Why a Balanced Score Card

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					    Why a Balanced Score Card?

The Challenge of Implementing and
     Sustaining Improvement
          The 10 Steps, - More or Less


    Laurie Francis, CEO,
Community Health Partners, Inc.
               Outline

Background of BSC process at
Community Health Partners
– Leadership and the Mission
– Organizational values and constant
  improvement
Implementation of BSC
– Focusing the effort
    The Process
    The Outcome
Summary
 General Leadership Concepts
    The vision is shared by all and the mission
              drives the organization

      Organizational beliefs and core concepts
             emanate from leadership

    A learning company “facilitates learning of all its
     members and is continually transforming itself.”
(Pedler, The Learning Company. A Strategy for Sustainable Development (1991)


                       Live the PDSA cycle
 Community Health Partners, Inc.
      Mission Statement

    To enhance community
     health and well-being
               through
      •Innovative programming
         •Strong partnerships
         •Improved outcomes


VISION - 100% ACCESS, 0 Disparity
          Core Concepts

  *Respect *Communication
      *Excellence *Change
  *Information    *Awareness
*Collaboration *Systems thinking
            *Commitment to
         learning…always
Community Health Partners, Inc.
           Beliefs

              Share the leadership
         Expect great things of people
    Everyone has strengths and growth areas
    We all live in fear of being “discovered”
      Relationships make the organization
 Appropriate challenges with adequate compensation
             Feedback is important
            Recognize contributions
             Ask the right question
   Ideas come from everywhere and everyone
                 We are all key
       Make it EASY to get excited…
             about CHANGE

Imbed mission
Spread enthusiasm
Provide the tools to do great work-
team work, leadership,
communication, technology
Bring “the experts” to the table
Celebrate improvements – create
measures to recognize progress!
       The Mission

        Strategic Plan


         This year’s
     Strategic Priorities

        Define GOAL


Short and Medium Range Goals
   Our Strategic Priorities - 04
Support the completion of a community needs assessment in both counties

Explore site expansion to create improved access in distance reaches of
counties

Maintain focus on chronic disease, emphasizing full implementation and
self-management

Offer full compliment of primary care services at GCC – pharmacy, dental
access, expanded medical capacity

Improve clinic efficiency with high staff and patient satisfaction – redesign
and technology

Strengthen literacy/clear communication staff approach at both sites
                       Implementation

1.   Reason for BSC at CHP
2.   Lots of time reading, brainstorming, sharing ideas
     with Executive Team, board and a few staff
     members
3.   Create draft and work over
4.   Take “final” draft for reworking through staff and
     board involvement – follows the 10 Step Process
5.   Ascertain staff perception about process
6.   Get it out and going!
7.   Form oversight group
8.   Ensure sustainability
9.   PDSA all the WAY and FOREVER!
       Staff Presentation
See handout with our slides
Share Information concerning purpose
CELEBRATE past accomplishments
Talk about our FUTURE
The Role of DATA
Why the BSC allows us to focus
Why staff input is crucial
What comes next
                         Balanced Score Card
                           Staff Evaluation

Do you have other ideas for the Balanced Score Card after hearing
  your co-workers thoughts that you haven’t already mentioned?

How would you rate your excitement about implementing the Balanced
  Score Card?
Dread     1    2     3    4    5    6     7    8     Very excited

Any concerns about the Balanced Score Card concept?

How would you rate today?
Lousy    1     2     3   4       5     6     7    8     Outstanding

If you gave it less than “8”, what would have made it better?

Any thing else we should ask/know?

                THANK YOU for your TIME today!!!!!
                                                               Current    Quarterly    Long Term
                                                                          GOAL         GOAL


Customer – Giving them what they want…(issues – quality, access)
 satisfaction - % moderate - very satisfied
 Pt.                                                            90%         90%          100%
       Cycle or wait time – begin second quarter                56                     50 min.

Internal Processes - Improving Care (access, quality, strong systems)
Established self-management goals on collaborative patients     32.7%        36%        70%
 Preventive Care – # of men, women and children seen in        M – 17%         3%       70%
three months                                                    W-33%         increa     in all
                                                                C-45%            se

Clear Comm. Goal – winter quarter?                                **
Health Literacy - # of indiv./families served                     **
Access to Medications - # of RXs                                  570        620        800

Financial – Recycling dollars for more patient care
               Visits/day
               Medical                                         14.84        16           17
               Dental                                           10          12           12
               Days in accounts receivable (AR)                  84          70           70

Staff – Creating fulfilling jobs
Staff satisfaction - scale 1-10                                 8.08         8            8

Community/Environment – always reaching out
Outside staff/board combined volunteer hours -average           1.3         1.5           2
Number of customer that are new to organization / month         263         270         280
     Before and beyond the BSC

Clarity of goals – organizational and
specific teams
An improvement plan – org. and team
Clearly defined roles of members
“Expert” team functioning
Communication, communication,
communication – two way
Leadership that supports attempts and
risk taking
                                                                 As new skills and abilities develop,
                                                                 The world we “see” shifts. Growing
                                                                 Understanding of ourselves and others
                                                                 Begin to “listen to the whole”.
                                            Awareness and
                                             Sensibilities

     Deep beliefs
   And assumptions
Change with experience
 Let go of hierarchical
 Organizational world
  View in favor of far                      Enduring                             Ability to reflect on
Greater latitude to shape                                                          assumptions and
      Our world.                             Change                              patterns of behavior.
                                                                                 Change because you
                                                                                 want to, not because
                                                             Skills and              you have to.
                            Attitudes and                                        See the whole from
                                                             Capabilities         an organizational
                                Beliefs
                                                                                      perspective
               Team Assessment
Team Goals and Objectives
There is consensus among          There is significant disagreement
participants regarding the team   among participants regarding the
goals and objectives.             eam goals and objectives.

1       2        3          4         5         6        7

Leadership
A leader or leaders has been clearly There is significant confusion
defined and the team understands     regarding leadership and the role
the role and function of leadership. and function of leadership.
1        2       3        4       5     6       7
                         3. Summary
               Sustained Change –
                CAUSE & EFFECT DIAGRAM
                                VISIBLE
             EFFECTIVE
 STAFF                       MANAGEMENT
               TEAM
 BUY-IN                        SUPPORT



                                                  SUSTANING
                                                    CHANGE


                                 SUPPORTING
 DYNAMIC      EFFECTIVE        ORGANIZATIONAL
KNOWLEDGE   COMMUNICATION         CULTURE &
   BASE         PLAN             STRUCTURE

                                      Dr. Anthony Amofah’s
                Summary
Mission - it has to be the driver
Prepare
– Set up is almost EVERYTHING…reinforce
  organizational alignment, make process
  transparent, be inclusive
Sustain
– If it is an organizational priority (and it should
  be), the work done to PREPARE will see you
  through