BALANCED SCORECARD BALANCED SCORECARD Integrating Cost, Quality, & Satisfaction Integrating Cost, Quality, & Satisfaction Measures Measures Steven W. Jagiela Jagiela Douglas J. Helfrich Steven W. Douglas J. Helfrich Management Engineering Management Engineering Lehigh Valley Hospital Lehigh Valley Hospital HIMSS 2000 Annual Conference April 9-13, 2000 - Dallas, TX HIMSS 2000
Agenda Agenda ! Lehigh Valley Hospital & Health Network ! Historical Perspective (Why Do This?) ! Approach: OI & Benchmarking ! The Project ! The Tool ! Using the Scorecard in the Budget Process ! Discussion…..Questions…..Answers? HIMSS 2000
WHAT YOU WILL LEARN TODAY WHAT YOU WILL LEARN TODAY ■ How Benchmarking can help set the stage for How Benchmarking can help set the stage for ■ major organizational effectiveness major organizational effectiveness ■ How You can build front line management How You can build front line management ■ muscle muscle ■ How You can help your whole team row in the How You can help your whole team row in the ■ same direction same direction ■ How to implement a simple, effective, How to implement a simple, effective, ■ comprehensive SCORECARD tool comprehensive SCORECARD tool HIMSS 2000
Lehigh Valley Hospital & Health Network Lehigh Valley Hospital & Health Network ■ Based in Allentown, Pennsylvania Based in Allentown, Pennsylvania ■ ■ Includes: Includes: ■ – Lehigh Valley Hospital (2 sites in Allentown) Lehigh Valley Hospital (2 sites in Allentown) – – Muhlenberg – Muhlenberg Hospital Center - Bethlehem Hospital Center - Bethlehem – Lehigh Valley Health Services Lehigh Valley Health Services – » » Home Health, Hospice, Sub-acute Care, Rehabilitation, Home Health, Hospice, Sub-acute Care, Rehabilitation, Pharmacy, Durable Medical Equipment, Laboratory Pharmacy, Durable Medical Equipment, Laboratory Services Services ■ Over 35,000 Inpatients, 200,000 Home Care visits, Over 35,000 Inpatients, 200,000 Home Care visits, ■ 3,300 Births 3,300 Births ■ 600+ Operating Beds & 6000+ Employees 600+ Operating Beds & 6000+ Employees ■ HIMSS 2000
Lehigh Valley Hospital & Health Network Lehigh Valley Hospital & Health Network ■ First Level 1 Trauma Center serving 1.6 million people First Level 1 Trauma Center serving 1.6 million people ■ over six-county area over six-county area ■ Regional Cancer Center Regional Cancer Center ■ – affiliated with Johns Hopkins Oncology Center affiliated with Johns Hopkins Oncology Center – – – draws patients throughout northeast Pennsylvania, handling draws patients throughout northeast Pennsylvania, handling more than 1500 new cancer cases annually more than 1500 new cancer cases annually ■ Member of Member of PennCare PennCare, a provider-led, integrated , a provider-led, integrated ■ healthcare delivery system comprised of 11 hospitals healthcare delivery system comprised of 11 hospitals in eastern Pennsylvania in eastern Pennsylvania ■ Affiliated with Penn State University for residency Affiliated with Penn State University for residency ■ programs programs HIMSS 2000
WHY DO THIS? WHY DO THIS? HIMSS 2000
APPROACH APPROACH Operations Improvement & Benchmarking Operations Improvement & Benchmarking How Projects Are Initiated ■ Comparison to “Best Practice” Comparison to “Best Practice” ■ – Operational Benchmarking Operational Benchmarking – – Clinical Benchmarking Clinical Benchmarking – – Local competitors Local competitors – – Other benchmarks Other benchmarks – ■ Process Improvement Process Improvement ■ ■ Employee Suggestions Employee Suggestions ■ HIMSS 2000
Integration of OI OI, PI, Benchmarking, and Budget , PI, Benchmarking, and Budget Integration of into Day-to-Day, Unit-level Management into Day-to-Day, Unit-level Management Process Improvement Operations Improvement Benchmarking Day-to-day Scorecard operations Monthly Financial Reports Capital and Operating Budgets Immediate Every 2 weeks Monthly Annually HIMSS 2000
THE PROJECT: THE PROJECT: Scorecard Development and Deployment Phases Scorecard Development and Deployment Phases Planning Prototype Development Deployment Scorecard Purpose To provide a management tool which is: Clear Consistent Timely Easily Accessible HIMSS 2000
THE PROJECT: THE PROJECT: Scorecard Development and Deployment Phases Scorecard Development and Deployment Phases Planning Prototype Development Deployment The scorecard will help us to run our business efficiently & effectively: • Monitor unit-level performance • Make changes that lead to improvements • Build budgets based on scorecard ratios HIMSS 2000
How Will We Know How We Are Doing? How Will We Know How We Are Doing? Member Satisfaction HIMSS 2000
How Will We Know How We Are Doing? How Will We Know How We Are Doing? Member Satisfaction Quality HIMSS 2000
How Will We Know How We Are Doing? How Will We Know How We Are Doing? Member Satisfaction Quality Operational Ratios: Labor and Non-Labor BALANCE will be key to our SUCCESS! ! HIMSS 2000
Development Approach Development Approach Plan Prototype Pilot Deploy Enhance Define & Develop Install & Build the follow Scorecard refine Scorecard deployment concept Scorecard process Nov ‘97 Jan ‘98 Spring ‘98 Summer & Fall ‘98 HIMSS 2000
Obvious Analogy to Sports Obvious Analogy to Sports ■ Highlight of Highlight of what matters most what matters most ■ ■ Time oriented Time oriented ■ ■ Timely reporting Timely reporting ■ ■ Balance of measures Balance of measures ■ ■ Comparison to Others Comparison to Others ■ ■ Central focus (“official” record) Central focus (“official” record) ■ ■ Influence on subsequent actions Influence on subsequent actions ■ ■ Interest to indirect participants Interest to indirect participants ■ HIMSS 2000
SCORECARD Prototype SCORECARD Prototype Current Yr Yr Previous Previous Yr Yr Current Period Period YTD YTD Period Period YTD YTD Target Benchmarks Benchmarks Target Efficiency Efficiency Labor Ratios Labor Ratios ■ ■ Total $ Ratios Total $ Ratios ■ ■ Effectiveness Effectiveness Quality Quality ■ ■ Satisfaction Satisfaction ■ ■ Economy Economy Revenue Revenue ■ ■ Margin Margin ■ ■ HIMSS 2000
Lehigh Valley Hospital Valley Hospital Lehigh SCORECARD PREVIEW SCORECARD PREVIEW HIMSS 2000
Development Pre-requisites Development Pre-requisites ■ Data Warehouse Data Warehouse ■ – Collection of data from source systems Collection of data from source systems – ■ Data Model Data Model ■ – Definition of relationships between data Definition of relationships between data – ■ Open Database Connectivity (ODBC) Open Database Connectivity (ODBC) ■ – Connection from PC through network Connection from PC through network – HIMSS 2000
Macro-Timeline Macro-Timeline June 1998 January 1998 Feb 1998 Expansion Fall 1997 First Team Meeting Pilot Launch Prototype Development Team Deployment & Pilot Departments Formation Team Selection Presentations Agreement COO Staff Prep for Roles & Responsibilities 1:1 Meetings Implementation Team Charter
Role of the Project Sponsor Role of the Project Sponsor ■ Have a Have a vision vision ■ ■ Communicate it effectively Communicate it effectively ■ ■ Sustain the vision Sustain the vision ■ – with project team with project team – – key stakeholders and organizational leaders key stakeholders and organizational leaders – ■ Fly air cover Fly air cover ■ ■ Integrate with operations to make it live! Integrate with operations to make it live! ■ HIMSS 2000
Scorecard Development & Deployment Scorecard Development & Deployment Plan Prototype Pilot Deploy Enhance Scorecard Deployment Team Project Sponsor - COO Project Leader - Director, Management Engineering Team Members Care Management Finance Human Resources Information Systems Internal Audit Organizational Development Patient Care Services Pharmacy Management Engineering Materials Management
Resource Managers Resource Managers Components Team Rep ■ Wage Expenses/Budget Wage Expenses/Budget Finance Finance ■ ■ Non Labor Expenses Non Labor Expenses Materials Mgmt Materials Mgmt ■ ■ Quality Measures Quality Measures Care Mgmt Care Mgmt ■ ■ Customer Satisfaction Customer Satisfaction Org Dev Dev Org ■ ■ Scorecard Mechanics Scorecard Mechanics Mgmt Eng Eng / IS / IS Mgmt ■ HIMSS 2000
Scorecard Development and Scorecard Development and Deployment Phases Deployment Phases Plan Prototype Pilot Deploy Enhance Spring 1998 LVH Pilot Departments Pharmacy Engineering Blood Bank 6B Cardiac Cath Lab MICU/SICU Labor & Delivery Radiology Supply Distribution ED HIMSS 2000
Scorecard •Operational Measures •Quality Measures •Member Satisfaction Measures Scorecard Kick-off Session February 2, 1998
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