Team Application: Balanced Scorecards

Leaders within health care often use a balanced scorecard to help monitor the state of their organization. In order to be an effective management tool, a scorecard must include the most important indicators of an organization's status, while not being so lengthy as to be overwhelming.

For this Team Application, you and your team members will review a scenario about a hypothetical health care organization and analyze its balanced scorecard. Using your team's dedicated discussion forum, you and your team members will critique this scorecard by answering questions in Part 1 and Part 2, below.

Scenario: West Central Hospital

West Central Hospital is a major teaching hospital that operates intern and residency programs, and is a member of a multihospital health care system. The hospital is located in the suburbs, and its community has new building construction, moderate population growth, and aging and pediatric populations that are increasing.

This hospital has these additional features:

• 410 licensed beds for general acute care, but only 370 operating (staffed) beds
• Annual admissions of about 30,000
• An emergency department with approximately 90,000 annual visits
• A case mix index of about 1.15 
• Both inpatient and outpatient rehabilitative (physical therapy, occupational therapy, and speech language pathology) services
• Behavioral health services
• A neonatal intensive care unit
• All other ancillary and support services expected of such a hospital

Among the services it provides are: The hospital is currently using a Balanced Scorecard for West Central Hospital. One of West Central Hospital's administrators asks your team to analyze and critique their scorecard and provide them with suggestions. Specific questions are provided below.

Prepare for your team work:

In order to facilitate more efficient team collaboration, complete the following before beginning to work with your team.

• Download and print a copy of theBalanced Scorecard for West Central Hospital, which can be found in theWeek 6 Resources area. Analyze it in light of the scenario above.
• Review your Learning Resources throughout the course regarding the purpose of balanced scorecards and recommendations on metric selections. These resources include pages 143-145 in the Langabeer text, and the"Boards, Dashboards, and Data" PowerPoint from the IHI website.
• Read through the categories of information on the scorecard. Review the various weekly topics in this course-e .g., forecasting, capacity management, reengineering, staffing, scheduling, productivity, and supply chain-to help you identify key areas that should be reflected in the scorecard and corresponding metrics that are important to health care organizations. Do you see any important areas missing? Anything redundant?
• Look closely at the metrics themselves; using your textbooks and other Learning Resources from throughout the course, identify what data they represent.
• Analyze the data to get a sense how this hospital is doing. Consider what the Custom Compare Group (CCG) data and the hospital's own 3-year trended data say about the hospital's performance. Is it improving, getting worse, or staying stable in the various areas? Do the data suggest any areas that are greatly in need of improvement?

Complete the following as a team:

Following a schedule developed by your team, complete the following through collaborative work. Use your team discussion forum and any other methods of communication (such as e-mail, or phone or video conferencing) chosen by the team for your collaboration.

In a 4- to 6-page paper, address Parts 1 and 2: 

Part 1: Individual Metrics

As a team, select four metrics, each from a different category, to analyze further. For each of these four metrics, complete the following:

• Identify and define the respective numerator, denominator and rate/ratio.
• Review and interpret the trended data. What do the data, and their trends, tell you about this particular aspect of the hospital?
• Suggest a likely type of database or data source for each metric (this can be from internal and/or external sources).
• Suggest actions that management could take to improve outcomes associated with the metric.

Part 2: Overall Scorecard and Monitoring a Strategic Goal

• Based on this scorecard, which areas of the organization seem to be doing well, and which ones are most in need of improvement? What are your grounds for concluding this? Summarize what these scorecard indicators say about this organization in comparison with its peer organizations (e.g., the Custom Compare Group).
• Consider the selection of metrics for this scorecard. Do you think this scorecard will provide managers and administrators with a balanced view of the organization's performance? Explain why or why not. Suggest adding and/or deleting any metrics and provide a rationale for doing so.
• Review the scenario and consider these details in connection with the scorecard data. Propose a significant, yet plausible strategic goal for this organization. Then identify 2-3 metrics the organization should focus on to help them meet this goal. Are these metrics in the scorecard already? If so, which ones are they? If not, which metrics would you add to the scorecard to help leadership monitor this strategic goal?