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Developing a Balanced Score Card

Session 1
Viki Massey, Quality Coordinator

A Joint Venture of London Health Sciences Centre and St. Josephs Health Care London

When you can measure what you are speaking about, and express it in numbers, you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meager and unsatisfactory kind.
William Thompson (Lord Kelvin), 1824-1907

What is a Balanced Score Card?

A measurement system 2) A strategic management system 3) A communication tool

BSC as a Measurement System

Translates mission, vision and strategy through objectives and measures Provides a framework to describe the key elements in the achievement of the strategy Measures four perspectives - Customer Relations - Financial - Internal Service Process - Learning, Innovation and Growth

BSC as a Measurement System


Customer Relations

Vision and Strategy

Internal Service Process

Learning, Innovation and Growth

Financial Perspective

What financial steps are necessary to ensure the execution of our strategy/goals? Are the programs/ departments goals, implementation, and execution contributing to the bottom line? Are we meeting operational and financial targets? Dimensions of Quality:

Internal Service Process Perspective

What critical processes must we excel at to satisfy our customers/stakeholders? What must be done internally to meet patient/customer expectations? Dimension of Quality:


Customer Relations Perspective


are our target customers? How do our patients/customers see us? How do patients/customers rate our performance? Dimension of Quality:
Accessibility Acceptability Continuity

Learning, Innovation and Growth Perspective


can we continue to improve? What capabilities and tools do our employees need to execute our strategy/goals? Dimension of Quality:
Competence Participation

BSC as a Strategic Management System


strategy into:

Objectives Measures Targets Initiatives

Translating with the BSC

Desired state Differentiating activities What must be done well to implement strategies


Vision Strategy/Goals Objectives

In each perspective

How strategic success is measured

In each perspective

LLSG Mission Statement

In the spirit of innovation and collaboration, London Laboratory Services Group (LLSG) provides the health care system with appropriate and comprehensive diagnostic, therapeutic and consultative services of the highest quality.

LLSG Goals/Strategy
The London Laboratory Services Group will:

be recognized as a centre of excellence and leader in providing diagnostic services develop an understanding of the needs of the users of our services be responsive to the needs of other health care providers communicate openly with users of our services be a leader in developing and implementing new technologies provide diagnostic and therapeutic services for the hospital, the region and beyond

LLSG Goals/Strategy contd

The London Laboratory Services Group will:

provide cost effective and efficient services provide an atmosphere of team work which is responsive to and supportive of learning collaborate with researchers to advance medical science partner with educational institutions to provide training for medical professionals develop partnerships with industry and other institutions which will enhance the range and scope of laboratory services

BSC as a Communication Tool

Describes and translates strategy to employees through clear and objective performance measures
Example Goal:
Objectives: Measures:

LLSG will provide cost effective and efficient services Reduce costs Increase productivity Supply costs Workload

Todays Exercise
Form 4 groups- one for each perspective Within each group: 1. Appoint a scribe/presenter 2. Brainstorm objectives 3. Record all objectives 4. Present objectives to other groups 5. Record other objectives as suggested by the other groups

Brainstorming Exercise
Purpose: to generate multiple ideas, in this case for developing BSC objectives

BSC Objectives
1. Describe the activities that we must

perform well to successfully implement strategy/goals 2. Answer the questions associated with each perspective 3. Start with an action verb: increase, develop, improve, lower, achieve etc.

Brainstorming Exercise

1. No

idea is a bad idea 2. Be creative 3. Take risks 4. No criticism allowed

Brainstorming Exercise
Method: Round Table

Out loud; round robin, one by one, each person states an idea which the scribe then records In silence; write ideas down on sticky notes. Pass notes to scribe to review out loud and record



Continue around the table until all ideas are exhausted

Next Steps

BSC perspective guides Review objectives generated by the brainstorming exercise Consolidate and clarify objectives Vote on top candidates Trim list to a maximum of 3 per BSC perspective


Balanced Score- Step by Step: Maximizing Performance and Maintaining Results Paul R. Niven