Session 1
Viki Massey, Quality Coordinator
A Joint Venture of London Health Sciences Centre and St. Joseph’s 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?
1)
2)
3)
A measurement system
A strategic management system
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
Financial
Customer
Relations
Vision and
Strategy
Internal Service
Process
Learning,
Innovation and
Growth



What financial steps are necessary to ensure the execution of our strategy/goals?
Are the program’s/ department’s goals, implementation, and execution contributing to the bottom line?
 Are we meeting operational and financial targets?
 Dimensions of Quality:
– Efficiency

 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:
– Effectiveness
– Appropriateness
– Safety

 Who 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
 How 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
 Translates strategy into:
 Objectives
 Measures
 Targets
 Initiatives

Desired state
Differentiating activities
What must be done well to implement strategies
How strategic success is measured
Mission
Vision
Strategy/Goals
Objectives
In each perspective
Measures
In each perspective

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.

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

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

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

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

1.
2.
3.
Describe the activities that we must perform well to successfully implement strategy/goals
Answer the questions associated with each perspective
Start with an action verb: increase, develop, improve, lower, achieve etc.

Rules:
1.
No idea is a bad idea
2.
Be creative
3.
Take risks
4.
No criticism allowed

Method: Round Table
1.
OR
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
2.
Continue around the table until all ideas are exhausted

 Review 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