Developing a Balanced

Score Card
Session 1

Viki Massey, Quality Coordinator

A Joint Venture of London Health Sciences Centre and St. Josephs Health Care London

When you can measure what you are

speaking about, and express it in
numbers, you know something about it;
but when you cannot measure it, when
you cannot express it in numbers, your
knowledge is of a meager and
unsatisfactory kind.
William Thompson (Lord Kelvin), 1824-1907

What is a Balanced Score Card?

A measurement system
2) A strategic management
system
3) A communication tool
1)

BSC as a Measurement System

Translates mission, vision and strategy

through objectives and measures
Provides a framework to describe the key
elements in the achievement of the strategy
Measures four perspectives
- Customer Relations
- Financial
- Internal Service Process
- Learning, Innovation and Growth

BSC as a Measurement System

Financial

Customer
Relations

Vision and
Strategy

Learning,
Innovation and
Growth

Internal Service
Process

Financial Perspective

What financial steps are necessary to ensure

the execution of our strategy/goals?
Are the programs/ departments goals,
implementation, and execution contributing to
the bottom line?
Are we meeting operational and financial
targets?
Dimensions of Quality:
Efficiency

Internal Service Process

Perspective

What critical processes must we excel at to

satisfy our customers/stakeholders?
What must be done internally to meet
patient/customer expectations?
Dimension of Quality:
Effectiveness
Appropriateness
Safety

Customer Relations
Perspective
Who

are our target customers?

How do our patients/customers see us?
How do patients/customers rate our
performance?
Dimension of Quality:
Accessibility
Acceptability
Continuity

Learning, Innovation and Growth

Perspective
How

can we continue to improve?

What capabilities and tools do our
employees need to execute our
strategy/goals?
Dimension of Quality:
Competence
Participation

BSC as a Strategic Management

System
Translates

Objectives
Measures
Targets
Initiatives

strategy into:

Translating with the BSC

Desired state
Differentiating activities
What must be done
well to implement
strategies
How strategic
success is
measured

Mission

Vision
Strategy/Goals
Objectives
In each perspective

Measures
In each perspective

LLSG Mission Statement

In the spirit of innovation and collaboration,
London Laboratory Services Group (LLSG)
provides the health care system with
appropriate and comprehensive diagnostic,
therapeutic and consultative services of the
highest quality.

LLSG Goals/Strategy
The London Laboratory Services Group will:

be recognized as a centre of excellence and leader in

providing diagnostic services
develop an understanding of the needs of the users of our
services
be responsive to the needs of other health care providers
communicate openly with users of our services
be a leader in developing and implementing new technologies
provide diagnostic and therapeutic services for the hospital,
the region and beyond

LLSG Goals/Strategy contd

The London Laboratory Services Group will:

provide cost effective and efficient services

provide an atmosphere of team work which is responsive to
and supportive of learning
collaborate with researchers to advance medical science
partner with educational institutions to provide training for
medical professionals
develop partnerships with industry and other institutions
which will enhance the range and scope of laboratory
services

BSC as a Communication Tool

Describes and translates strategy to
employees through clear and objective
performance measures
Example
Goal:
Objectives:
Measures:

LLSG will provide cost effective and

efficient services
Reduce costs
Increase productivity
Supply costs
Workload

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

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

BSC Objectives
1. Describe the activities that we must

perform well to successfully

implement strategy/goals
2. Answer the questions associated with
each perspective
3. Start with an action verb: increase,
develop, improve, lower, achieve etc.

Brainstorming Exercise
Rules:
1. No

idea is a bad idea

2. Be creative
3. Take risks
4. No criticism allowed

Brainstorming Exercise
Method: Round Table
1.

Out loud; round robin, one by one,

each person states an idea which
the scribe then records

OR
In silence; write ideas down on
sticky notes. Pass notes to scribe to
review out loud and record
2.

Continue around the table until all

ideas are exhausted

Next Steps
Review

BSC perspective guides

Review objectives generated by the
brainstorming exercise
Consolidate and clarify objectives
Vote on top candidates
Trim list to a maximum of 3 per BSC
perspective

Reference
Balanced

Score- Step by Step:

Maximizing Performance and
Maintaining Results
Paul R. Niven