Title: Implementing a balanced scorecard approach at an NHS library
1Implementing a balanced scorecard approach at an
NHS library serviceKostoris Library
- Steve Glover, Education Business Manager
- Anne Webb, Library Operations Manager
2Background
- What is a balanced scorecard?
- Why did we introduce the BSC at the library
service? - What did the literature tell us?
- How does the BSC work?
- Design and implementation
- How does it work in practice?
- Tips for designing a BSC system
3The balanced scorecard
- Kaplan and Norton (1992, 1996)
- Kaplan and Nortons heralded publication
introducing the balanced scorecard was published
in the Harvard Business Review in 1992. - Initially taken up by the private sector, the
balanced scorecard approach has gained a wider
acceptance by non-profit, charitable, and
government public sector organisations in their
drive for greater efficiencies, and deriving best
value for the use of public funds
4The balanced scorecard
- Kaplan and Norton (1992, 1996)
- Looks at the organisations performance from four
perspectives - Customer perspective
- Internal business processes perspective
- Learning growth perspective
- Financial
5Balance Performance
- Successful organisations use performance
measurement systems that include elements beyond
the purely financial (Gumbus 2005). - Within health care and public sector
organisations traditional performance management
methods are financially employed through
budgetary negotiation (Verzola et al 2009). - These traditional methods rarely link easily with
health care performance and therefore can lack
clarity.
6Balance Performance
- The four perspectives of the balanced scorecard
are of equal importance to the overall success of
the system in managing the alignment of strategy
and achieving performance. The Chief Medical
Director at Duke Childrens Hospital in Durham,
North Carolina, sums it up as follows - If you sacrifice too much in one quadrant to
satisfy another, your organization as a whole in
thrown out of balance. We could, for example cut
costs to improve to financial quadrant by firing
half the staff, but that would hurt quality of
service. (McLean and Mahaffrey, 2000).
7BSC in non-Profit organisations
- Profit not always the organisations primary
mission - Highly accountable to their funders such as
donors or government bodies - Accountable to regulator bodies (e.g. Monitor,
CQC, GMC, NHSLA) - PMS can improve accountability, alignment to
strategy, and improved financial performance - Business can learn from non-profit sectors
8Health sector use of the BSC in the literature
(1)
- Huang and colleagues (2004) reported the improved
performance of a Taiwanese emergency department
after implementing the BSC system - Improved performance by comparing evaluations of
laboratory test efficiency rates, staff and
patient satisfaction scores before and after
implementation. - All measures improved, as part of the internal
processes measured, blood and urine test results
were returned faster and with more accuracy. - As a result patient complaints dropped and
satisfaction scores improved.
9Health sector use of the BSC in the literature (2)
- Duke University Childrens Hospital introduced
the system and reported significant improvements
in results in terms of operating margins and the
quality of care (Meliones, 2000) - Grant and Proctor (2011) published a review of
using the balanced scorecard in a clinical
setting to increase the quality of nursing care - system is easy to use because staff can see at
a glance where improvements are needed due to
the traffic light system employed to indicate
performance against set tolerances.
10Health sector use of the BSC in the literature (3)
- Verzola and colleagues (2009) reported on the
evaluation of the balanced scorecard implemented
in two departments of the St Anna University
Hospital, Ferrara, Italy. - The balanced scorecard offered a common language
for health professionals from a multidisciplinary
range of personnel such as nurses, allied health
professionals, medical staff and administrators.
11Health sector use of the BSC in the literature (4)
- Rimar and Garstka (1999) developed a scorecard
for a Yale University Medical School clinical
academic department. - They recognised that changes in health care
financing would have significant impact on the
revenues and the mission of medical education - - Lessons learned
- - Faculty involvement
- - Identifying appropriate metrics
-
12Balanced Scorecard in Library Services
- University of Virginia library service (Self,
2003 2004) - Focused management on activities that made a
difference - Key performance measures aligned to organisations
strategy - Value for money
- Customers satisfaction
13How does the BSC work?
- Uses traffic light system to show performance
- Gives an at-a-glance view
- Can be reviewed by non-experts
- Uses set tolerances to define performance
- Shows changes in performance over time
- Allows staff input
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16Developing the Library Scorecard
- Need a clear library strategy
- Consider the 4 perspectives developed by Kaplan
and Norton - Customer perspective
- Internal business processes perspective
- Learning growth perspective
- Financial
- Consider what to communicate to stakeholders
- Select measures which reflect activities
important to the strategic goals of the library - Map to strategic objectives
- Use measures for which data is obtainable
- Include all staff
17 Library Strategy
- Provide access to high quality peer-reviewed
information - To maintain a repository of bibliographic data
- Develop the online library services
- Provide access to a professionally qualified
librarian - Provide innovative current awareness services..
- To provide value for money..
- To provide excellent customer service and monitor
feedback
18Key Performance Areas
- Stock monitoring and development
- Compliance with BMA core oncology list
- Online library resources (e-books)
- Online library resources (e-journals)
- Literature searching
- Current awareness services
- Information skills training sessions
- Processing new book stock and resources
- Library publications and leaflets
- Website quality
- Repository development - latest staff research
articles captured and submitted - Outreach services
- Marketing and promotion
19Perspectives
- Customer
- How do we want to appear to our customers?
- Document Delivery Services turnaround vs
satisfied requests - Value Added Service delivery and feedback
- Financial
- How should we appear to our stakeholders
- Budget control?
- Cost effectiveness - cost/use?
- Return on investment
20Customer Perspective
21Perspectives
- Internal Business Processes
- Operational and functional processes
- Making resources available
- Books and online resources
- Stock processing
- Learning and Growth
- Individual level
- Service level
22Internal Processes Perspective
23BSC figures
24Library Balanced Score Card Dashboard
25School of Oncology Strategy
Library Strategy
Marketing Plan
Outreach Plan
Library Action Plan
Balanced Score Card
Library Operations Team Meeting
Library Staff Meeting
26Pros and cons
- Advantages
- Staff involvement- reported in staff team
meetings - Highlights successes and stresses -used in
operational team meetings - Easy to see where problems develop
- Easy to demonstrate activity in relation to
strategy - Uses indicators that matter
- Performance on developmental activity rather than
just current processes
- Disadvantages
- Difficult to get metrics right
- Need to consider balance
- It takes time to implement
- Requires commitment
- Resistance
- Difficult to select un biased measures
27Summary (1)
- Hardest part of designing a BSC is defining the
metrics - Use Key performance indicators
- Try and use data that you are already collecting
- Tool for the department
- Involve all staff in contributing to the BSC
- Review at team meetings
- Fluid document
28Summary (2)
- BSC should reflected the four perspectives
- Design of the BSC should focus on activities
related to the library strategy - BSC should become integral to the agenda for team
meetings - Reviewed regularly
- Be inclusive to all staff in the department
- Be a tool for measurement as well as management
29References (1)
- Grant, L., and Proctor, T. (2011). Measuring
quality how to empower staff to take control.
Nursing Times, 107(7), pp.22-25. - Gumbus, A. (2005). Introducing the balanced
scorecard creating metrics to measure
performance. Journal of Management Education,
29(4), pp.617-630. - Huang, S.H., Chen, P.L., Yang, M.C., Chang, W.Y.,
and Lee, H.J. (2004). Using a balanced scorecard
to improve the performance of an emergency
department. Nursing Economics, 22(3),140-146. - Kaplan, R.S., and Norton, D.P. (1992). The
balanced scorecard measures that drive
performance. Harvard Business Review, 70(1),
pp.71-79. - Kaplan, R.S., and Norton, D.P. (1996a). Using the
balanced scorecard as a strategic management
system. Harvard Business Review, 17(1), pp.75-85.
- Kaplan, R.S., and Norton, D.P. (1996b), The
balanced scorecard translating strategy into
action, Boston Harvard Business School Press.
30References (2)
- McLean, S., and Mahaffey, S. (2000). Implementing
a surgical balanced scorecard. Surgical Services
Management. pp.48-52. - Meliones J., (2000). Saving money, saving lives.
Harvard Business Review, 78, pp.57-65. - Rimar, S., and Garstka, S.J. (1999). The
balanced scorecard development and
implementation in an academic clinical
department. Academic Medicine, 74(2), pp.114-122. - Self, J. (2003). From values to metrics
implementation of the balanced scorecard at a
university library. Performance Measurement and
Metrics, 4(2), pp.57-63. - Self, J. (2004). Metrics and management applying
the results of the balanced scorecard.
Performance Measurement and Metrics, 5(3),
pp.101-105. - Verzola, A., Bentivegna, R., Carandina, G.,
Trevisani, L., Gregorio, P., Mandini, A.
(2009). Multidimensional evaluation of
performance experimental application of the
balanced scorecard in Ferrara University
Hospital. Cost Effectiveness and Resource
Allocation, 7(15), pp.1-8.