic task. Most of the balance tests used in medicine provide incomplete information on this coordination ability of the human body. The aim of this study was to review methods of assessment of the patient's postural balance function, including various tests used in medical diagnostics centers.

The Association of Flexibility, Balance, and Lumbar Strength with Balance Ability: Risk of Falls in Older Adults

PubMed Central

Emilio, Emilio J. Martínez-López; Hita-Contreras, Fidel; Jiménez-Lara, Pilar M.; Latorre-Román, Pedro; Martínez-Amat, Antonio

2014-01-01

The purpose of the present study was to determine the effects of a proprioceptive training program on older adults, as well as to analyze the association between flexibility, balance and lumbar strength (physical fitness test) with balance ability and fall risk (functional balance tests). This study was a controlled, longitudinal trial with a 12-week follow-up period. Subjects from a population of older adults were allocated to the intervention group (n = 28) or to the usual care (control) group (n = 26). Subjects performed proprioceptive training twice weekly (6 specific exercises with Swiss ball and BOSU). Each session included 50 minutes (10 minutes of warm-up with slow walk, 10 minutes of mobility and stretching exercises, 30 minutes of proprioceptive exercises). The outcome variables were physical fitness (lower-body flexibility, hip-joint mobility, dynamic balance, static balance, and lumbar strength) and functional balance (Berg scale and Tinetti test). The experimental group obtained significantly higher values than the control group in lower-body flexibility, dynamic balance, and lumbar strength (p = 0.019, p < 0.001, and p = 0.034 respectively). Hip-joint mobility, dynamic balance, and lumbar strength were positively associated with balance ability (p < 0.001, p < 0.001, and p = 0.014, respectively) and the prevention of falls (p = 0.001, p < 0.001, and p = 0.017 respectively). These findings suggest that a 12-week proprioception program intervention (twice a week) significantly improves flexibility, balance, and lumbar strength in older adults. Hip-joint mobility, dynamic balance and lumbar strength are positively associated to balance ability and the risk of falls in older adults. This proprioceptive training does not show a significant improvement in hip-joint mobility or static balance. Key points A 12-week proprioceptive intervention program (two times per week) significantly improves flexibility, balance, and lumbar strength in older adults. The

20 years of mass balances on the Piloto glacier, Las Cuevas river basin, Mendoza, Argentina

NASA Astrophysics Data System (ADS)

Leiva, J. C.; Cabrera, G. A.; Lenzano, L. E.

2007-10-01

Climatic changes of the 20th century have altered the water cycle in the Andean basins of central Argentina. The most visible change is seen in the mountain glaciers, with loss of part of their mass due to decreasing thickness and a substantial recession in the last 100 years. This paper briefly describes the results of glacier mass balance research since 1979 in the Piloto Glacier at the Cajón del Rubio, in the headwaters of Las Cuevas River, presenting new results for the period 1997-2003. Very large interannual variability of net annual specific balance is evident, due largely to variations in winter snow accumulation, with a maximum net annual value of + 151 cm w.e. and a minimum value of - 230 cm w.e. Wet El Niño years are normally associated with positive net annual balances, while dry La Niña years generally result in negative balances. Within the 24-year period, 67% of the years show negative net annual specific balances, with a cumulative mass balance loss of - 10.50 m water equivalent (w.e.). Except for exceptions normally related to El Niño events, a general decreasing trend of winter snow accumulation is evident in the record, particularly after 1992, which has a strong effect in the overall negative mass balance values. The glacier contribution to Las Cuevas River runoff is analysed based on the Punta de Vacas River gauge station for a hypothetical year without snow precipitation (YWSP), when the snowmelt component is zero. Extremely dry years similar to a YWSP have occurred in 1968-1969, 1969-1970 and 1996-1997. The Punta de Vacas gauge station is located 62 km downstream from Piloto Glacier, and the basin contains 3.0% of uncovered glacier ice and 3.7% of debris-covered ice. The total glacier contribution to Las Cuevas River discharge is calculated as 82 ± 8% during extremely dry years. If glacier wastage continues at the present trend as observed during the last 2 decades, it will severely affect the water resources in the arid central Andes of

Balanced multiwavelets with interpolatory property.

PubMed

Li, Baobin; Peng, Lizhong

2011-05-01

Balanced multiwavelets with interpolatory property are discussed in this paper. This kind of multiwavelets can have a sampling property like Shannon's sampling theorem. It has been shown that the corresponding matrix-valued refinable mask has special structure, and an orthogonal multifilter bank {H(z),G(z)} can be reduced to a scalar valued conjugate quadrature filter (CQF) a(z) . But it does not mean that any scalar CQF can form a "good" multifilter bank which can generate a vector-valued refinable function with some degree of smoothness. In the context of balanced multiwavelets, we give the definition of transferring balance order, which a scalar CQF a(z) satisfies, to guarantee that the multiwavelet Ψ generated is balanced. On the basis of the parametrization of a scalar CQF with any length and conditions of transferring balance order, parametrization of multifilter banks which can generate interpolatory multiwavelet and interpolatory scaling function, is gotten. Moreover, some balanced interpolatory multiwavelets have been constructed. Interpolatory analysis-ready multiwavelets (armlets) are also discussed in this paper. It is known that conditions of armlets are easy to validate, compared with balanced multiwavelets. But it will be present that if the corresponding scaling function Φ is interpolatory, the multiwavelet Ψ is balanced of order n if and only if it is an armlet of order n. Finally, the application of balanced multiwavelets with interpolatory property in image processing is also discussed.

Modern rotor balancing - Emerging technologies

NASA Technical Reports Server (NTRS)

Zorzi, E. S.; Von Pragenau, G. L.

1985-01-01

Modern balancing methods for flexible and rigid rotors are explored. Rigid rotor balancing is performed at several hundred rpm, well below the first bending mode of the shaft. High speed balancing is necessary when the nominal rotational speed is higher than the first bending mode. Both methods introduce weights which will produce rotor responses at given speeds that will be exactly out of phase with the responses of an unbalanced rotor. Modal balancing seeks to add weights which will leave other rotor modes unaffected. Also, influence coefficients can be determined by trial and error addition of weights and recording of their effects on vibration at speeds of interest. The latter method is useful for balancing rotors at other than critical speeds and for performing unified balancing beginning with the first critical speed. Finally, low-speed flexible balancing permits low-speed tests and adjustments of rotor assemblies which will not be accessible when operating in their high-speed functional configuration. The method was developed for the high pressure liquid oxygen turbopumps for the Shuttle.

The Six-Component Wind Balance

NASA Technical Reports Server (NTRS)

Zahm, A F

1923-01-01

Dr. Zahm's report is a description of the six-component wind-tunnel balance in use at the Aerodynamic Laboratory, Washington Navy Yard. The description of the balance gives the mechanical details and the method of operation, and is accompanied by line drawings showing the construction of the balance. The balance is of particular interest, as it allows the model to be set up quickly and accurately in roll, pitch, and yaw, without stopping the wind. It is possible to measure automatically, directly, and independently the drag, cross-wind force, and lift; also the rolling, pitching, and yawing moments. It is also possible to make the balance self-recording.

Human stick balancing: tuning Lèvy flights to improve balance control.

PubMed

Cabrera, Juan Luis; Milton, John G

2004-09-01

State-dependent, or parametric, noise is an essential component of the neural control mechanism for stick balancing at the fingertip. High-speed motion analysis in three dimensions demonstrates that the controlling movements made by the fingertip during stick balancing can be described by a Lèvy flight. The Lèvy index, alpha, is approximately 0.9; a value close to optimal for a random search. With increased skill, the index alpha does not change. However, the tails of the Lèvy distribution become broader. These observations suggest a Lèvy flight that is truncated by the properties of the nervous and musculoskeletal system; the truncation decreasing as skill level increases. Measurements of the cross-correlation between the position of the tip of the stick and the fingertip demonstrate that the role of closed-loop feedback changes with increased skill. Moreover, estimation of the neural latencies for stick balancing show that for a given stick length, the latency increases with skill level. It is suggested that the neural control for stick balancing involves a mechanism in which brief intervals of consciously generated, corrective movements alternate with longer intervals of prediction-free control. With learning the truncation of the Lèvy flight becomes better optimized for balance control and hence the time between successive conscious corrections increases. These observations provide the first evidence that changes in a Lèvy flight may have functional significance for the nervous system. This work has implications for the control of balancing problems ranging from falling in the elderly to the design of two-legged robots and earthquake proof buildings. Copyright 2004 American Institute of Physics

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

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…

Validation of the Balance Board for Clinical Evaluation of Balance During Serious Gaming Rehabilitation Exercises.

PubMed

Bonnechère, Bruno; Jansen, Bart; Omelina, Lubos; Sholukha, Victor; Van Sint Jan, Serge

2016-09-01

Balance and posture can be affected in various conditions or become decreased with aging. A diminution of balance control induces an increase of fall's risk. The Nintendo Wii Balance Board™ (WBB) is used in rehabilitation to perform balance exercises (using commercial video games). The WBB has also been validated to assess balance and posture in static conditions. However, there is currently no study investigating the use of WBB to assess balance during the realization of balance exercises using this device. The aim of this study was to validate the use of WBB, coupled with specially developed serious games, to assess dynamic balance during rehabilitation exercises. Thirty five subjects participated in this study. Subjects were asked to play two specially developed serious games. Center of pressure (CP) displacements were simultaneously recorded with a WBB and a gold standard force plate (FP). Nine parameters were derived from CP displacement. Bland and Altman plots, paired-sample t tests, intraclass correlation coefficient's, and Pearson's coefficient correlations were computed. Excellent correlation between both devices was found for each parameter for the two games (R = 0.95 and 0.96). Unlike previous work on the WBB, these excellent results were obtained without using any calibration procedure. Despite this, results were highly correlated between the WBB and the FP. The WBB could be used in clinics to assess balance during rehabilitation exercises and, thus, allows a more regular patient follow-up.

Virtual-reality balance training with a video-game system improves dynamic balance in chronic stroke patients.

PubMed

Cho, Ki Hun; Lee, Kyoung Jin; Song, Chang Ho

2012-09-01

Stroke is one of the most serious healthcare problems and a major cause of impairment of cognition and physical functions. Virtual rehabilitation approaches to postural control have been used for enhancing functional recovery that may lead to a decrease in the risk of falling. In the present study, we investigated the effects of virtual reality balance training (VRBT) with a balance board game system on balance of chronic stroke patients. Participants were randomly assigned to 2 groups: VRBT group (11 subjects including 3 women, 65.26 years old) and control group (11 subjects including 5 women, 63.13 years old). Both groups participated in a standard rehabilitation program (physical and occupational therapy) for 60 min a day, 5 times a week for 6 weeks. In addition, the VRBT group participated in VRBT for 30 min a day, 3 times a week for 6 weeks. Static balance (postural sway velocity with eyes open or closed) was evaluated with the posturography. Dynamic balance was evaluated with the Berg Balance Scale (BBS) and Timed Up and Go test (TUG) that measures balance and mobility in dynamic balance. There was greater improvement on BBS (4.00 vs. 2.81 scores) and TUG (-1.33 vs. -0.52 sec) in the VRBT group compared with the control group (P < 0.05), but not on static balance in both groups. In conclusion, we demonstrate a significant improvement in dynamic balance in chronic stroke patients with VRBT. VRBT is feasible and suitable for chronic stroke patients with balance deficit in clinical settings.

Leadership and Work-Life Balance.

PubMed

Mattock, Sarah L

2015-01-01

Simply stated, work-life balance is something that is both difficult to define and difficult to achieve. Leaders, throughout the continuum of trauma care, need to have a sound understanding of what work-life balance means and set an example of a healthy work-life balance for those they lead. This article offers strategies for enhancing work-life balance and challenges individuals to use self-reflection as a means to furthering their personal and professional growth.

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.

Validity and reliability of balance assessment software using the Nintendo Wii balance board: usability and validation.

PubMed

Park, Dae-Sung; Lee, GyuChang

2014-06-10

A balance test provides important information such as the standard to judge an individual's functional recovery or make the prediction of falls. The development of a tool for a balance test that is inexpensive and widely available is needed, especially in clinical settings. The Wii Balance Board (WBB) is designed to test balance, but there is little software used in balance tests, and there are few studies on reliability and validity. Thus, we developed a balance assessment software using the Nintendo Wii Balance Board, investigated its reliability and validity, and compared it with a laboratory-grade force platform. Twenty healthy adults participated in our study. The participants participated in the test for inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with balance assessment software using the Nintendo Wii balance board and a laboratory-grade force platform. Data such as Center of Pressure (COP) path length and COP velocity were acquired from the assessment systems. The inter-rater reliability, the intra-rater reliability, and concurrent validity were analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement (SEM). The inter-rater reliability (ICC: 0.89-0.79, SEM in path length: 7.14-1.90, SEM in velocity: 0.74-0.07), intra-rater reliability (ICC: 0.92-0.70, SEM in path length: 7.59-2.04, SEM in velocity: 0.80-0.07), and concurrent validity (ICC: 0.87-0.73, SEM in path length: 5.94-0.32, SEM in velocity: 0.62-0.08) were high in terms of COP path length and COP velocity. The balance assessment software incorporating the Nintendo Wii balance board was used in our study and was found to be a reliable assessment device. In clinical settings, the device can be remarkably inexpensive, portable, and convenient for the balance assessment.

An alternative to the balance error scoring system: using a low-cost balance board to improve the validity/reliability of sports-related concussion balance testing.

PubMed

Chang, Jasper O; Levy, Susan S; Seay, Seth W; Goble, Daniel J

2014-05-01

Recent guidelines advocate sports medicine professionals to use balance tests to assess sensorimotor status in the management of concussions. The present study sought to determine whether a low-cost balance board could provide a valid, reliable, and objective means of performing this balance testing. Criterion validity testing relative to a gold standard and 7 day test-retest reliability. University biomechanics laboratory. Thirty healthy young adults. Balance ability was assessed on 2 days separated by 1 week using (1) a gold standard measure (ie, scientific grade force plate), (2) a low-cost Nintendo Wii Balance Board (WBB), and (3) the Balance Error Scoring System (BESS). Validity of the WBB center of pressure path length and BESS scores were determined relative to the force plate data. Test-retest reliability was established based on intraclass correlation coefficients. Composite scores for the WBB had excellent validity (r = 0.99) and test-retest reliability (R = 0.88). Both the validity (r = 0.10-0.52) and test-retest reliability (r = 0.61-0.78) were lower for the BESS. These findings demonstrate that a low-cost balance board can provide improved balance testing accuracy/reliability compared with the BESS. This approach provides a potentially more valid/reliable, yet affordable, means of assessing sports-related concussion compared with current methods.

Work-Life Balance: Strategies for Attaining and Maintaining Work-Life Balance

ERIC Educational Resources Information Center

Winkler, Josette Chinchiolo

2010-01-01

Purpose: It was the purpose of this study (a) to identify and describe the elements of balance that elementary principals perceive as most important to their personal and professional lives; (b) to identify the strategies elementary principals perceive as most important to maintain balance in their personal and professional lives; (c) to determine…

Application of the groundwater-balance equation to indicate interbasin and vertical flow in two semi-arid drainage basins, Mexico

NASA Astrophysics Data System (ADS)

Carrillo-Rivera, J. J.

2000-09-01

conclusion est qu'une étude par bilan de la nappe est une méthode qui n'est pas satisfaisante pour déterminer certains paramètres comme le coefficient d'emmagasinement. En particulier, l'approche par le bilan de la nappe donne des résultats qui ne sont pas fiables lorsque l'on ignore la drainance verticale ou que l'on ne peut pas la définir correctement. L'existence d'une drainance verticale est prouvée par des températures de l'eau souterraine pouvant être supérieures de 23 °C à la température ambiante. Des failles régionales peuvent permettre ces écoulements vers le haut. Lorsque l'on ignore la drainance verticale, on introduit une incertitude sur l'estimation de l'emmagasinement à partir des calculs du bilan régional de la nappe. Sur la base de l'équation du bilan de la nappe, une valeur de S=0,19 semble représenter les conditions captives de la partie développée de l'aquifère ce résultat est plus élevé, de plusieurs ordres de grandeur, que celui que l'on peut raisonnablement attendre des conditions géologiques. Ces résultats sont utiles pour évaluer si une ressource en eau souterraine est "surexploitée". Ces conclusions sont intéressantes lorsque l'on applique des modèles d'écoulement transitoire dans lesquels on ne prend pas en compte la drainance verticale d'une eau plus légère remontant. Resumen. En este trabajo, se investigan las entradas y salidas de flujo horizontal en la ecuación de balance de agua subterránea, así como el papel que desempeñan en el flujo entre cuencas. Se analizan dos ejemplos de México, uno en la Península de Baja California y otro en la parte central del país. En ambos, destaca la influencia del flujo entre cuencas, ya que se estima que una parte importante (aproximadamente el 70%) del agua termal extraída procede de una cuenca superficial externa. Se concluye que el método basado en cálculos de balance de agua subterránea no es satisfactorio para determinar algunos parámetros, como, por ejemplo, el

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.

Balance System

NASA Technical Reports Server (NTRS)

1988-01-01

TherEx Inc.'s AT-1 Computerized Ataxiameter precisely evaluates posture and balance disturbances that commonly accompany neurological and musculoskeletal disorders. Complete system includes two-strain gauged footplates, signal conditioning circuitry, a computer monitor, printer and a stand-alone tiltable balance platform. AT-1 serves as assessment tool, treatment monitor, and rehabilitation training device. It allows clinician to document quantitatively the outcome of treatment and analyze data over time to develop outcome standards for several classifications of patients. It can evaluate specifically the effects of surgery, drug treatment, physical therapy or prosthetic devices.

40 CFR 35.118 - Unexpended balances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Unexpended balances. 35.118 Section 35... balances. Subject to any relevant provisions of law, if a recipient's Financial Status Report shows unexpended balances, the Regional Administrator will deobligate the unexpended balances and make them...

40 CFR 35.518 - Unexpended balances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Unexpended balances. 35.518 Section 35... Unexpended balances. Subject to any relevant provisions of law, if a recipient's final Financial Status Report shows unexpended balances, the Regional Administrator will deobligate the unexpended balances and...

40 CFR 35.518 - Unexpended balances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Unexpended balances. 35.518 Section 35... Unexpended balances. Subject to any relevant provisions of law, if a recipient's final Financial Status Report shows unexpended balances, the Regional Administrator will deobligate the unexpended balances and...

40 CFR 35.118 - Unexpended balances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Unexpended balances. 35.118 Section 35... balances. Subject to any relevant provisions of law, if a recipient's Financial Status Report shows unexpended balances, the Regional Administrator will deobligate the unexpended balances and make them...

Home-based balance training programme using Wii Fit with balance board for Parkinsons's disease: a pilot study.

PubMed

Esculier, Jean-Francois; Vaudrin, Joanie; Bériault, Patrick; Gagnon, Karine; Tremblay, Louis E

2012-02-01

To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.

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.

Work-life balancing: challenges and strategies.

PubMed

Chittenden, Eva H; Ritchie, Christine S

2011-07-01

Balancing the personal and the professional is an ongoing struggle for most professionals, and palliative care clinicians are no exception. A sustained lack of balance can lead to feelings of frustration, inadequacy, and guilt. Palliative care physicians may find this balance particularly difficult due to the nature of their work: caring for patients and families who are often suffering and in crisis. In this article, we describe challenges to work-life balancing and strategies that may promote balance, including "timeshifting," goal setting, cognitive reframing, and self-care. We argue that the search for balance is a lifelong endeavor that entails self-reflection and continuing examination of one's values and goals.

Validity and reliability of balance assessment software using the Nintendo Wii balance board: usability and validation

PubMed Central

2014-01-01

Background A balance test provides important information such as the standard to judge an individual’s functional recovery or make the prediction of falls. The development of a tool for a balance test that is inexpensive and widely available is needed, especially in clinical settings. The Wii Balance Board (WBB) is designed to test balance, but there is little software used in balance tests, and there are few studies on reliability and validity. Thus, we developed a balance assessment software using the Nintendo Wii Balance Board, investigated its reliability and validity, and compared it with a laboratory-grade force platform. Methods Twenty healthy adults participated in our study. The participants participated in the test for inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with balance assessment software using the Nintendo Wii balance board and a laboratory-grade force platform. Data such as Center of Pressure (COP) path length and COP velocity were acquired from the assessment systems. The inter-rater reliability, the intra-rater reliability, and concurrent validity were analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement (SEM). Results The inter-rater reliability (ICC: 0.89-0.79, SEM in path length: 7.14-1.90, SEM in velocity: 0.74-0.07), intra-rater reliability (ICC: 0.92-0.70, SEM in path length: 7.59-2.04, SEM in velocity: 0.80-0.07), and concurrent validity (ICC: 0.87-0.73, SEM in path length: 5.94-0.32, SEM in velocity: 0.62-0.08) were high in terms of COP path length and COP velocity. Conclusion The balance assessment software incorporating the Nintendo Wii balance board was used in our study and was found to be a reliable assessment device. In clinical settings, the device can be remarkably inexpensive, portable, and convenient for the balance assessment. PMID:24912769

Balance circuit classes to improve balance among rehabilitation inpatients: a protocol for a randomised controlled trial

PubMed Central

2013-01-01

Background Impaired balance and mobility are common among rehabilitation inpatients. Poor balance and mobility lead to an increased risk of falling. Specific balance exercise has been shown to improve balance and reduce falls within the community setting. However few studies have measured the effects of balance exercises on balance within the inpatient setting. The aim of this randomised controlled trial is to investigate whether the addition of circuit classes targeting balance to usual therapy lead to greater improvements in balance among rehabilitation inpatients than usual therapy alone. Methods/Design A single centre, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. One hundred and sixty two patients admitted to the general rehabilitation ward at Bankstown-Lidcombe Hospital will be recruited. Eligible participants will have no medical contraindications to exercise and will be able to: fully weight bear; stand unaided independently for at least 30 seconds; and participate in group therapy sessions with minimal supervision. Participants will be randomly allocated to an intervention group or usual-care control group. Both groups will receive standard rehabilitation intervention that includes physiotherapy mobility training and exercise for at least two hours on each week day. The intervention group will also receive six 1-hour circuit classes of supervised balance exercises designed to maximise the ability to make postural adjustments in standing, stepping and walking. The primary outcome is balance. Balance will be assessed by measuring the total time the participant can stand unsupported in five different positions; feet apart, feet together, semi-tandem, tandem and single-leg-stance. Secondary outcomes include mobility, self reported physical functioning, falls and hospital readmissions. Performance on the outcome measures will be assessed before randomisation and at two-weeks and three-months after

More on Chemical Reaction Balancing.

ERIC Educational Resources Information Center

Swinehart, D. F.

1985-01-01

A previous article stated that only the matrix method was powerful enough to balance a particular chemical equation. Shows how this equation can be balanced without using the matrix method. The approach taken involves writing partial mathematical reactions and redox half-reactions, and combining them to yield the final balanced reaction. (JN)

Acerca del moho

EPA Pesticide Factsheets

El moho forma parte del medio ambiente natural. Afuera del hogar, el moho juega un papel en la naturaleza al desintegrar materias organicas tales como las hojas que se han caido o los arboles muertos. El moho puede crecer adentro del hogar cuando las espor

26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Effect of prefunding balance and funding standard...(f)-1 Effect of prefunding balance and funding standard carryover balance. (a) In general—(1... funding standard account under section 412(b) (as in effect prior to amendment by the Pension Protection...

Engineering redox balance through cofactor systems.

PubMed

Chen, Xiulai; Li, Shubo; Liu, Liming

2014-06-01

Redox balance plays an important role in the production of enzymes, pharmaceuticals, and chemicals. To meet the demands of industrial production, it is desirable that microbes maintain a maximal carbon flux towards target metabolites with no fluctuations in redox. This requires functional cofactor systems that support dynamic homeostasis between different redox states or functional stability in a given redox state. Redox balance can be achieved by improving the self-balance of a cofactor system, regulating the substrate balance of a cofactor system, and engineering the synthetic balance of a cofactor system. This review summarizes how cofactor systems can be manipulated to improve redox balance in microbes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Produccion Gaseosa del Cometa Halley: Erupciones Y Fotodisociacion del Radical OH

NASA Astrophysics Data System (ADS)

Silva, A. M.; Mirabel, I. F.

1990-11-01

RESUMEN:En este trabajo informamos la detecci6n de 20 erupciones en la li'nea de =18cm (1667MHz) del radical OH en el Cometa Halley.Las observaciones incluyen todos los monitoreos existentes y se extienden desde 120 dias antes del perihelio hasta 90 dias despues.Se detectan bruscos crecimientos en el flujo medido,hasta un factor 1O,seguidos por decaimientos lentos asociados con la fotodisociaci6n del OH. Se obtuvieron valores para el tiempo de vida fotoquimico del OH y del H2O basandose en el modelo desarrollado previamente por Silva(1988). Esos tiempos de vida estan de acuerdo con predicciones teoricas y con las observaciones en el Ultravioleta, y los resultados, los que son fuertemente dependientes de la velocidad heliocentrica del Coineta (variando hasta un factor 6), han sido calculados para varios rangos de velocidad entre +28 y -28 km/seg. Key wo'L :

26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Effect of prefunding balance and funding... § 1.430(f)-1 Effect of prefunding balance and funding standard carryover balance. (a) In general—(1... funding standard account under section 412(b) (as in effect prior to amendment by the Pension Protection...

26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 5 2014-04-01 2014-04-01 false Effect of prefunding balance and funding... § 1.430(f)-1 Effect of prefunding balance and funding standard carryover balance. (a) In general—(1... funding standard account under section 412(b) (as in effect prior to amendment by the Pension Protection...

46 CFR 232.4 - Balance sheet accounts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Balance sheet accounts. 232.4 Section 232.4 Shipping... ACTIVITIES UNIFORM FINANCIAL REPORTING REQUIREMENTS Balance Sheet § 232.4 Balance sheet accounts. (a.... (b) Purpose of balance sheet accounts. The balance sheet accounts are intended to disclose the...

46 CFR 232.4 - Balance sheet accounts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Balance sheet accounts. 232.4 Section 232.4 Shipping... ACTIVITIES UNIFORM FINANCIAL REPORTING REQUIREMENTS Balance Sheet § 232.4 Balance sheet accounts. (a.... (b) Purpose of balance sheet accounts. The balance sheet accounts are intended to disclose the...

Field balancing in the real world

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

Bracher, B.

Field balancing can achieve significant results when other problems are present in the frequency spectrum and multiple vibrations are evident in the waveform. Many references suggest eliminating other problems before attempting to balance. That`s great - if you can do it. There are valid reasons for this approach, and it would be much easier to balance machinery when other problems have been corrected. It is the theoretical ideal in field balancing. However, in the real world of machinery maintained for years by reacting to immediate problems, the classic vibration signature for unbalance is rarely seen. Maintenance personnel make most ofmore » their decisions with limited information. The decision to balance or not to balance is usually made the same way. This paper will demonstrate significant results of field balancing in the presence of multiple problems. By examining the data available and analyzing the probabilities, a reasonable chance for success can be assured.« less

Balance circuit classes to improve balance among rehabilitation inpatients: a protocol for a randomised controlled trial.

PubMed

Treacy, Daniel; Schurr, Karl; Sherrington, Catherine

2013-07-20

Impaired balance and mobility are common among rehabilitation inpatients. Poor balance and mobility lead to an increased risk of falling. Specific balance exercise has been shown to improve balance and reduce falls within the community setting. However few studies have measured the effects of balance exercises on balance within the inpatient setting. A single centre, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. One hundred and sixty two patients admitted to the general rehabilitation ward at Bankstown-Lidcombe Hospital will be recruited. Eligible participants will have no medical contraindications to exercise and will be able to: fully weight bear; stand unaided independently for at least 30 seconds; and participate in group therapy sessions with minimal supervision. Participants will be randomly allocated to an intervention group or usual-care control group. Both groups will receive standard rehabilitation intervention that includes physiotherapy mobility training and exercise for at least two hours on each week day. The intervention group will also receive six 1-hour circuit classes of supervised balance exercises designed to maximise the ability to make postural adjustments in standing, stepping and walking. The primary outcome is balance. Balance will be assessed by measuring the total time the participant can stand unsupported in five different positions; feet apart, feet together, semi-tandem, tandem and single-leg-stance. Secondary outcomes include mobility, self reported physical functioning, falls and hospital readmissions. Performance on the outcome measures will be assessed before randomisation and at two-weeks and three-months after randomisation by physiotherapists unaware of intervention group allocation. This study will determine the impact of additional balance circuit classes on balance among rehabilitation inpatients. The results will provide essential information to guide evidence

Rotary balances: A selected, annotated bibliography

NASA Technical Reports Server (NTRS)

Tuttle, Marie H.; Kilgore, Robert A.; Sych, Karen L.

1989-01-01

This bibliography on rotary balances contains 102 entries. It is part of NASA's support of the AGARD Fluid Dynamics Panel Working Group 11 on Rotary Balances. This bibliography includes works that might be useful to anyone interested in building or using rotor balances. Emphasis is on the rotary balance rigs and testing techniques rather than the aerodynamic data. Also included are some publications of historical interest which relate to key events in the development and use of rotary balances. The arrangement is chronological by date of publication in the case of reports and by presentation in the case of papers.

A Balance of Power?

ERIC Educational Resources Information Center

Mosey, Edward

1991-01-01

The booming economy of the Pacific Northwest region promotes the dilemma of balancing the need for increased electrical power with the desire to maintain that region's unspoiled natural environment. Pertinent factors discussed within the balance equation are population trends, economic considerations, industrial power requirements, and…

Consideration of Dynamical Balances

NASA Technical Reports Server (NTRS)

Errico, Ronald M.

2015-01-01

The quasi-balance of extra-tropical tropospheric dynamics is a fundamental aspect of nature. If an atmospheric analysis does not reflect such balance sufficiently well, the subsequent forecast will exhibit unrealistic behavior associated with spurious fast-propagating gravity waves. Even if these eventually damp, they can create poor background fields for a subsequent analysis or interact with moist physics to create spurious precipitation. The nature of this problem will be described along with the reasons for atmospheric balance and techniques for mitigating imbalances. Attention will be focused on fundamental issues rather than on recipes for various techniques.

Airplane Balance

NASA Technical Reports Server (NTRS)

Huguet, L

1921-01-01

The authors argue that the center of gravity has a preponderating influence on the longitudinal stability of an airplane in flight, but that manufacturers, although aware of this influence, are still content to apply empirical rules to the balancing of their airplanes instead of conducting wind tunnel tests. The author examines the following points: 1) longitudinal stability, in flight, of a glider with coinciding centers; 2) the influence exercised on the stability of flight by the position of the axis of thrust with respect to the center of gravity and the whole of the glider; 3) the stability on the ground before taking off, and the influence of the position of the landing gear. 4) the influence of the elements of the glider on the balance, the possibility of sometimes correcting defective balance, and the valuable information given on this point by wind tunnel tests; 5) and a brief examination of the equilibrium of power in horizontal flight, where the conditions of stability peculiar to this kind of flight are added to previously existing conditions of the stability of the glider, and interfere in fixing the safety limits of certain evolutions.

Dynamic load balancing of applications

DOEpatents

Wheat, Stephen R.

1997-01-01

An application-level method for dynamically maintaining global load balance on a parallel computer, particularly on massively parallel MIMD computers. Global load balancing is achieved by overlapping neighborhoods of processors, where each neighborhood performs local load balancing. The method supports a large class of finite element and finite difference based applications and provides an automatic element management system to which applications are easily integrated.

Radar channel balancing with commutation

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

Doerry, Armin Walter

2014-02-01

When multiple channels are employed in a pulse-Doppler radar, achieving and maintaining balance between the channels is problematic. In some circumstances the channels may be commutated to achieve adequate balance. Commutation is the switching, trading, toggling, or multiplexing of the channels between signal paths. Commutation allows modulating the imbalance energy away from the balanced energy in Doppler, where it can be mitigated with filtering.

How body balance influences political party evaluations: a wii balance board study.

PubMed

Dijkstra, Katinka; Eerland, Anita; Zijlmans, Josjan; Post, Lysanne S

2012-01-01

Embodied cognition research has shown how actions or body positions may affect cognitive processes, such as autobiographical memory retrieval or judgments. The present study examined the role of body balance (to the left or the right) in participants on their attributions to political parties. Participants thought they stood upright on a Wii(™) Balance Board, while they were actually slightly tilted to the left or the right. Participants then ascribed fairly general political statements to one of 10 political parties that are represented in the Dutch House of Representatives. Results showed a significant interaction of congruent leaning direction with left- or right-wing party attribution. When the same analyses were performed with the political parties being divided into affiliations to the right, center, and left based on participants' personal opinions rather than a ruling classification, no effects were found. The study provides evidence that conceptual metaphors are activated by manipulating body balance implicitly. Moreover, people's judgments may be colored by seemingly trivial circumstances such as standing slightly out of balance.

Effect of the Power Balance® band on static balance, hamstring flexibility, and arm strength in adults.

PubMed

Verdan, Princess J R; Marzilli, Thomas S; Barna, Geanina I; Roquemore, Anntionette N; Fenter, Brad A; Blujus, Brittany; Gosselin, Kevin P

2012-08-01

The purpose of this study was to determine the effect of Power Balance® bands on strength, flexibility, and balance. Strength and flexibility were measured using the MicroFit system. Strength was measured via a bicep curl and flexibility via the sit-and-reach method. Balance was measured by the BIODEX System SD. There were 4 different conditions for the balance test: eyes open on a firm surface (EOFS), eyes closed on a firm surface (ECFS), eyes open on a foam surface (EOFoS), and eyes closed on a foam surface (ECFoS). There were 24 subjects in the study (10 men and 14 women). A counterbalance, double-blind, placebo, controlled within-subject design was used. Each of the subjects participated in 3 treatment sessions, consisting of Power Balance®, placebo band, and no band. An alpha level of p ≤ 0.05 was set a priori. There were no significant differences in strength, flexibility, or balance with regard to the treatments used. There was a significant difference between the conditions in the balance test (p = 0.000): EOFS (0.51), ECFS (0.68), EOFoS (0.99), and ECFoS (2.18); however, these were independent of the treatment conditions. The results indicate that the Power Balance® bands did not have an effect on strength, flexibility, or balance.

Balance Function Disorders

NASA Technical Reports Server (NTRS)

1991-01-01

Researchers at the Balance Function Laboratory and Clinic at the Minneapolis (MN) Neuroscience Institute on the Abbot Northwestern Hospital Campus are using a rotational chair (technically a "sinusoidal harmonic acceleration system") originally developed by NASA to investigate vestibular (inner ear) function in weightlessness to diagnose and treat patients with balance function disorders. Manufactured by ICS Medical Corporation, Schaumberg, IL, the chair system turns a patient and monitors his or her responses to rotational stimulation.

Validity and reliability of wii fit balance board for the assessment of balance of healthy young adults and the elderly.

PubMed

Chang, Wen-Dien; Chang, Wan-Yi; Lee, Chia-Lun; Feng, Chi-Yen

2013-10-01

[Purpose] Balance is an integral part of human ability. The smart balance master system (SBM) is a balance test instrument with good reliability and validity, but it is expensive. Therefore, we modified a Wii Fit balance board, which is a convenient balance assessment tool, and analyzed its reliability and validity. [Subjects and Methods] We recruited 20 healthy young adults and 20 elderly people, and administered 3 balance tests. The correlation coefficient and intraclass correlation of both instruments were analyzed. [Results] There were no statistically significant differences in the 3 tests between the Wii Fit balance board and the SBM. The Wii Fit balance board had a good intraclass correlation (0.86-0.99) for the elderly people and positive correlations (r = 0.58-0.86) with the SBM. [Conclusions] The Wii Fit balance board is a balance assessment tool with good reliability and high validity for elderly people, and we recommend it as an alternative tool for assessing balance ability.

Validity and Reliability of Wii Fit Balance Board for the Assessment of Balance of Healthy Young Adults and the Elderly

PubMed Central

Chang, Wen-Dien; Chang, Wan-Yi; Lee, Chia-Lun; Feng, Chi-Yen

2013-01-01

[Purpose] Balance is an integral part of human ability. The smart balance master system (SBM) is a balance test instrument with good reliability and validity, but it is expensive. Therefore, we modified a Wii Fit balance board, which is a convenient balance assessment tool, and analyzed its reliability and validity. [Subjects and Methods] We recruited 20 healthy young adults and 20 elderly people, and administered 3 balance tests. The correlation coefficient and intraclass correlation of both instruments were analyzed. [Results] There were no statistically significant differences in the 3 tests between the Wii Fit balance board and the SBM. The Wii Fit balance board had a good intraclass correlation (0.86–0.99) for the elderly people and positive correlations (r = 0.58–0.86) with the SBM. [Conclusions] The Wii Fit balance board is a balance assessment tool with good reliability and high validity for elderly people, and we recommend it as an alternative tool for assessing balance ability. PMID:24259769

Home-based virtual reality balance training and conventional balance training in Parkinson's disease: A randomized controlled trial.

PubMed

Yang, Wen-Chieh; Wang, Hsing-Kuo; Wu, Ruey-Meei; Lo, Chien-Shun; Lin, Kwan-Hwa

2016-09-01

Virtual reality has the advantage to provide rich sensory feedbacks for training balance function. This study tested if the home-based virtual reality balance training is more effective than the conventional home balance training in improving balance, walking, and quality of life in patients with Parkinson's disease (PD). Twenty-three patients with idiopathic PD were recruited and underwent twelve 50-minute training sessions during the 6-week training period. The experimental group (n = 11) was trained with a custom-made virtual reality balance training system, and the control group (n = 12) was trained by a licensed physical therapist. Outcomes were measured at Week 0 (pretest), Week 6 (posttest), and Week 8 (follow-up). The primary outcome was the Berg Balance Scale. The secondary outcomes included the Dynamic Gait Index, timed Up-and-Go test, Parkinson's Disease Questionnaire, and the motor score of the Unified Parkinson's Disease Rating Scale. The experimental and control groups were comparable at pretest. After training, both groups performed better in the Berg Balance Scale, Dynamic Gait Index, timed Up-and-Go test, and Parkinson's Disease Questionnaire at posttest and follow-up than at pretest. However, no significant differences were found between these two groups at posttest and follow-up. This study did not find any difference between the effects of the home-based virtual reality balance training and conventional home balance training. The two training options were equally effective in improving balance, walking, and quality of life among community-dwelling patients with PD. Copyright © 2015. Published by Elsevier B.V.

Improving Balance Function Using Low Levels of Electrical Stimulation of the Balance Organs

NASA Technical Reports Server (NTRS)

Bloomberg, Jacob; Reschke, Millard; Mulavara, Ajitkumar; Wood, Scott; Serrador, Jorge; Fiedler, Matthew; Kofman, Igor; Peters, Brian T.; Cohen, Helen

2012-01-01

Crewmembers returning from long-duration space flight face significant challenges due to the microgravity-induced inappropriate adaptations in balance/ sensorimotor function. The Neuroscience Laboratory at JSC is developing a method based on stochastic resonance to enhance the brain s ability to detect signals from the balance organs of the inner ear and use them for rapid improvement in balance skill, especially when combined with balance training exercises. This method involves a stimulus delivery system that is wearable/portable providing imperceptible electrical stimulation to the balance organs of the human body. Stochastic resonance (SR) is a phenomenon whereby the response of a nonlinear system to a weak periodic input signal is optimized by the presence of a particular non-zero level of noise. This phenomenon of SR is based on the concept of maximizing the flow of information through a system by a non-zero level of noise. Application of imperceptible SR noise coupled with sensory input in humans has been shown to improve motor, cardiovascular, visual, hearing, and balance functions. SR increases contrast sensitivity and luminance detection; lowers the absolute threshold for tone detection in normal hearing individuals; improves homeostatic function in the human blood pressure regulatory system; improves noise-enhanced muscle spindle function; and improves detection of weak tactile stimuli using mechanical or electrical stimulation. SR noise has been shown to improve postural control when applied as mechanical noise to the soles of the feet, or when applied as electrical noise at the knee and to the back muscles.

Occupational balance in health professionals in Sweden.

PubMed

Wagman, Petra; Lindmark, Ulrika; Rolander, Bo; Wåhlin, Charlotte; Håkansson, Carita

2017-01-01

Health care employees are often women, a group that has high degrees of sick leave and perhaps problems attaining occupational balance. However, people think differently about their everyday activities and it is therefore important to take their perceptions into account but occupational balance has not yet been measured in health professionals. The aim was to describe occupational balance in three different samples of health professionals in Sweden. A further aim was to investigate whether occupational therapists (OTs) rate their occupational balance differently from other health professionals. Four hundred and eighty-two health professionals, employees in public dentistry, mental health care and OTs, aged 21-70 years participated. The participants' occupational balance was measured using the occupational balance questionnaire (OBQ). The ratings of occupational balance were similar to earlier studies and did not differ significantly between the samples. The OTs' occupational balance was also similar to that of the other health professionals. The similarities in occupational balance indicate the same difficulties in attaining it. The result highlights the possibility that working people face similar difficulties in achieving occupational balance. Further research is warranted about how to attain it.

Dynamic load balancing of applications

DOEpatents

Wheat, S.R.

1997-05-13

An application-level method for dynamically maintaining global load balance on a parallel computer, particularly on massively parallel MIMD computers is disclosed. Global load balancing is achieved by overlapping neighborhoods of processors, where each neighborhood performs local load balancing. The method supports a large class of finite element and finite difference based applications and provides an automatic element management system to which applications are easily integrated. 13 figs.

Active balance system and vibration balanced machine

NASA Technical Reports Server (NTRS)

White, Maurice A. (Inventor); Qiu, Songgang (Inventor); Augenblick, John E. (Inventor); Peterson, Allen A. (Inventor)

2005-01-01

An active balance system is provided for counterbalancing vibrations of an axially reciprocating machine. The balance system includes a support member, a flexure assembly, a counterbalance mass, and a linear motor or an actuator. The support member is configured for attachment to the machine. The flexure assembly includes at least one flat spring having connections along a central portion and an outer peripheral portion. One of the central portion and the outer peripheral portion is fixedly mounted to the support member. The counterbalance mass is fixedly carried by the flexure assembly along another of the central portion and the outer peripheral portion. The linear motor has one of a stator and a mover fixedly mounted to the support member and another of the stator and the mover fixedly mounted to the counterbalance mass. The linear motor is operative to axially reciprocate the counterbalance mass.

Vigilando la Calidad del Agua de los Grandes Rios de la Nacion: El Programa NASQAN del Rio Grande (Rio Bravo del Norte)

USGS Publications Warehouse

Lurry, Dee L.; Reutter, David C.; Wells, Frank C.; Rivera, M.C.; Munoz, A.

1998-01-01

La Oficina del Estudio Geologico de los Estados Unidos (U.S. Geological Survey, 0 USGS) ha monitoreado la calidad del agua de la cuenca del Rio Grande (Rio Bravo del Norte) desde 1995 como parte de la rediseiiada Red Nacional para Contabilizar la Calidad del Agua de los Rios (National Stream Quality Accounting Network, o NASOAN) (Hooper and others, 1997). EI programa NASOAN fue diseiiado para caracterizar las concentraciones y el transporte de sedimento y constituyentes quimicos seleccionados, encontrados en los grandes rios de los Estados Unidos - incluyendo el Misisipi, el Colorado y el Columbia, ademas del Rio Grande. En estas cuatro cuencas, el USGS opera actualmente (1998) una red de 40 puntos de muestreo pertenecientes a NASOAN, con un enfasis en cuantificar el flujo en masa (la cantidad de material que pasa por la estacion, expresado en toneladas por dial para cada constituyente. Aplicacando un enfoque consistente, basado en la cuantificacion de flujos en la cuenca del Rio Grande, el programa NASOAN esta generando la informacion necesaria para identificar fuentes regionales de diversos contaminantes, incluyendo sustancias qui micas agricolas y trazas elementos en la cuenca. EI efecto de las grandes reservas en el Rio Grande se puede observar segun los flujos de constituyentes discurren a 10 largo del rio. EI analisis de los flujos de constituyentes a escala de la cuenca proveera los medios para evaluar la influencia de la actividad humana sobre las condiciones de calidad del agua del Rio Grande.

Balancing Authority Cooperation Concepts to Reduce Variable Generation Integration Costs in the Western Interconnection: Consolidating Balancing Authorities and Sharing Balancing Reserves

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

Samaan, Nader A.; Makarov, Yuri V.; Nguyen, Tony B.

2017-05-07

The study described in this chapter demonstrates the benefits of BA consolidation with the help of a detailed WECC system model and advanced methodology, which is also described in this chapter. The study aims to determine the potential savings in production cost and reduction in balancing reserve requirements in the WECC system. The study has found that effective use of the diversity in load and variable generation over a wide area can indeed help to achieve significant savings. The implementation cost for the consolidation was beyond the scope of this study. The analysis was performed for two different scenarios ofmore » VG penetration: 11% (8% wind and 3% solar) and 33% (24% wind and 9% solar) of WECC projected energy demand in 2020. In analysis of balancing reserves, the objective was to determine the reduction in balancing reserve requirements due to BA consolidation, in terms of required capacity and ramp-rates. Hour-ahead and 10-minute ahead forecast errors for load, wind, and solar were simulated. In addition, 1-minute resolution load, wind and solar data were used to derive balancing reserve requirements i.e. load-following and regulation requirements for each individual BA and for the consolidated BA (CBA). The reduction in balancing reserves was determined by calculating the difference between total reserve requirements that need to be carried by different BAs if they operate individually, and reserve requirements that need to be carried by the CBA. The study results show that the consolidated WECC system would have about a 50% overall reduction in balancing reserves for the 11% penetration scenario and a 65% reduction for the 33% penetration scenario in comparison with total reserve requirements that need to be carried by different BAs if they operate individually.« less

"K"-Balance Partitioning: An Exact Method with Applications to Generalized Structural Balance and Other Psychological Contexts

ERIC Educational Resources Information Center

Brusco, Michael; Steinley, Douglas

2010-01-01

Structural balance theory (SBT) has maintained a venerable status in the psychological literature for more than 5 decades. One important problem pertaining to SBT is the approximation of structural or generalized balance via the partitioning of the vertices of a signed graph into "K" clusters. This "K"-balance partitioning problem also has more…

Judicial Checks and Balances

ERIC Educational Resources Information Center

La Porta, Rafael; Lopez-de-Silanes, Florencio; Pop-Eleches, Cristian; Shleifer, Andrei

2004-01-01

In the Anglo-American constitutional tradition, judicial checks and balances are often seen as crucial guarantees of freedom. Hayek distinguishes two ways in which the judiciary provides such checks and balances: judicial independence and constitutional review. We create a new database of constitutional rules in 71 countries that reflect these…

State of balance of the cryosphere

NASA Technical Reports Server (NTRS)

Van Der Veen, C. J.

1991-01-01

Available observations and mass balance estimates of the cryosphere are summarized. Problems discussed include mountain glaciers, the Greenland ice sheet, the Antarctic ice sheet, conventional glacier measurement techniques, and satellite applications in glacier mass balance studies. It is concluded that the interior part of the Greenland ice sheet is thickening or in near equilibrium. Estimates of the mass balance of the Antarctic ice sheet suggest that it is positive, although the error limits allow for a slightly negative balance.

A Smartphone Inertial Balance

ERIC Educational Resources Information Center

Barrera-Garrido, Azael

2017-01-01

In order to measure the mass of an object in the absence of gravity, one useful tool for many decades has been the inertial balance. One of the simplest forms of inertial balance is made by two mass holders or pans joined together with two stiff metal plates, which act as springs.

Biofeedback-Based, Videogame Balance Training in Autism.

PubMed

Travers, Brittany G; Mason, Andrea H; Mrotek, Leigh Ann; Ellertson, Anthony; Dean, Douglas C; Engel, Courtney; Gomez, Andres; Dadalko, Olga I; McLaughlin, Kristine

2018-01-01

The present study examined the effects of a visual-based biofeedback training on improving balance challenges in autism spectrum disorder (ASD). Twenty-nine youth with ASD (7-17 years) completed an intensive 6-week biofeedback-based videogame balance training. Participants exhibited training-related balance improvements that significantly accounted for postural-sway improvements outside of training. Participants perceived the training as beneficial and enjoyable. Significant moderators of training included milder stereotyped and ritualistic behaviors and better starting balance. Neither IQ nor BMI moderated training. These results suggest that biofeedback-based balance training is associated with balance improvements in youth with ASD, most robustly in those with less severe repetitive behaviors and better starting balance. The training was perceived as motivating, further suggesting its efficacy and likelihood of use.

14 CFR 23.659 - Mass balance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Mass balance. 23.659 Section 23.659 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... Surfaces § 23.659 Mass balance. The supporting structure and the attachment of concentrated mass balance...

14 CFR 23.659 - Mass balance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Mass balance. 23.659 Section 23.659 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... Surfaces § 23.659 Mass balance. The supporting structure and the attachment of concentrated mass balance...

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.

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.

Alternative Fuels Data Center: Lifecycle Energy Balance

Science.gov Websites

Energy Balance to someone by E-mail Share Alternative Fuels Data Center: Lifecycle Energy Balance on Facebook Tweet about Alternative Fuels Data Center: Lifecycle Energy Balance on Twitter Bookmark Alternative Fuels Data Center: Lifecycle Energy Balance on Google Bookmark Alternative Fuels Data Center

Mass balancing of hollow fan blades

NASA Technical Reports Server (NTRS)

Kielb, R. E.

1986-01-01

A typical section model is used to analytically investigate the effect of mass balancing as applied to hollow, supersonic fan blades. A procedure to determine the best configuration of an internal balancing mass to provide flutter alleviation is developed. This procedure is applied to a typical supersonic shroudless fan blade which is unstable in both the solid configuration and when it is hollow with no balancing mass. The addition of an optimized balancing mass is shown to stabilize the blade at the design condition.

45 CFR 1628.5 - Fund balance deficits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Fund balance deficits. 1628.5 Section 1628.5... FUND BALANCES § 1628.5 Fund balance deficits. (a) Sound financial management practices such as those... spending. Use of current year LSC grant funds to liquidate deficit balances in the LSC fund from a...

45 CFR 1628.5 - Fund balance deficits.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Fund balance deficits. 1628.5 Section 1628.5... FUND BALANCES § 1628.5 Fund balance deficits. (a) Sound financial management practices such as those... spending. Use of current year LSC grant funds to liquidate deficit balances in the LSC fund from a...

40 CFR 1065.290 - PM gravimetric balance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false PM gravimetric balance. 1065.290... balance. (a) Application. Use a balance to weigh net PM on a sample medium for laboratory testing. (b) Component requirements. We recommend that you use a balance that meets the specifications in Table 1 of...

40 CFR 1065.290 - PM gravimetric balance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false PM gravimetric balance. 1065.290... balance. (a) Application. Use a balance to weigh net PM on a sample medium for laboratory testing. (b) Component requirements. We recommend that you use a balance that meets the specifications in Table 1 of...

Balance across contexts: importance of balanced need satisfaction across various life domains.

PubMed

Milyavskaya, Marina; Gingras, Isabelle; Mageau, Geneviève A; Koestner, Richard; Gagnon, Hugo; Fang, Jianqun; Boiché, Julie

2009-08-01

Self-determination theory posits that satisfaction of three basic psychological needs-autonomy, competence, and relatedness-are required for psychological well-being, and a recent study showed that the balance in the satisfaction of these three needs independently affects well-being. The present investigation builds on these findings by examining the balance of adolescents' need satisfaction across distinct life contexts. The results of three studies show that adolescents who experience a balance of need satisfaction across important life contexts, including at school, at home, with friends, and in part-time jobs, reported higher well-being and better school adjustment. This finding emerged consistently across four countries and across multiple measures of school adjustment, including teacher reports. Together, these results support previous research that highlights the importance of consistency for psychological functioning.

14 CFR 29.659 - Mass balance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Mass balance. 29.659 Section 29.659...

14 CFR 27.659 - Mass balance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Mass balance. 27.659 Section 27.659...

14 CFR 29.659 - Mass balance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Mass balance. 29.659 Section 29.659...

14 CFR 27.659 - Mass balance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Mass balance. 27.659 Section 27.659...

14 CFR 27.659 - Mass balance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Mass balance. 27.659 Section 27.659...

14 CFR 29.659 - Mass balance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Mass balance. 29.659 Section 29.659...

Nitrogen balance in older individuals in energy balance depends on timing of protein intake.

PubMed

Jordan, Leora Y; Melanson, Edward L; Melby, Christopher L; Hickey, Matthew S; Miller, Benjamin F

2010-10-01

To explore whether nitrogen retention can differ on an isonitrogenous diet by changing when protein is consumed, we performed a short-term study in older individuals (64.5 ± 2.0 years) performing daily exercise while in energy balance. Participants consumed an isonitrogenous-isocaloric diet with the timing of a protein or carbohydrate beverage after exercise (protein after exercise [PRO], carbohydrate after exercise [CHO]) versus earlier in the day. Three-day mean energy balance (PRO: 202 ± 36 kcal and CHO: 191 ± 44 kcal; p = .68) did not differ between trials, but 3-day mean nitrogen balance was significantly more positive in the PRO (1.2 ± 0.32 g N) trial than the CHO trial (0.8 ± 0.45 g N; p < .05). Older individuals were better able to maintain nitrogen balance by simply changing when a portion of an identical amount of daily protein was consumed.

14 CFR 29.659 - Mass balance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Mass balance. 29.659 Section 29.659... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor... flutter at any speed up to the maximum forward speed. (b) The structural integrity of the mass balance...

14 CFR 27.659 - Mass balance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Mass balance. 27.659 Section 27.659... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors... flutter at any speed up to the maximum forward speed. (b) The structural integrity of the mass balance...

14 CFR 27.659 - Mass balance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Mass balance. 27.659 Section 27.659... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors... flutter at any speed up to the maximum forward speed. (b) The structural integrity of the mass balance...

14 CFR 29.659 - Mass balance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Mass balance. 29.659 Section 29.659... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor... flutter at any speed up to the maximum forward speed. (b) The structural integrity of the mass balance...

Balanced Flow Meters without Moving Parts

NASA Technical Reports Server (NTRS)

Kelley, Anthony R.; VanBuskirk, Paul

2008-01-01

Balanced flow meters are recent additions to an established class of simple, rugged flow meters that contain no moving parts in contact with flow and are based on measurement of pressure drops across objects placed in flow paths. These flow meters are highly accurate, minimally intrusive, easily manufacturable, and reliable. A balanced flow meter can be easily mounted in a flow path by bolting it between conventional pipe flanges. A balanced flow meter can be used to measure the flow of any of a variety of liquids or gases, provided that it has been properly calibrated. Relative to the standard orifice-plate flow meter, the balanced flow meter introduces less turbulence and two times less permanent pressure loss and is therefore capable of offering 10 times greater accuracy and repeatability with less dissipation of energy. A secondary benefit of the reduction of turbulence is the reduction of vibration and up to 15 times less acoustic noise generation. Both the balanced flow meter and the standard orifice-plate flow meter are basically disks that contain holes and are instrumented with pressure transducers on their upstream and downstream faces. The most obvious difference between them is that the standard orifice plate contains a single, central hole while the balanced flow meter contains multiple holes. The term 'balanced' signifies that in designing the meter, the sizes and locations of the holes are determined in an optimization procedure that involves balancing of numerous factors, including volumetric flow, mass flow, dynamic pressure, kinetic energy, all in an effort to minimize such undesired effects as turbulence, pressure loss, dissipation of kinetic energy, and non-repeatability and nonlinearity of response over the anticipated range of flow conditions. Due to proper balancing of these factors, recent testing demonstrated that the balanced flow-meter performance was similar to a Venturi tube in both accuracy and pressure recovery, but featured reduced

Balance in non-hydrostatic rotating stratified turbulence

NASA Astrophysics Data System (ADS)

McKiver, William J.; Dritschel, David G.

It is now well established that two distinct types of motion occur in geophysical turbulence: slow motions associated with potential vorticity advection and fast oscillations due to inertiamaster variable this is known as balance. In real geophysical flows, deviations from balance in the form of inertiaimbalance|N/f) where optimal potential vorticity balancenonlinear quasi-geostrophic balance’ procedure expands the equations of motion to second order in Rossby number but retains the exact (unexpanded) definition of potential vorticity. This proves crucial for obtaining an accurate estimate of balanced motions. In the analysis of rotating stratified turbulence at Ro1 and N/f1, this procedure captures a significantly greater fraction of the underlying balance than standard (linear) quasi-geostrophic balance (which is based on the linearized equations about a state of rest). Nonlinear quasi-geostrophic balance also compares well with optimal potential vorticity balance, which captures the greatest fraction of the underlying balance overall.More fundamentally, the results of these analyses indicate that balance dominates in carefully initialized simulations of freely decaying rotating stratified turbulence up to O(1) Rossby numbers when N/f1. The fluid motion exhibits important quasi-geostrophic features with, in particular, typical height-to-width scale ratios remaining comparable to f/N.

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.

Dynamic power balance analysis in JET

NASA Astrophysics Data System (ADS)

Matthews, G. F.; Silburn, S. A.; Challis, C. D.; Eich, T.; Iglesias, D.; King, D.; Sieglin, B.; Contributors, JET

2017-12-01

The full scale realisation of nuclear fusion as an energy source requires a detailed understanding of power and energy balance in current experimental devices. In this we explore whether a global power balance model in which some of the calibration factors applied to the source or sink terms are fitted to the data can provide insight into possible causes of any discrepancies in power and energy balance seen in the JET tokamak. We show that the dynamics in the power balance can only be properly reproduced by including the changes in the thermal stored energy which therefore provides an additional opportunity to cross calibrate other terms in the power balance equation. Although the results are inconclusive with respect to the original goal of identifying the source of the discrepancies in the energy balance, we do find that with optimised parameters an extremely good prediction of the total power measured at the outer divertor target can be obtained over a wide range of pulses with time resolution up to ∼25 ms.

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 'Balanced' Life: Work-Life Balance and Sickness Absence in Four Nordic Countries.

PubMed

Antai, D; Oke, A; Braithwaite, P; Anthony, D S

2015-10-01

Little attention has been given to the relationship between work-life balance and sickness absence. To investigate the association between poor work-life balance and sickness absence in 4 Nordic welfare states. Multivariable logistic regression analysis was performed on pooled cross-sectional data of workers aged 15-65 years from Denmark, Finland, Sweden, and Norway (n=4186) obtained from the 2010 European Working Conditions Survey (EWCS). Poor work-life balance was defined based on the fit between working hours and family or social commitments outside work. Self-reported sickness absence was measured as absence for ≥7 days from work for health reasons. Poor work-life balance was associated with elevated odds (OR 1.38, 95% CI 1.06 to 1.80) of self-reported sickness absence and more health problems in the 4 Nordic countries, even after adjusting for several important confounding factors. Work-related characteristics, ie, no determination over schedule (OR 1.26, 95% CI 1.04 to 1.53), and job insecurity (OR 1.56, 95% CI 1.21 to 2.02) increased the likelihood of sickness absence, and household characteristics, ie, cohabitation status (OR 0.75, 95% CI 0.58 to 0.96) reduced this likelihood. The associations were non-significant when performed separately for women and men. Sickness absence is predicted by poor work-life balance. Findings suggest the need for implementation of measures that prevent employee difficulties in combining work and family life.

Walk-based measure of balance in signed networks: Detecting lack of balance in social networks

NASA Astrophysics Data System (ADS)

Estrada, Ernesto; Benzi, Michele

2014-10-01

There is a longstanding belief that in social networks with simultaneous friendly and hostile interactions (signed networks) there is a general tendency to a global balance. Balance represents a state of the network with a lack of contentious situations. Here we introduce a method to quantify the degree of balance of any signed (social) network. It accounts for the contribution of all signed cycles in the network and gives, in agreement with empirical evidence, more weight to the shorter cycles than to the longer ones. We found that, contrary to what is generally believed, many signed social networks, in particular very large directed online social networks, are in general very poorly balanced. We also show that unbalanced states can be changed by tuning the weights of the social interactions among the agents in the network.

[Striking the work-life balance].

PubMed

Dumas, Marc

2014-11-01

Solutions for finding a satisfactory balance between home life and work lie in the organisation of work and the work environment. Line managers in particular have a key role to play in helping their staff maintain this balance.

Work-life balance and welfare.

PubMed

Evans, Lois; Young, Greg

2017-04-01

An online survey and focus groups were conducted, providing qualitative information on the work-life balance of psychiatrists and trainees in Australasia. An invitation to participate in an anonymous online welfare survey was emailed to all the Royal Australian and New Zealand College of Psychiatrists trainees, Fellows, and Affiliates. Following this, nine focus groups were held across Australia and New Zealand. Responses received were thematically analysed. The emergent patterns are presented in this report. Our research suggests that work-life balance can be subjectively and objectively measured. There are phases of good and bad work-life balance, depending on stage of career and other commitments. Work-life balance may be an indicator of the health of individuals and organisations. Due to its complexity, with intrinsic and extrinsic factors involved, solutions are unlikely to be simple. Further studies are needed to substantiate our findings.

Cryogenic balances for the US NTF

NASA Technical Reports Server (NTRS)

Ferris, Alice T.

1989-01-01

Force balances were used to obtain aerodynamic data in the National Transonic Facility (NTF) wind tunnel since it became operational in 1983. These balances were designed, fabricated, gaged, and calibrated to Langley Research Center's specifications to operate over the temperature range of -320 F to +140 F without thermal control. Some of the materials and procedures developed to obtain a balance that would perform in this environment are reviewed. The degree of success in using these balances thus far is reported. Some of the problem areas that need additional work are specified and some of the progress addressing these problems is described.

Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance.

PubMed

Clark, Ross A; Bryant, Adam L; Pua, Yonghao; McCrory, Paul; Bennell, Kim; Hunt, Michael

2010-03-01

Impaired standing balance has a detrimental effect on a person's functional ability and increases their risk of falling. There is currently no validated system which can precisely quantify center of pressure (COP), an important component of standing balance, while being inexpensive, portable and widely available. The Wii Balance Board (WBB) fits these criteria, and we examined its validity in comparison with the 'gold standard'-a laboratory-grade force platform (FP). Thirty subjects without lower limb pathology performed a combination of single and double leg standing balance tests with eyes open or closed on two separate occasions. Data from the WBB were acquired using a laptop computer. The test-retest reliability for COP path length for each of the testing devices, including a comparison of the WBB and FP data, was examined using intraclass correlation coefficients (ICC), Bland-Altman plots (BAP) and minimum detectable change (MDC). Both devices exhibited good to excellent COP path length test-retest reliability within-device (ICC=0.66-0.94) and between-device (ICC=0.77-0.89) on all testing protocols. Examination of the BAP revealed no relationship between the difference and the mean in any test, however the MDC values for the WBB did exceed those of the FP in three of the four tests. These findings suggest that the WBB is a valid tool for assessing standing balance. Given that the WBB is portable, widely available and a fraction of the cost of a FP, it could provide the average clinician with a standing balance assessment tool suitable for the clinical setting. Copyright 2009 Elsevier B.V. All rights reserved.

Dynamic balance and stepping versus tai chi training to improve balance and stepping in at-risk older adults.

PubMed

Nnodim, Joseph O; Strasburg, Debra; Nabozny, Martina; Nyquist, Linda; Galecki, Andrzej; Chen, Shu; Alexander, Neil B

2006-12-01

To compare the effect of two 10-week balance training programs, Combined Balance and Step Training (CBST) versus tai chi (TC), on balance and stepping measures. Prospective intervention trial. Local senior centers and congregate housing facilities. Aged 65 and older with at least mild impairment in the ability to perform unipedal stance and tandem walk. Participants were allocated to TC (n = 107, mean age 78) or CBST, an intervention focused on improving dynamic balance and stepping (n = 106, mean age 78). At baseline and 10 weeks, participants were tested in their static balance (Unipedal Stance and Tandem Stance (TS)), stepping (Maximum Step Length, Rapid Step Test), and Timed Up and Go (TUG). Performance improved more with CBST than TC, ranging from 5% to 10% for the stepping tests (Maximum Step Length and Rapid Step Test) and 9% for TUG. The improvement in TUG represented an improvement of more than 1 second. Greater improvements were also seen in static balance ability (in TS) with CBST than TC. Of the two training programs, in which variants of each program have been proven to reduce falls, CBST results in modest improvements in balance, stepping, and functional mobility versus TC over a 10-week period. Future research should include a prospective comparison of fall rates in response to these two balance training programs.