The tertiary care hospital has as its primary responsibility to deliver health care to the most sick and severely ill. The management of the critically ill is seen as a wrathful driver of costs within the confines of the tertiary care hospital both in the United States and abroad. Through utilization of the Balanced Scorecard not only are the needed financial metrics elevated but the added dimensions of customer (both internal and external), internal business processes, and learning and growth dimensions are part of the balanced scorecard perspectives. Through use of the balanced scorecard in the tertiary care hospital, the wrath of the cost driver of the therapeutic management and intervention of the critically ill is assuaged. Tertiary care hospitals are able to deliver solid operating margins while ensuring patient satisfaction with good clinical outcome of the critically ill while experiencing much employee engagement. The tertiary care hospital enjoys the interconnectedness of the dimensions realizing quickly that over time all the Balance Scorecard perspectives are financial dimensions.
Most reliable diagnostic and pathology center to watch..Merry D'souza
This edition of Most Reliable Diagnostic and Pathology Centres to Watch places the spotlight on healthcare service providers that are leveraging such revolutionary technologies to deliver the best to those seeking their services.
Medical Affairs, as a function, sits at a crossroads in the pharmaceutical industry. The department is expected to act as a bridge between the commercial and scientific arms of an organization. Medical Affairs is further tasked with being the conduit of information between the company and external stakeholders, bringing efficacy and safety data to the medical community as well as gathering insights from the medical community to share internally. All responsibilities must be undertaken while keeping in mind strict regulatory controls and ensuring that medical data are interpreted appropriately.
ISR has designed this report to be used as a benchmarking tool for companies to compare their Medical Affairs functions to those of Top 50 pharmaceutical organizations.
See more: http://bit.ly/medaffairs
Most reliable diagnostic and pathology center to watch..Merry D'souza
This edition of Most Reliable Diagnostic and Pathology Centres to Watch places the spotlight on healthcare service providers that are leveraging such revolutionary technologies to deliver the best to those seeking their services.
Medical Affairs, as a function, sits at a crossroads in the pharmaceutical industry. The department is expected to act as a bridge between the commercial and scientific arms of an organization. Medical Affairs is further tasked with being the conduit of information between the company and external stakeholders, bringing efficacy and safety data to the medical community as well as gathering insights from the medical community to share internally. All responsibilities must be undertaken while keeping in mind strict regulatory controls and ensuring that medical data are interpreted appropriately.
ISR has designed this report to be used as a benchmarking tool for companies to compare their Medical Affairs functions to those of Top 50 pharmaceutical organizations.
See more: http://bit.ly/medaffairs
Service Marketing Mix 7Ps and Patient Satisfaction in Clinics A Review ArticleYogeshIJTSRD
This study aims to review the healthcare marketing mix and patient satisfaction in clinics. The findings indicate that the healthcare marketing mix 7Ps in clinics7Ps comprises people, product services , process, physical evidence, price, place, and process. The proposed theoretical framework is shown the relationship between the service marketing mix in clinics and patient satisfaction. Managers may adopt the 7Ps of this review article to achieve patient satisfaction and intended performance levels. The researcher recommended further study to clarify the relationship in this sector. Supaprawat Siripipatthanakul | Pattanapong Chana "Service Marketing Mix (7Ps) and Patient Satisfaction in Clinics: A Review Article" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd43944.pdf Paper URL: https://www.ijtsrd.com/management/marketing/43944/service-marketing-mix-7ps-and-patient-satisfaction-in-clinics-a-review-article/supaprawat-siripipatthanakul
Background: Safe, timely and accessible essential surgery and anesthesia is now integral to universal health coverage with the passage of World Health Organization Resolution
68/15. In the past, hospital-based surgical assessment surveys and indices were critical for advocacy, illustrating real infrastructure deficits and needs. The Lancet
Commissions on Global Surgery goals for 2030 and its indicators, targeting anesthesia, obstetrics and surgery in low-income countries, indicated the creation of a new global surgery index.
Methods: Indicator thresholds and data were identified and collected from World Health Organization public data sets and available literature. Quintile categories were used to assign points and descriptive statistics were used generated indices of low-income countries, as well as illustrating data collection needs.
Results: A Lancet Commissions on Global Surgery indicator-based index was generated.
The Democratic People's Republic of Korea had the lowest surgical capacity index at
9.09%; Ethiopia and Sierra Leone had the highest at 81.81%. The average equaled
60.41%. 6 out of 17 indicators had no reported data; while only cesarean section rate had reported data from all LICs.
Conclusion: This Lancet Commissions on Global Surgery indicator-based index can be used in real-time surgical system capacity-building (such as infrastructure planning and assessment for expanding best practices in low-income countries) to achieve safe, timely and accessible global essential surgery and anesthesia by 2030. Despite the WHA
Resolution, data collection gaps may slow the pace of attaining that vision. Thus, stakeholders can use this tool to aid in assuring surgical access, quality improvement, and stronger data collection.
From Social Media through to Artificial intelligence...and more. In this presentation I covered the trends that we're currently seeing in Medical Affairs - those trends which are important now, those trends which will impact Medical Affairs in the future, and the skills required to be successful.
To read the LinkedIn article here’s the link: https://www.linkedin.com/pulse/trends-medical-affairs-presented-appa-march-14-2018-glenn-carter/
For further discussion phone us on:
Sydney (02) 8877 8777
Melbourne (03) 9938 7100
Or for additional insights go to one of our specialised websites:
Healthcare Professionals Group
(https://www.hpgconnect.com/)
Health & Aged Care Professionals (https://www.hacpconnect.com/)
Pharmaceutical & Medical Professionals
(https://www.pmpconnect.com/)
Rural & Remote Healthcare Professionals
(https://www.rrhpconnect.com/)
Benchmarking Bio-Pharmaceutical Medical Education Programs: Structures, Resou...Best Practices
Bio-pharmaceutical organizations have long relied on medical education programs to provide latest medical knowledge to physicians and other health care professionals. However, recent compliance rules and regulations have tempered the sponsorship of some medical education programs by bio-pharmaceutical companies, as well as some third-party providers of such services.
Best Practices, LLC, undertook benchmarking research to probe emerging medical education trends at top bio-pharmaceutical companies. In particular, this research provides benchmarks on the proper size, structure, activities performed, staffing, and investment for the Medical Education function.
Download Full Report: http://bit.ly/2cf5PYb
Benchmarking Advisory Board Management At Large Pharmaceutical And Medical De...Best Practices
Pharmaceutical advisory boards provide strategic inputs and guidance to organizations on various business aspects. However, successful advisory board management requires optimum investment in resources and operations. To maximize the return on investment it is important for pharmaceutical and medical device professionals to ensure that the quality of meetings and dialogue with advisory boards is excellent.
This research from Best Practices, LLC is designed for pharmaceutical and biotech executives seeking ways to best utilize the knowledge of advisory boards. Research findings provide benchmarks on the appropriate structure for various types of advisory boards, selection of advisory board participants, advisory board operational and resource benchmarks.
Optimize the Role of Medical Affairs in Health Economics & Outcomes Research ...Best Practices
The Medical Affairs function plays an important role in health outcomes (HO) information exchange between bio-pharmaceutical organizations and key external stakeholders.
Development of robust health outcomes capabilities within Medical Affairs function requires an increase in the function’s involvement with health outcomes groups, development of field-based health outcomes capabilities, customization of health outcomes data as per stakeholders’ needs, and building real world data capabilities to generate and utilize health outcomes information.
This benchmarking research from Best Practices, LLC is designed to assist companies focused on oncology therapies find better ways to develop effective health outcomes groups. It provides current data and best practices from Medical Affairs leaders with an oncology focus at leading bio-pharmaceutical companies.
Download Full Report: http://bit.ly/2e3sl9Q
Overview of aspects of pharma's value added services and its primary aspects to deliver them.
Learn what others do and reflect how it's an opportunity for your pharma company..
Motivated and performance driven; clinical and business professional. Determined and passionate about implementing best practices while targeting education and improving staff development efficiently. Expert knowledge of healthcare environment, ability to positively influence behavior for quality patient outcomes. Demonstrates ability to creatively use consulting and listening skills when working with interdisciplinary teams, promoting consensus with communication and transparency of program goals. Organized and presents research and analytic benchmarks proficiently with cross functional team collaboration.
Lifecare is the country's premier full-service diagnostic center with laboratory, providing expertise in imaging and digital pathology services. Our integrated diagnostic services help doctors personalize patient care to optimally treat disease and maintain health and wellness. We are committed to providing only the highest level of testing quality and service and working with you to provide unique solutions to your most challenging needs. http://www.lifecareindia.com/
Service Marketing Mix 7Ps and Patient Satisfaction in Clinics A Review ArticleYogeshIJTSRD
This study aims to review the healthcare marketing mix and patient satisfaction in clinics. The findings indicate that the healthcare marketing mix 7Ps in clinics7Ps comprises people, product services , process, physical evidence, price, place, and process. The proposed theoretical framework is shown the relationship between the service marketing mix in clinics and patient satisfaction. Managers may adopt the 7Ps of this review article to achieve patient satisfaction and intended performance levels. The researcher recommended further study to clarify the relationship in this sector. Supaprawat Siripipatthanakul | Pattanapong Chana "Service Marketing Mix (7Ps) and Patient Satisfaction in Clinics: A Review Article" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd43944.pdf Paper URL: https://www.ijtsrd.com/management/marketing/43944/service-marketing-mix-7ps-and-patient-satisfaction-in-clinics-a-review-article/supaprawat-siripipatthanakul
Background: Safe, timely and accessible essential surgery and anesthesia is now integral to universal health coverage with the passage of World Health Organization Resolution
68/15. In the past, hospital-based surgical assessment surveys and indices were critical for advocacy, illustrating real infrastructure deficits and needs. The Lancet
Commissions on Global Surgery goals for 2030 and its indicators, targeting anesthesia, obstetrics and surgery in low-income countries, indicated the creation of a new global surgery index.
Methods: Indicator thresholds and data were identified and collected from World Health Organization public data sets and available literature. Quintile categories were used to assign points and descriptive statistics were used generated indices of low-income countries, as well as illustrating data collection needs.
Results: A Lancet Commissions on Global Surgery indicator-based index was generated.
The Democratic People's Republic of Korea had the lowest surgical capacity index at
9.09%; Ethiopia and Sierra Leone had the highest at 81.81%. The average equaled
60.41%. 6 out of 17 indicators had no reported data; while only cesarean section rate had reported data from all LICs.
Conclusion: This Lancet Commissions on Global Surgery indicator-based index can be used in real-time surgical system capacity-building (such as infrastructure planning and assessment for expanding best practices in low-income countries) to achieve safe, timely and accessible global essential surgery and anesthesia by 2030. Despite the WHA
Resolution, data collection gaps may slow the pace of attaining that vision. Thus, stakeholders can use this tool to aid in assuring surgical access, quality improvement, and stronger data collection.
From Social Media through to Artificial intelligence...and more. In this presentation I covered the trends that we're currently seeing in Medical Affairs - those trends which are important now, those trends which will impact Medical Affairs in the future, and the skills required to be successful.
To read the LinkedIn article here’s the link: https://www.linkedin.com/pulse/trends-medical-affairs-presented-appa-march-14-2018-glenn-carter/
For further discussion phone us on:
Sydney (02) 8877 8777
Melbourne (03) 9938 7100
Or for additional insights go to one of our specialised websites:
Healthcare Professionals Group
(https://www.hpgconnect.com/)
Health & Aged Care Professionals (https://www.hacpconnect.com/)
Pharmaceutical & Medical Professionals
(https://www.pmpconnect.com/)
Rural & Remote Healthcare Professionals
(https://www.rrhpconnect.com/)
Benchmarking Bio-Pharmaceutical Medical Education Programs: Structures, Resou...Best Practices
Bio-pharmaceutical organizations have long relied on medical education programs to provide latest medical knowledge to physicians and other health care professionals. However, recent compliance rules and regulations have tempered the sponsorship of some medical education programs by bio-pharmaceutical companies, as well as some third-party providers of such services.
Best Practices, LLC, undertook benchmarking research to probe emerging medical education trends at top bio-pharmaceutical companies. In particular, this research provides benchmarks on the proper size, structure, activities performed, staffing, and investment for the Medical Education function.
Download Full Report: http://bit.ly/2cf5PYb
Benchmarking Advisory Board Management At Large Pharmaceutical And Medical De...Best Practices
Pharmaceutical advisory boards provide strategic inputs and guidance to organizations on various business aspects. However, successful advisory board management requires optimum investment in resources and operations. To maximize the return on investment it is important for pharmaceutical and medical device professionals to ensure that the quality of meetings and dialogue with advisory boards is excellent.
This research from Best Practices, LLC is designed for pharmaceutical and biotech executives seeking ways to best utilize the knowledge of advisory boards. Research findings provide benchmarks on the appropriate structure for various types of advisory boards, selection of advisory board participants, advisory board operational and resource benchmarks.
Optimize the Role of Medical Affairs in Health Economics & Outcomes Research ...Best Practices
The Medical Affairs function plays an important role in health outcomes (HO) information exchange between bio-pharmaceutical organizations and key external stakeholders.
Development of robust health outcomes capabilities within Medical Affairs function requires an increase in the function’s involvement with health outcomes groups, development of field-based health outcomes capabilities, customization of health outcomes data as per stakeholders’ needs, and building real world data capabilities to generate and utilize health outcomes information.
This benchmarking research from Best Practices, LLC is designed to assist companies focused on oncology therapies find better ways to develop effective health outcomes groups. It provides current data and best practices from Medical Affairs leaders with an oncology focus at leading bio-pharmaceutical companies.
Download Full Report: http://bit.ly/2e3sl9Q
Overview of aspects of pharma's value added services and its primary aspects to deliver them.
Learn what others do and reflect how it's an opportunity for your pharma company..
Motivated and performance driven; clinical and business professional. Determined and passionate about implementing best practices while targeting education and improving staff development efficiently. Expert knowledge of healthcare environment, ability to positively influence behavior for quality patient outcomes. Demonstrates ability to creatively use consulting and listening skills when working with interdisciplinary teams, promoting consensus with communication and transparency of program goals. Organized and presents research and analytic benchmarks proficiently with cross functional team collaboration.
Lifecare is the country's premier full-service diagnostic center with laboratory, providing expertise in imaging and digital pathology services. Our integrated diagnostic services help doctors personalize patient care to optimally treat disease and maintain health and wellness. We are committed to providing only the highest level of testing quality and service and working with you to provide unique solutions to your most challenging needs. http://www.lifecareindia.com/
- Functions of score card
- How to implement score card
- How score card conduct
- Examples of how score cards are used in finance, government & hospital
Healthcare Dashboards: 3 Keys for Creating Effective and Insightful Executive...Health Catalyst
As the use of data-driven Key Performance Indicators (KPIs) increases, healthcare organizations are adopting Executive Dashboards to track organizational performance. While dashboards deliver insight and identify areas for improvement, they fail to make the data actionable and the value is often offset by the unproductive fire drills and churn they create. There are three keys to create and deploy insightful and effective dashboards successfully:
1. Aggregation of underlying dashboards to create the executive dashboard
2. Establishment of clear ownership and accountability
3. Sustainable process
Public Health in Malaysia (2014)
This slide presentation contain
1.The Development of public health in Malaysia.
2.Public Health today in Malaysia
3.General Outlook of Public Health
4.Policy and action from our government.
5.The 1Care Program (1Care Concept)
6.1Malaysia Clinics
7.Vaccination
8.Disease Control For Vector Species
9.MySihat
10.Private Events For Public Health
11. etc.
The Relationship BetweenPatient Satisfaction and Inpatient.docxssusera34210
The Relationship Between
Patient Satisfaction and Inpatient
Imissions Across Teaching
Daniel J. Messina, PhD, FACHE, LNHA, senior vice president and chief operating
officer, CentraState Healthcare System, Freehold, New Jersey; Dennis J. Scotti, PhD,
FACHE, FHFMA, Alfred E. Driscoll Professor, Healthcare and Life Sciences
Management, Fairleigh Dickinson University, Teaneck, New Jersey; Rodney Caney,
PhD, founder. Press Caney Associates, South Bend, Indiana; and Cenevieve
Pinto Zipp, EdD, PT, chair and associate professor, Craduate Programs in Health
Sciences, Seton Hall University, South Orange, New Jersey
E X E C U T I V E S U M M A R Y
The need for healthcare executives to better understand the relationship between
patient satisfaction and admission volume takes on greater importance in this age
of rising patient expectations and declining reimbursement. Management of patient
satisfaction has become a critical element in the day-to-day operations of healthcare
organizations pursuing high performance.
This study is guided by two principal research questions. First, what is the nature
of the relationship between patient satisfaction (as measured by scored instruments)
and inpatient admissions in acute care hospitals? Second, does the relationship
between patient satisfaction (as measured by scored instruments) and inpatient
admissions differ between teaching hospitals and nonteaching hospitals? Although
not suggestive of direct causation, the study findings revealed a statistically significant
and positive correlation between patient satisfaction and admission volume in teach-
ing hospitals only. In contrast, a nonsignificant, negative correlation was seen be-
tween patient satisfaction and admission in nonteaching hospitals. In the combined
teaching and nonteaching sample, a statistically significant, negative correlation was
found between patient satisfaction scores and admission volume.
With financial performance being driven in part by admission volume and with
patient satisfaction affecting hospital patronage, the business case for a strategic focus
on patient satisfaction in teaching hospitals is clearly evident. The article concludes
with a set of recommendations for strengthening patient satisfaction and organiza-
tional performance.
For more information on the concepts in this article, please contact Dr. Messina
at [email protected]
177
JOURNAL OF HEALTHCARE MANAGEMENT 5 4 : 3 M A Y / J U N E 2 0 0 9
n n today's healthcare marketplace,
U providers increasingly compete against
one another for business. In the late
1980s, healthcare executives were
confronted with the realization that
they could not just increase charges to
generate revenue, but rather they had
to contain costs as well. Providers now
compete on business factors other than
price, such as quality, service, reputa-
tion, and other nonmonetary attributes.
Ettinger (1998) stressed that success-
ful competition relies on the provider
retaining awareness of who it wa ...
The Relationship BetweenPatient Satisfaction and Inpatient.docxoreo10
The Relationship Between
Patient Satisfaction and Inpatient
Imissions Across Teaching
Daniel J. Messina, PhD, FACHE, LNHA, senior vice president and chief operating
officer, CentraState Healthcare System, Freehold, New Jersey; Dennis J. Scotti, PhD,
FACHE, FHFMA, Alfred E. Driscoll Professor, Healthcare and Life Sciences
Management, Fairleigh Dickinson University, Teaneck, New Jersey; Rodney Caney,
PhD, founder. Press Caney Associates, South Bend, Indiana; and Cenevieve
Pinto Zipp, EdD, PT, chair and associate professor, Craduate Programs in Health
Sciences, Seton Hall University, South Orange, New Jersey
E X E C U T I V E S U M M A R Y
The need for healthcare executives to better understand the relationship between
patient satisfaction and admission volume takes on greater importance in this age
of rising patient expectations and declining reimbursement. Management of patient
satisfaction has become a critical element in the day-to-day operations of healthcare
organizations pursuing high performance.
This study is guided by two principal research questions. First, what is the nature
of the relationship between patient satisfaction (as measured by scored instruments)
and inpatient admissions in acute care hospitals? Second, does the relationship
between patient satisfaction (as measured by scored instruments) and inpatient
admissions differ between teaching hospitals and nonteaching hospitals? Although
not suggestive of direct causation, the study findings revealed a statistically significant
and positive correlation between patient satisfaction and admission volume in teach-
ing hospitals only. In contrast, a nonsignificant, negative correlation was seen be-
tween patient satisfaction and admission in nonteaching hospitals. In the combined
teaching and nonteaching sample, a statistically significant, negative correlation was
found between patient satisfaction scores and admission volume.
With financial performance being driven in part by admission volume and with
patient satisfaction affecting hospital patronage, the business case for a strategic focus
on patient satisfaction in teaching hospitals is clearly evident. The article concludes
with a set of recommendations for strengthening patient satisfaction and organiza-
tional performance.
For more information on the concepts in this article, please contact Dr. Messina
at [email protected]
177
JOURNAL OF HEALTHCARE MANAGEMENT 5 4 : 3 M A Y / J U N E 2 0 0 9
n n today's healthcare marketplace,
U providers increasingly compete against
one another for business. In the late
1980s, healthcare executives were
confronted with the realization that
they could not just increase charges to
generate revenue, but rather they had
to contain costs as well. Providers now
compete on business factors other than
price, such as quality, service, reputa-
tion, and other nonmonetary attributes.
Ettinger (1998) stressed that success-
ful competition relies on the provider
retaining awareness of who it wa ...
1) Write a paper of 900 words regarding the statistical significanc.docxlindorffgarrik
1) Write a paper of 900 words regarding the statistical significance of outcomes as presented in Messina's, et al. article "The Relationship between Patient Satisfaction and Inpatient Admissions Across Teaching and Nonteaching Hospitals."
2) Assess the appropriateness of the statistics used by referring to the chart presented in the Module 4 lecture and the resource "Statistical Assessment."
3) Discuss the value of statistical significance vs. pragmatic usefulness.
4) Prepare this assignment according to the APA guidelines found in the APA Style Guide located in the Student Success Center. An abstract is not required.
h
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EXECUTIVE SUMMARY
The need for healthcare executives to better understand the relationship between patient satisfaction and admission volume takes on greater importance in this age of rising patient expectations and declining reimbursement. Management of patient satisfaction has become a critical element in the day-to-day operations of healthcare organizations pursuing high performance.
This study is guided by two principal research questions. First, what is the nature of the relationship between patient satisfaction (as measured by scored instruments) and inpatient admissions in acute care hospitals? Second, does the relationship between patient satisfaction (as measured by scored instruments) and inpatient admissions differ between teaching hospitals and nonteaching hospitals? Although not suggestive of direct causation, the study findings revealed a statistically significant and positive correlation between patient satisfaction and admission volume in teaching hospitals only. In contrast, a nonsignificant, negative correlation was seen between patient satisfaction and admission in nonteaching hospitals. In the combined teaching and nonteaching sample, a statistically significant, negative correlation was found between patient satisfaction scores and admission volume.
With financial performance being driven in part by admission volume and with patient satisfaction affecting hospital patronage, the business case for a strategic focus on patient satisfaction in teaching hospitals is clearly evident. The article concludes with a set of recommendations for strengthening patient satisfaction and organizational performance.
In today's healthcare marketplace, providers increasingly compete against one another for business. In the late 1980s, healthcare executives were confronted with the realization that they could not just increase charges to generate revenue, but rather they had to contain costs as well. Providers now compete on business factors other than price, such as quality, service, reputation, and other nonmonetary attributes. Ettinger (1998) stressed that successful competition relies on the provider retaining awareness of who it wants to serve, what value it creates for the customer, and how it will create that value operationally. In the end, the provider needs to be strateg.
Mahankali Week 15 - DiscussionCOLLAPSETop of FormWeek 15 –.docxcroysierkathey
Mahankali
Week 15 - Discussion
COLLAPSE
Top of Form
Week 15 – Discussion
ERM at Learner Centered Teaching & Strategic Risk Management:
Learner Centered Teaching (LCT) is based on learning research that summons more active, inductive instruction. It is extremely interesting to see students strongly arguing for the most important step in an ERM process even when there may not actually be a hierarchy, Increased student engagement strengthened team-based skills, personalized student guidance, focused classroom discussion, and faculty freedom are several benefits of the growing LCT adoption.
Managing Financial Risk assessment is a major point that TL approach gives an example of the trade-offs, costs, and benefits of hedging with futures contracts often starting with a simple natural hedge. Here, the student records the respective payoffs to long and short positions when prices change. Students memorize the transactions and expect to replicate the steps with different numbers, and maybe even a different futures contract for a challenging TL course.
ERM is a business management support process for several years and proponents of ERM have been advocating incorporating the ERM process into strategic and business planning to increase its utility. The specific purpose is to reduce the impact of adverse events and be ready to exploit emerging opportunities and adapting the ERM process within the existing strategic and business planning methodology. Organizations that view the ERM process as supporting business strategies should consider positioning it where the primary goals are both to grow the business and to protect value: corporate planning and the business units can be utilized to incorporate ERM into the strategic and annual business planning process with three internal scan elements -
· Surveying the C-Suite on risk managements
· Effectiveness of risk controls & security audit
· Creating ERM Risk register
The surveys will enable a comparison between the current state of risk management activities and the corresponding risk control efforts and ERM risk register is a tool for organizing the identified risks and their internal owners.
References:
· Fraser, J., Simkins, B., & Narvaez, K. (2014). Implementing enterprise risk management: Case studies and best practices. John Wiley & Sons.
Bottom of Form
For the final paper in this course, you will find a case study on a healthcare organization that conducted a quality improvement (QI) project where they implemented a quality improvement process such as those found in Chapter 4 of the textbook including, but not limited to: Shewhart Cycle or PDCA/PDSA Cycle, API Improvement Model, Six Sigma, Baldridge Award, etc. Once you identify the case study, you will include the following sections in your paper listed below.
You are required to submit your selected case study for approval. Please check the course schedule for the due date.
· Introduction/Background
· Background information about the healthca ...
Running head RESEARCH PAPER ON HOSPITAL SYSTEM .docxjeanettehully
Running head: RESEARCH PAPER ON HOSPITAL SYSTEM 1
RESEARCH PAPER ON HOSPITAL SYSTEM 13
Research Paper on Hospital System
Name:
Institutional Affiliation:
Research Paper on Hospital System
Introduction
Mergers and acquisition are important in the development of any given organization. Having the merger of the 300-400 beds and four locations makes it possible for the development of quality services. It brings together both human and financial resources to initiate the needed services to the patients in the healthcare sector. This means that effective financial and productivity management resonates to improved efficiency. Risk management experts support implementation of the above strategies in the healthcare sector. Hospitals and healthcare systems employ enterprise risk management to boost their competitive advantage, improvement of market shares, deal with risks, and stabilize risk bottom lines. The alignment of risk management and the safety of patient through effective programs is instrumental in the above case. The above document serves as a foundation of ensuring the aspect of discussing the relationship between enterprise risk management and the development of hospital systems. The merger between the two inpatient hospital systems is important in ensuring an in-depth evaluation of the risks involved and developing the right framework in ensuring positive outcomes.
Presentation of Merger on the Two Hospital Systems
With the merger of the two health systems in different locations, it means that the outcomes will have to adopt to the dramatic change. This dramatic change will originate from the aspect of ensuring that there is a proper alignment of advanced technology, regulatory changes, and globalization among other factors. The operating environment for two hospitals will have to understand the rapid shifting in relation to the change experienced. The shifting is from a volume-based delivery model to one that is value-dependent (Zou, Kiviniemi, & Jones, 2017). A guideline for hospitals to transform from their current fee-for-service first model to pay-for-performance second curve system continue to take the center stage. It serves as the most significant high-priority strategy to initiate increase efficiency. It also improves the quality of standards in the operations of the healthcare industry. It aligns the hospitals, healthcare staff, and providers across the healthcare continuum. It also influences patient safety by improving quality via the utilization of medical practices that are evidence-based.
Literature Review of Enterprise Risk Management and Hospital Systems
Zou, Kiviniemi, & Jones (2017) argue that enterprise risk management serves as a framework that allows the achievement of safe, reliable, and secure health care delivery. It can ensure that there is an opportunity of providing a struc ...
Copyright 2014 American Medical Association. All rights reserv.docxdickonsondorris
Copyright 2014 American Medical Association. All rights reserved.
Compensation of Chief Executive Officers
at Nonprofit US Hospitals
Karen E. Joynt, MD, MPH ; Sidney T. Le, BA; E. John Orav, PhD; Ashish K. Jha, MD, MPH
H ospital chief executive officers (CEOs) play a criticalrole in shaping the performance of their organiza-tions through setting organizational priorities, allo-
cating resources, and hiring clinical leadership. Indeed, in a
recent large national survey1 of hospital board chairpersons,
respondents reported that CEOs were the single most influ-
ential individuals in shaping quality performance at their
institutions.
One way to potentially improve quality at an institution
is to tie the CEO’s compensation to the institution’s perfor-
mance. This has been broadly used in other industries, and data
suggest that metrics chosen for inclusion in CEO compensa-
tion packages can affect executives’ behavior.2,3 However, we
know little about how CEOs in the hospital industry are paid
and the specific factors that underlie their compensation, with
much of the data either decades old or focused on a limited
sample of institutions.4-8 These issues are particularly salient
among nonprofit institutions, in which the metric of organi-
zational success in many industries—the profitability of the or-
ganization—must be balanced against more mission-driven fac-
tors, such as the quality of care delivered and the degree of
community benefit provided. Yet, we are unaware of any em-
pirical data on the metrics by which CEOs of nonprofit hospi-
tals are paid or to what degree the hospital’s quality of care or
level of community benefit affects their compensation.
In mid-2012, national data on compensation of CEOs of
nonprofit entities became publicly available for the first time.
We used these newly available data to answer 3 questions. First,
IMPORTANCE Hospital chief executive officers (CEOs) can shape the priorities and
performance of their organizations. The degree to which their compensation is based on their
hospitals’ quality performance is not well known.
OBJECTIVE To characterize CEO compensation and examine its relation with quality metrics.
DESIGN, SETTING, AND PARTICIPANTS Retrospective observational study. Participants
included 1877 CEOs at 2681 private, nonprofit US hospitals.
MAIN OUTCOMES AND MEASURES We used linear regression to identify hospital structural
characteristics associated with CEO pay. We then determined the degree to which a hospital’s
performance on financial metrics, technologic metrics, quality metrics, and community
benefit in 2008 was associated with CEO pay in 2009.
RESULTS The CEOs in our sample had a mean compensation of $595 781 (median, $404 938)
in 2009. In multivariate analyses, CEO pay was associated with the number of hospital beds
overseen ($550 for each additional bed; 95% CI, 429-671; P < .001), teaching status
($425 078 more at major teaching vs nonteaching hospitals; 95% CI, 315 238-534 918;
P.
Learn how a shift in processes, leadership and culture to an integrated solution can put your hospital on track to achieve improved clinical outcomes, metrics and patient experiences, each of which can have a potentially dramatic financial impact.
NAMESave as and name file yourname_5.4Record answers in med blue, b.docxrosemarybdodson23141
NAME:Save as and name file yourname_5.4Record answers in med blue, bold font.5.4 Honors Energy Photo WebquestUse the Internet or textbook to find answers to the following. You will add a photo into each answer. Make sure to site your sources.Good sources: Usgs.govEpa.govNOAA.govNasa.govPbs.org
1. What’s the difference between renewable and nonrenewable resources?
2. What is a lode?
3. What is a placer deposit?
4. Name at least three uses of a mineral resources.
5. Another name for a fossil fuel is a hydro-___ .
6. What is carbonization?
7. What is a petrochemical?
8. What are the main environmental problems with fossil fuels?
9. What are some examples of Alternative Energies in the U.S.?
10. List 2 examples of where Alternative Energy (non-fossil) sources are being used in North Carolina and explain the type of energy used in each location. List your sources at the end of your answers.
Case Study
High-Performing Health Care Organization • March 2009
The mission of The Commonwealth
Fund is to promote a high performance
health care system. The Fund carries
out this mandate by supporting
independent research on health care
issues and making grants to improve
health care practice and policy. Support
for this research was provided by
The Commonwealth Fund. The views
presented here are those of the authors
and not necessarily those of The
Commonwealth Fund or its directors,
officers, or staff.
For more information about this study,
please contact:
Aimee Lashbrook, J.D., M.H.S.A.
Health Management Associates
[email protected]
To download this publication and
learn about others as they become
available, visit us online at
www.commonwealthfund.org and
register to receive Fund e-Alerts.
Commonwealth Fund pub. 1360
Vol. 35
Texas Health Harris Methodist–Cleburne:
A System Approach to Surgical Improvement
Aimee LAshbrook, J.D., m.h.s.A.
heALth mAnAgement AssociAtes
Vital Signs
Location: Cleburne, Texas
Type: Private, not-for-profit hospital
Beds: 137
Distinction: Top 2 percent in composite of five surgical care improvement process-of-care measures,
among more than 2,300 hospitals (more than half of U.S. acute-care hospitals) eligible for the
analysis.
Timeframe: April 2007 through March 2008. See Appendix for full methodology.
This case study describes the strategies and factors that appear to contribute to high performance
on surgical care improvement measures at Texas Health Harris Methodist–Cleburne. It is based on
information obtained from interviews with key hospital personnel, publicly available information, and
materials provided by the hospital during May through June 2009.
SuMMAry
Texas Health Harris Methodist–Cleburne is one of the top performers in the
country on the surgical care process-of-care measures, often referred to as the
“core” or Surgical Care Improvement Project (SCIP) measures. The measures,
developed by the Hospital Quality Alliance and reported to the .
Many healthcare financial decisions have a direct effect on nursin.docxalfredacavx97
Many healthcare financial decisions have a direct effect on nursing practice and patient care delivery. What are the ethical implications of these financial decisions? Discuss and explain two specific ways to involve nursing staff in financial planning.
Peer 1 Response:
Lauren Van Hemelrijck posted
The ethical implications of financial decisions that have a direct effect on nursing practice consist of the reduction in available money that is spent on staffing in order to ensure there are appropriate ratios at all times as well as cutting costs related to specific equipment and or tools needed to perform our jobs. Specific nurse to patient ratios have been implemented in some places however, it is not currently the norm regardless of numerous studies that have been conducted and shown that the higher the ratio the worse a patient's outcome. Although facilities will save a substantial amount of money when they cut down on staff, which is why they often choose to do so, an immoral and unethical act in and of itself, the end result effects the patients in often times very negative ways. If patients are having poor experiences they are either not likely to return because they are afraid the care that they receive will continue to be less than adequate or they will have to return due to complications that could have been prevented had there been an appropriate nurse to patient ratio when they were being cared for. As a study on this very subject has found "there is already a significant amount of empirical evidence showing the relationship between certain individual and organizational characteristics of hospital nursing and patient outcomes. These characteristics include nurses' level of education, patient-to-ratios, percentage of RNs among all nursing staff (skill mix), and the nurse practice environment" (Simonetti, 2019, p. 79).
Often times, more expensive equipment makes our jobs easier because it is more efficient and or effective. If we begin to "cut corners" in these ways it will undoubtedly have a direct impact on how well we are able to perform our jobs in certain situations. This is unethical because equipment could mean the difference between accuracy and efficiency among other things. This then means that it could then make or break a patient's outcome. If safety is compromised it is completely inappropriate to substitute equipment that might be unsafe thus putting the patient at an increased risk for illness or injury. This is not only incredibly unethical, it will have an all around negative impact on the facility's reputation and financial standing in the long run. Nurses should have a say in how money is spent because they are often times the most knowledgeable about all of the above. One article that looks at lifting equipment or lack there of states that "the results indicate that fewer than 12 percent of the responding nurses told us they have a "No Lift Policy". More than 85 perfect of hospitals have some type of.
THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my.docxjuliennehar
THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my post. Hope this helps
Ryan,
Inadequate levels of nursing professionals were first discussed more than 80 years ago (Whelan, n.d.). Recently, scholars have opined many reasons for the shortage of nurses. Factors such as work stress, burnout, violence against healthcare professionals, a lack of qualified nursing instructors, and nurses unable to adapt to changing technology or clinical environments have been addressed (Haddad & Toney-Butler, 2019). As many nurses may attest, doing more with less can lead to mistakes and dissatisfaction with a nursing career. Ultimately, patient care suffers.
Organizations employ various tactics to help strengthen nurse retention. Halter et al. (2017) suggest strong nursing leadership and assigning preceptors to new nurses can help minimize nursing resignation rates. At the writer’s employment, hospital administrators use several ways to retain nurses. Each quarter, a nurse is recognized for outstanding achievement by receiving a certificate, gift card, and editorial mention on the hospital’s intranet. Moreover, the hospital caters lunch for all employees, dayside and nighttime staff, twice a year for meeting quality targets. Also, the hospital uses various national celebration days such as ice cream, donuts, coffee, bagels, and candy to reward all employees. Creating a level of goodwill and institutional collaboration can help retain nurses and improve job satisfaction (Kurnat-Thoma et al., 2017).
Reference
Haddad, L.M., & Toney-Butler, T.J. (2019). Nursing shortage. StatPearls Publishing.
Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108-123. https://doi.org/10.2174/1874434601711010108
Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover: A 10-element onboarding program intervention. SAGE Open Nursing, 3. https://doi.org/10.1177/2377960817697712
Whelan, J.C. (n.d.). Where did all the nurses go? Retrieved from https://www.nursing.upenn.edu/nhhc/workforce-issues/where-did-all-the-nurses-go/
By Thomas C. Ricketts and Erin P. Fraher
Reconfiguring Health Workforce
Policy So That Education,
Training, And Actual Delivery
Of Care Are Closely Connected
ABSTRACT There is growing consensus that the health care workforce in
the United States needs to be reconfigured to meet the needs of a health
care system that is being rapidly and permanently redesigned.
Accountable care organizations and patient-centered medical homes, for
instance, will greatly alter the mix of caregivers needed and create new
roles for existing health care workers. The focus of health system
innovation, however, has largely been on reorganizing care delivery
processes, reengineering workflows, and adopting electronic technolo ...
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A Memorandum of Association (MOA) is a legal document that outlines the fundamental principles and objectives upon which a company operates. It serves as the company's charter or constitution and defines the scope of its activities. Here's a detailed note on the MOA:
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Capital Clause: This clause specifies the authorized capital of the company, i.e., the maximum amount of share capital the company is authorized to issue. It also mentions the division of this capital into shares and their respective nominal value.
Association Clause: It simply states that the subscribers wish to form a company and agree to become members of it, in accordance with the terms of the MOA.
Importance of Memorandum of Association:
Legal Requirement: The MOA is a legal requirement for the formation of a company. It must be filed with the Registrar of Companies during the incorporation process.
Constitutional Document: It serves as the company's constitutional document, defining its scope, powers, and limitations.
Protection of Members: It protects the interests of the company's members by clearly defining the objectives and limiting their liability.
External Communication: It provides clarity to external parties, such as investors, creditors, and regulatory authorities, regarding the company's objectives and powers.
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Binding Authority: The company and its members are bound by the provisions of the MOA. Any action taken beyond its scope may be considered ultra vires (beyond the powers) of the company and therefore void.
Amendment of MOA:
While the MOA lays down the company's fundamental principles, it is not entirely immutable. It can be amended, but only under specific circumstances and in compliance with legal procedures. Amendments typically require shareholder
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The world of search engine optimization (SEO) is buzzing with discussions after Google confirmed that around 2,500 leaked internal documents related to its Search feature are indeed authentic. The revelation has sparked significant concerns within the SEO community. The leaked documents were initially reported by SEO experts Rand Fishkin and Mike King, igniting widespread analysis and discourse. For More Info:- https://news.arihantwebtech.com/search-disrupted-googles-leaked-documents-rock-the-seo-world/
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...BBPMedia1
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Retail media wordt gezien als het nieuwe advertising-medium en ook mediabureaus richten massaal retail media-afdelingen op. Merken die niet in de betreffende winkel liggen staan ook nog niet in de rij om op de retail media netwerken te adverteren. Marvin belicht de uitdagingen die er zijn om echt aansluiting te vinden op die markt van non-endemic advertising.
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Sustainability has become an increasingly critical topic as the world recognizes the need to protect our planet and its resources for future generations. Sustainability means meeting our current needs without compromising the ability of future generations to meet theirs. It involves long-term planning and consideration of the consequences of our actions. The goal is to create strategies that ensure the long-term viability of People, Planet, and Profit.
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LEARNING OBJECTIVES
1. Develop a comprehensive understanding of the fundamental principles and concepts that form the foundation of sustainability within corporate environments.
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3. Identify and define best practices and critical success factors essential for achieving sustainability goals within organizations.
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3. Measures and Reporting in Sustainability
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The tertiary care hospital utilization of the balanced scorecard
1. THE TERTIARY CARE HOSPITAL
SYSTEM
UTILIZATION OF THE BALANCED SCORECARD
Nancy Southerland
September 14, 2014
Abstract
The tertiary carehospital has asits primary responsibility to deliver health care to the most sick
and severely ill.The management of the critically ill isseen as a wrathful driver of costs within
the confines of the tertiary care hospital both in the United States and abroad.Through
utilization of the Balanced Scorecard not only are the needed financial metrics elevated but the
added dimensions of customer (both internal and external), internal businessprocesses,and
learningand growth dimensions arepartof the balanced scorecard perspectives.Through use of
the balanced scorecard in thetertiary carehospital,the wrath of the cost driver of the
therapeutic management and intervention of the critically ill isassuaged.Tertiary carehospitals
are ableto deliver solid operatingmargins whileensuringpatientsatisfaction with good clinical
outcome of the critically ill whileexperiencingmuch employee engagement. The tertiary care
hospital enjoys the interconnectedness of the dimensions realizingquickly thatover time all the
BalanceScorecard perspectives arefinancial dimensions.
2. 1
Introduction
The tertiary care hospital industry/business has been in a state of distinct challenge at home
and abroad for multiple decades. For multiple decades entrepreneurs and businessmen failed to
see even the hospital system particularly the tertiary care hospital/business system as a strategic
business unit primarily because of the care being provided to people. This blinding of eyes has
been removed with ubiquitous stated health care reforms and pressure upon hospitals to make the
black far exceed the red. Pressure has been even more predominant upon the larger tertiary care
hospital system/business unit verses the smaller community hospital since chronic disease is a
cost driver that affects the tertiary care hospital system with greater vengeance. In fact, many
tertiary care hospitals have struggled to maintain a solid operating margin in these challenging
days.
This paper puts forward the deliverance of the global tertiary care hospital/business system
through the utilization of the Balanced Scorecard. As stated, pressure has been more
predominant upon the larger tertiary care hospital/business system given chronic disease,
intensive care, surgery intensive care, etc. are all wrathful cost drivers. In fact, all chronic disease
states requiring therapeutic intervention and treatment are cost drivers. These circumstances
affect the global tertiary care hospital/business system more exponentially since their patient
base has these greater concentrations. Initially, the balanced scorecard can offer the tertiary care
hospital/business system key metrics in order to evaluate adverse patient occurrences alerting
management that their morbidity issues do not meet quality standards when their mortality rates
are acceptable (Dey, 2008). Since morbidity occurrences are cost drivers which reduce operating
margins, we see the major impedes of utilization of the Balanced Scorecard would be to lower
the cost drivers of the management of the critically ill which are the primary patient base in the
3. 2
tertiary care hospital/business system. The major success of the Balanced Scorecard within the
tertiary hospital care system has shed light upon the shortcomings of financed-based
performance measurement models (Dey, 2008). In fact, the Balanced Scorecard serves as a
workhorse to combat the ever consistent business challenges within the tertiary care
hospital/business system.
While the Balanced Score offers significant advantages in the deliverance of financial metrics
within the confines of the tertiary care hospital system, reliance alone upon financial measures of
performance is insufficient for the management of such a complex organization such as the
tertiary hospital care system (Dunn, 2006). The tertiary care hospital/business system is as
intensive and massive as any corporation/organization with the need of a paradigm shift. This is
accomplished by the Balanced Scorecard performance measurement with the assessment of more
than financial metrics. The performance indicators of significant value to this business system of
the tertiary care hospital/business system are non-financial performance indicators i.e. patient
focused (customer), operational (internal processes), and/or learning/growth (employee) as well
the critically need financial metrics (Dunn, 2006).
Scope of the Analysis
Therefore, this paper will examine the utilization of the balanced score among four identified
tertiary care hospital systems. Duke University Hospital System, a leading academic medical
center of 957 beds, is located in Durham, North Carolina (Silow-Carroll, 2008). Duke is a large,
full-service tertiary and quaternary care hospital and is a member of the Duke Health System,
which includes the Duke University School of Medicine, the Duke School of Nursing, the Duke
Clinic, and other member hospitals (Silow-Carroll, 2008). Likewise, further collaboration of the
change initiatives of the Balanced Scorecard within the Beaumont Hospitals of Royal Oak,
4. 3
Michigan, a suburb outside of Detroit, will be presented. Beaumont Healthcare System is an
1100-bed tertiary care, teaching, research, and referral center and is one of the busiest hospitals
in the United States (Larson, 2007). Hospitals admissions are recorded at 56,000 for the year
2013 (Becker’s Hospital Review, 2014).
Subsequent discussion of the use of the Balanced Scorecard at Yale-New Haven Health
System which is located in New Haven, Connecticut will be presented. Yale-New Haven Health
System is a 944-bed tertiary referral center and is the primary teaching hospital for Yale
University School of Medicine and includes the 201-bed Yale-New Haven Children’s Hospital
and the 76-bed Yale-New Haven Psychiatric Hospital (Gumbus, 2003). Lastly, as the United
States serves the globe and stands as a global leader, discussion of Mackay Memorial Hospital’s
implementation of the Balanced Scorecard will be provided. Mackay Memorial Hospital is an
accredited medical center, teaching hospital, and tertiary care hospital located in Taipei, Taiwan.
Mackay Memorial Hospital, with a bed size of 2149 beds and more than 9000 outpatient visits
per day, attributes implementing the Balanced Scorecard from the direct influence of the
American healthcare industry (Wen-Cheng, 2008) The Balanced Scorecard was implemented
five years past the United States (Wen-Cheng, 2008).
The Literature
Wilsey (2014) positions the Balanced Score as a strategic planning and management system
that has been used to align business activities to the vision and strategy of the organization; a
strategic planning and management system to improve internal and external communications;
and a strategic planning and management system to help monitor organization performance
against strategic goals. In fact, the innovators of the Balanced Scorecard system, Kaplan and
Norton, published their first work in 1992. The Balanced Scorecard has been called one of the
5. 4
most important management innovations of the 20th century (Zelman, 2003). Since the
introduction of this new innovation, there has been a plethora of literature published both in
academia and in industry. The Balanced Scorecard has survived the test of time well into the 21st
century with more than half of major companies in the United States, Europe, and Asia using
Balanced Scorecard approaches (Wilsey, 2014). As with any new innovation, the product and/or
innovation can be expected to go through a product life cycle i.e. introduction, growth, maturity,
and decline. The balanced scorecard as far as its use in healthcare is in its growth phase (Zelman,
2003). Thus, the purpose of this paper is to provide proof text of the validity of the Balanced
Scorecard in the tertiary care hospital/business system so as to grow its usage.
Likewise, the first published articles with the use of the Balanced Scorecard in healthcare
appeared in 1994 with subsequent copious publications in a multiplicity of trade journals and
academia (Zelman, 2003). Hospitals cited in the balanced scorecard literature include academic,
military, health science centers, community, and specialty hospitals (Zelman, 2003). In this
examination of the balanced scorecard in the tertiary-care hospital, Zelman et al. (2003) have
stood out in all reference lists/research readings and will serve as a cohesive binding unit to this
research/work to add to the collaboration of the Balanced Scorecard in the utilization in the
tertiary care hospital system. Likewise, Zelman et al. (2003) argues the importance of the
Balanced Score findings amongst the identified hospitals as particularly important since the
findings may serve as input or even as a catalyst for policy formulation and/or change by federal,
state, and local governments. Policy formation is a particular key concern as we have seen in
significant changes in healthcare in 2014. The need is so great since medical costs continue to
rise and consume an ever increasing proportion of Gross National Product.
6. 5
Furthermore, Hansel (2009) identifies a major problem among the large hospital i.e. the
tertiary care hospital system has the difficulty dealing with massive amounts of data from an IT
department that may/may not be in useable format. The Balanced Scorecard is the solution to this
identified problem and allows the institution to identify the key metrics which really drive
performance across while creating synergy among the patient i.e. the customer and the employee,
the internal customer.
Subsequently, the thrust of this examination is to assess and make evaluation of the utility of
the Balanced Scorecard in the tertiary care hospital with the above stated selections. Therefore,
Silow-Carroll (2008) through the Commonwealth Fund, which has as its mission to promote a
high performance health care system as well as to improve health care practice and policy, offers
a thorough discussion of the findings of the Balanced Scorecard system at Duke University.
Briggs (2010) further evaluates Duke University and the utilization and implementation of the
Balanced Scorecard emphasizing the exponential quantifiable growth in internal customer use of
the Balanced Scorecard within Duke University being up 207%. This is definite
employer/employee engagement. Likewise, Larson (2007) provided evaluation of Beaumont
Hospitals identifying the Balanced Scorecard as an innovated solution (a definite change agent).
Gumbus et al. (2003) assessed supply chain savings in one calendar year at a Yale-New Haven
Hospital of $750,000 with the utilization of the Balanced Scorecard within the confines of the
hospital/business system.
Lastly, since the utilization of the Balanced Scorecard in the United States Hospital Systems
have served as a benchmark for the global tertiary hospital system, this paper will further the
collaboration in the discussion of the United States in this leadership role to our global
neighbors. As developing nations continue to look to the United States, this paper will also
7. 6
provide an assessment of the Balanced Scorecard in a tertiary care hospital system outside the
United States as well with discussion of comparative results to the United States hospitals
provided. Therefore, Wen-Cheng et al. (2008) examines the utilization of the Balanced Score in
a tertiary hospital system in Taiwan identifying tremendous performance improvement with
implementation of this change initiative called the Balanced Scorecard.
The Analysis
Duke University Hospital System
Duke University Hospital System holds the distinction of the top 5 percent of more than 700
large hospitals (300 plus beds) in the portion of patients who gave a rating of 9 or 10 when they
rate their hospital overall (Silow-Caroll, 2008). This is a category of distinction as a leading
tertiary/quaternary care hospital with 957 beds (Silow-Caroll, 2008). Thus, ensuring and
improving patient satisfaction to receive marks such as theses requires both an organizational
strategy as well as tactical strategies. A hospital wide thrust must be done to employ and sustain
a culture that emphasizes patient satisfaction, for it takes a team to impact patient satisfaction to
this high level. When a tertiary hospital care system implements a “Patient Satisfaction
University” as part of implementation of the balanced scorecard, one would surmise that the
ramifications will only be positive (Silow-Caroll, 2008). That is exactly the results at Duke.
Thus, Duke employs the Balanced Score card in which patient satisfaction is assessed in
manager and clinical unit evaluations and is included in performance improvement plans (Silow-
Caroll, 2008). Evaluations within Duke University Health System are based upon a Balanced
Scorecard.
8. 7
The Balanced Scorecard at Duke is a management tool in which customer service (measured
through outpatient and inpatient patient satisfaction in each unit) is one of the quadrants along
with finances, work culture, and clinical quality (Silow-Caroll, 2008). In fact, the customer
service quadrant has a goal statement to continuously improve both internal and external
customers (Silow-Caroll, 2008). In this we see the attitude that is pervasive throughout the
corporate culture of Duke, “that it takes teamwork to drive patient satisfaction to the level of
distinction”. Thus, the internal customer is deemed just as important as the external customer to
Duke.
Likewise, directly across customer service is the quadrant that houses work culture with
stated goal to consistently improve the work culture consistent with the Duke University
Hospital System value proposition (Silow-Caroll, 2008). Duke measures through surveys
employee’s assessments of their satisfaction and engagement within the confines of their
workplace about such aspects such as their ability to grow, to improve, to learn, and to accelerate
in their career pathways. The utility of the Balanced Scorecard system is clearly seen as we see
that the staff of Duke receive their commitment for training and job enhancement in reference to
patient interactions, which in turns improves patient satisfaction. Therefore, this supports the
interconnectedness of the four quadrants. Ultimately, the interconnectedness drives the financial
dynamics of the Duke.
Having begun the journey with the Balanced Scorecard in 2001 as a 60 page slide
presentation, Duke has now grown into 300 cards and 10,000 data points updated monthly and
used extensively (Briggs, 2010). The Balanced Scorecard system having gone through much
evolution from four now incorporates five cascade levels that plot trends of 5200 measures and
has much impact on decision making within the Duke University (Briggs, 2010). Hager, who is
9. 8
Director of Performance Services at Duke University, feels that the reputation of Duke having
success in performance management and operations, including Duke’s benchmarking ability to
maintain a solid operating margin in such a challenging industry, feels distinctly this level of
performance is due to the continued successful penetration and use of the Balanced Scorecard
within the tertiary care hospital/business system (Briggs, 2010).
Beaumont Hospitals
Similarly, this paper examines the utilization of the Balanced Scorecard in the Beaumont
Hospitals of Royal Oak, a suburb outside of Detroit. Beaumont Hospitals is an 1100-bed tertiary
care, teaching, research, and referral center and is part of another hospital system with 329 beds
(Larson, 2007). The entire hospital system employees 16,000 employees and is the third largest
employer in the county (Larson, 2007). Beaumont Hospitals is a leader in the industry and has
maintained ranking in Solucient’s Top 100 Hospitals list for several years as well as being
named as one of America’s Best Hospitals by U.S. News and World Reports (Larson, 2007).
Despite the years of success, the board of directors and management felt that change was
needed. Patient satisfaction scores were a solid B average and employee engagement scores
indicated room for improvement (Larson, 2007). In addition, patient volumes were becoming
very flat in a shrinking market with more and more competition for fewer patients and dollars
(Larson, 2007). The local economy had also been suffering the loss of the automotive industry.
Past evaluations of net income were a meager 2% despite higher patient volumes recorded at the
time and investments in new technologies and buildings (Larson, 2007).
10. 9
The board of directors felt that the utilization of the balanced score system would change
theses parameters. The four parameters of this change initiative are customer satisfaction,
quality, finances, and grow and organizational development (Larson, 2007). The CEO is
identified as saying that this only the beginning of the journey but the implementation of the
Balanced Scorecard system has brought the 16,000 employees of the organization working
together with a clearer understanding of their role in the success of the organization. In fact,
employee engagement survey participate rates have increased from 41% to 61% (Larson, 2007).
We can see from our examination of the Balanced Scorecard at Beaumont Hospitals that the
business environment is one of intense pressure not only internally from the cost drivers of the
tertiary care patients themselves but also from the forces from outside the hospital as indicated
by the loss of the patient volume since the local economy was failing. The tertiary care hospital
faces the pressure to maintain and increase quality of care. The Balanced Scorecard has been a
management tool to provide a relief valve for Beaumont Hospitals so that the financial metrics of
revenues and operating costs are adequately attended yet also provide attention to other non-
financial metrics such as quality, patient satisfaction, and staff retention. Since ultimately all the
metrics have such interconnectedness, they eventually turn out to affect the financial aspects of
the business and are seen as drivers of financial success. Thus, Beaumont Hospitals, is being
delivered through the utilization of the Balanced Scorecard system.
Yale-New Haven Health Systems
Bridgeport Hospital
Since the Balanced Scorecard provides a distinct, unique advantage as a framework for the
measurement of performance in a complex and changing medical environment coupled with
11. 10
what appears to be received as a change initiative when 70% of all change initiatives fail, we
further the evaluation of the Balanced Scorecard management tool as we assess the three year
journey of organizational and financial health of Bridgeport Hospital, a member of Yale-New
Haven Hospital Systems of New Haven, Connecticut (Gumbus, 2003). Bridgeport Hospital,
though thoroughly capitated, had been experiencing losses (a $1,000,000 per year operating loss)
due to financial pressures that are inherent in tertiary care hospital as the federal government,
managed care, and the shift to outpatient care forces downsizes and even hospital closures
(Gumbus, 2003). Thus, all management groups including the Board of Directors came in
agreement to map out the strategy to bring Bridgeport back to financial health again.
As indicated earlier, the Balanced Scorecard has served as a workhorse in the tertiary care
hospital. Therefore, at Bridgeport, in order to reach the strategic objective, a plan to utilize the
Balanced Scorecard system was created so that financial health could be restored. The four most
important strategic dimensions on the card were Organizational Health, Quality and Process
Improvement, Volume and Market Share Growth, and Financial Health (Gumbus, 2003). Further
evolution of the Balanced Scorecard system at Bridgeport took place as the hospital expanded
emphasis from strategic planning at rollout to human resource development and the dimension of
Organizational Health to have linkage to compensation and appraisal. The hospital has made
excellent customer service a contingency for performance rewards further reiterating the
emphasis and linkage of the Organizational Health quadrant of the Balanced Score to
compensation and evaluation of employees. For example, performance indicators driving
customer service such as: I will introduce myself to patients 100% of the time; I will knock
when entering room or coworker office; I will say hello to those I pass in the hallway; and I will
provide assistance to patients and guests were measured (Gumbus, 2003).
12. 11
Likewise, with the maturing of the use of the Balanced Scorecard at Bridgeport, the further
linking of capital budgeting to the financial health quadrant was established with the three major
areas of capital projects being Clinical, Non-clinical, and Information Systems now resulting into
the Balanced Scorecard system at Bridgeport having five dimensions (Gumbus, 2003).
With that said, we see the extreme adaptability of the Balanced Scorecard to grow with the
utilization within the tertiary care hospital/business system. The Balanced Scorecard has further
added benefit of adding medical staff engagement in the planning and measuring of results. At
Bridgeport, patient satisfaction scores have also risen. The understanding of marketing the
hospital to the community as well as marketing the physician became prevalent. Full grasp of
patient flow as well as the understanding for the establishment of a wellness center was
established (Gumbus, 2003). Pertinent quantifiable results with this change initative were
achieved including $750,000 cost savings in supply chain management (Gumbus, 2003). While
Bridgeport Hospital retained the financial measures of Balanced Scorecard, the financial drivers
of success, likewise, were incorporated in the card i.e. volume, and market share growth, doctors
and staff, satisfied patients, expert clinical care providers, and quality clinical outcomes all
attributing to becoming a permanent part of the strategic process at Bridgeport Hospital
(Gumbus, 2003). The Balance Scorecard has become a way of life at Bridgeport making it a way
to compete and survive in this competitive tertiary care marketplace.
Mackay Memorial Hospital
Furthermore, as we examine the significant advantages of the Balanced Scorecard in the
tertiary care system, it is prudent to see if there are same results outside the United States in
developing nations. The same needs in the American tertiary care hospital care system such as
the identified Duke University System, Beaumont Hospitals, and Yale-New Haven Hospital
13. 12
System in this research are also needed cross-culturally. Therefore, we examine the performance
measurement of Mackay Memorial Hospital in Taiwan which is a 2149 bed tertiary care hospital
with 9000 outpatient visits per day (Wen-Cheng, 2008). In fact, greater financial press has
come upon Taiwan’s healthcare institutions since they have become integrated health systems
comprising hospital systems, outpatient clinics, home health services, and nursing homes
(Wen-Cheng, 2008).
Mackay Memorial Hospital, is an integrated institution that includes academic and medical
systems and is the oldest and largest tertiary care hospital employing 4660 and 639 staff
physicians (Wen-Cheng, 2008). We have established the therapeutic intervention of the
chronically ill as a major cost driver of the tertiary care hospital necessitating the need for relief
at Mackay Memorial Hospital since the hospital bears the burden as the largest tertiary care
provider in Taiwan.
Mackay Memorial Hospital was perhaps the first hospital in Taiwan to develop its Balanced
Scorecard for the entire organization verses isolating the scorecard system to a single
department. The United States was used as a benchmark standard giving the board of directors
and senior management the confidence to go hospital wide verses isolating to a single
department. This was done to relieve the financial burden of the patient base of the tertiary care
population identified. Therefore, Mackay Memorial Hospital adopted the Balanced Scorecard in
response to the Board of Directors and formed the Balanced Scorecard Executive Team,
comprised of both the board and senior management. Initially, the Balanced Scorecard Executive
Team with its subgroups based on the four perspectives or quadrants of the Balanced Scorecard:
1) financial 2) customer 3) internal business processes 4) learning and growth had the
responsibility for translating Mackay’s mission, core values, and vision into strategic objectives,
14. 13
and operational measures pertaining to a specific perspective (Wen-Cheng, 2008). Subsequently,
we see the addition of a fifth perspective i.e. social commitment with an indicator being the
number of visits of the disadvantaged since Mackay is a Christian hospital and has as its mission
statement to provide care for the disadvantaged.
After two years of implementation, the Balanced Scorecard was felt to be a routine
management system and continual process at Mackay Hospital. Further benefits reached at the
four year mark were that managers were perceived more credible before the Board of Directors
since they now have better understanding and awareness about the measures and target results
for which the CEO, other top executives, and other managers would be accountable for (Wen-
Cheng, 2008). Likewise, the implementation of the Balanced Scorecard allowed board members
and executives to speed up their decisions on large investments in intangible assets (Wen-Cheng,
2008).
In the evaluations of financial metric, Mackay’s revenues for the years 2003, 2004, and 2005
were $8516 million, $9394 million, and $9256 million respectively (Wen-Cheng, 2008). The
Balance Scorecard is attributing to a steady growth in revenues. This is impressive, for the value
of Case Mix Index (CMI) changed from 1.03 to 1.16 within 3 years, meaning that Mackay cared
more and more for the acutely and severely ill patients (Wen-Cheng, 2008). Therefore, we can
see the Balanced Scorecard alleviating some of the pressure within the tertiary care hospital
system that has pandemic a cost driver of the more acutely and severely ill patient. Similarly,
patient satisfaction rose from 83.3% in 2003 to 85.79% in 2005 (Wen-Cheng, 2008). Further, an
improvement in time in those patients admitted to the ICU from the ER in less than 3 hours is
seen showing an increment from 47.83% in 2004 to 82.45% in 2005 (Wen-Cheng, 2008).
15. 14
Conclusively, the Balanced Scorecard at Mackay Hospital began and continues to be an excellent
performance and strategic management tool.
Recommendations and Implementation
As identified within this research, much has been achieved utilizing the Balanced Scorecard
in the tertiary care hospital system. Despite the tremendous results that have been shown in the
elevation of financial and non-financial metric, there is still the pandemic rise of the health care
dollar at home and globally with the tremendous need for the health care dollar expenditure to be
curtailed. Thus, further discussion will be that hospitals that have traditionally focused on
serving the ill and injured should provide both community health care and institutional health
care to improve the overall health of populations; therefore, preventing the necessity of health
care dollars by increasing the community health status (Olden, 2008). It is accepted knowledge
that health scholars, professional associations, health management texts, and health care leaders
have further emphasized that hospitals are notably responsible for improving the health of their
local populations rather than just caring for the sick and informed (Olden, 2008). Therein lies the
significant benefit of the Balanced Scorecard system as a management tool i.e. its adaptability to
an ever changing medical climate.
Therefore, it is recommended that hospital leaders take the next step and modify the Balanced
Scorecards to include community health status that is demanded by all of the stakeholders and
that is already included in most hospital’s vision, mission, and long range plans (Olden, 2008). In
implementation, the tertiary care hospital must continue to reflect the traditional quadrants of
financial, customer, learning and growth, and internal business process but also must reflect their
work to improve community health status. Hospitals should then include community health
16. 15
measures-both leading and lagging indicators-in their balanced scorecards with direct link
strategy and resource allocation to progress towards those goals (Olden, 2008).
Hospital leaders will have to select appropriate Balanced Scorecard targets and measures i.e.
actual health outcomes for the community population which are the lagging measures and the
leading measures which are activities, processes, and resources the hospital intends to allocate to
achieve the health status goals and outcomes-the process drivers (Olden, 2008). In doing so, the
hospital system becomes externally focused by including appropriate indigenous community
health measures to their Balanced Scorecard. The increase in community health lowers the
necessity for the health care dollar i.e. the health care expenditure. The tertiary care hospital
system, which has a primary cost driver the critically ill, benefits from the increase in the
community health status of a community since the community health status is elevating and is
not as sick nor critically ill. The community health status can be added as one of the dimensions
on the Balanced Scorecard within the business unit of the tertiary care hospital system.
Summary
In conclusion, the management of the tertiary care hospital is even more stringent and
difficult due to its primary population base being the critically ill. The critically ill and their
management and therapeutic intervention are the primarily cost drivers within the tertiary care
hospital. The Balanced Scorecard has been shown in this research to provide the necessary relief
if not deliverance to the identified tertiary care hospital systems of Duke University Hospital
System, Beaumont Hospital Systems, Bridgeport Hospital of Yale-New Haven Hospital
Systems- all of the United States- and Mackay Memorial Hospital of Taiwan. The Balanced
Scorecard management tool has been implemented with the typical dimensions of not only
17. 16
financial metrics, but also customer, learning and growth, and internal businesses processes in
these tertiary care hospitals.
One primary significant benefit that has been seen is that the Balanced Scorecard is
adaptability in the tertiary care hospital system in day-to-day business operations as seen in the
capability of Bridgeport Hospital adding the dimension of Capital Budgeting to the financial
dimension once they had become adept with usage of the Balanced Scorecard within their
institution. We have further stated the increase results in patient satisfaction and employee
engagement in all tertiary care hospitals examined. Given that the tertiary care hospitals
researched have seen improvement in their operating margins as well as other financial metrics,
the Balanced Scorecard will continue to be an excellent strategic and performance management
choice by boards and senior management within the tertiary care hospital system. Likewise, as
we have examined the potential of the Balanced Scorecard as a management tool for the tertiary
care hospital, the adaptability to include all stakeholders by adding community health status to
the dimensions of the Balanced Scorecard even raises the value of the tool exponentially giving
opportunity to prevent the necessity of the health care dollar beforehand. As indicated, the
Balanced Scorecard which is in the growth phase is truly an innovation with much promise on
the horizon.
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