The document discusses the balanced scorecard as a tool for medical practices to maximize performance and maintain results. It describes the balanced scorecard as being based on four performance perspectives: patient experience, internal processes, employee learning and growth, and financial outcomes. The measures selected for the balanced scorecard represent a way for practices to communicate how they will achieve their mission and strategy objectives. Maintaining the balanced scorecard requires long-term strategic planning, defining roles and reporting timeframes, and allowing changes to objectives and measures in some cases.

1. The Balanced Scorecard
Maximizing Performance and
Maintaining Results For
Your Medical Practice
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2. What Is A Balanced Scorecard?
Driven by the medical
practice’s Vision and Strategy
Based on four performance
drivers from the perspectives
of:
1. Patient Experience
2. Internal Processes
3. Employee Learning and
Growth
4. Financial Outcome
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3. What Is The Purpose of A
Balanced Scorecard?
The measures selected for the
Balanced Scorecard (BSC)
represents a tool of the client
to use in communicating to
staff, owners, and investors
the outcome of performance
drivers by which the medical
practice will achieve its
mission and strategy
objectives.
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4. The Patient Perspective
When choosing methods and measures for the patient
perspective of the BSC, the client should answer three critical
questions:
 Who are our target patients?
 What is our value proposition in servicing them?
 What do our patients expect from our practice?
Measures for the patient perspective typically are:
 Patient Satisfaction
 Patient Retention
 Market Share
 Patient Acquisition.
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5. The Internal Process
Perspective
The business owner should identify the key processes the
practice must excel at in order to continue adding value for
patients and ultimately practice owner(s).
The task here is to identify processes that add to the value
proposition and develop the best possible objectives and
measures with which to track progress:
 Cycle-time improvement
 Efficiencies in workflow
 Optimization of patient-facing time
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6. The Employee Learning and
Growth Perspective
The objectives and measures of the Employee Learning and
Growth Perspective of the BSC are really the enablers of the
other three perspectives.
Identify the gaps between the current organizational
infrastructure:
 Staff skills (human capital)
 Information systems (informational capital)
 The practice environment required to
achieve success (organizational capital)
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7. The Financial Perspective
The objectives and measures in this perspective will
tell the business owner whether the strategy
execution is leading to improved bottom-line results.
Classic lagging measures are reported in the
Financial Perspective. Typical examples include:
 Profitability
 Revenue growth
 Asset utilization
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8. What Is A Dashboard?
Name derived from the instrumentation of a car dashboard
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9. Leading and Lagging Measures
A Leading Measure A Lagging Measure
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10. Leading and Lagging
Measures
Lagging Measures
A “snapshot” of your
current state
Leading Measures
Predictors of your
future forecast
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11. Maintaining The
Balanced Scorecard
Establishing Balanced Scorecard Policies, Procedures,
and Processes
 Long-range strategic planning
 Reporting timeframes
 Roles and responsibilities
 Thresholds of performance
 Changing objectives, measures, and targets
The Balanced Scorecard Is Never “Complete”
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12. Maintaining The
Balanced Scorecard
Long-range Strategic Planning
The scorecard should be at the forefront of strategic planning
After the initial development of a scorecard,
some organizations tend to revert back to
their previous methods. The business owner
should continue to work with the developer
to define the scorecard’s role in the process
on an on-going basis, ensuring that it will
remain the key tool in the effective execution
of strategy
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13. Maintaining The
Balanced Scorecard
Scorecard Timeframes
Data will need to be collected and entered into the
scorecard whether it is automated or not. Those
responsible for providing data must be aware of the
timeliness associated with reporting and the importance of
timely and accurate data submission.
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14. Maintaining The
Balanced Scorecard
Roles and Responsibilities
Determine who is accountable for administering the scorecard
system in the practice and what their responsibilities are. Someone
in the practice must be seen as the scorecard’s “owner.”
In the case of a medical practice, this should ideally be the Practice
Administrator. Whoever the owner is, that person must be able to
coordinate the collection of data, summarize and analyze the data,
and ultimately report the practice’s performance to the business
owner on a monthly basis.
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15. Maintaining The
Balanced Scorecard
Changing Objectives, Measures, and Targets
Should you allow a mid-year change in any of the performance
indicators?
Changes should be permitted only in clear
cases of a misguided objective, measure or
target. Perhaps the calculation of a measure
is leading to incorrect decision making or the
target’s perceived difficulty is demotivating
the staff. In these situations a change may
be warranted.
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16. The Balanced Scorecard - Recap
Driven by the medical
practice’s Vision and The measures selected for
Strategy the Balanced Scorecard
represents a tool of the
Based on four client to use in
performance drivers from communicating to staff,
the perspectives of: owners, and investors the
• Patient Experience outcome of performance
• Internal Processes drivers by which the
• Employee Learning medical practice will
and Growth achieve its mission and
• Financial Outcome strategy objectives.
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17. The Balanced Scorecard
Questions
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