Developing and implementing a balanced scorecard to improve efficiency, cost-effectiveness, and patient experience.

Abstract

3 Background: MD Anderson Cancer Center’s Balanced Scorecard initially created in 2005 by the Office of the SVP and Chief of Operations reports key monthly financial, productivity, process and satisfaction metrics for 29 outpatient care centers on the main campus. It was developed as a management tool of standardized metrics to help align the centers’ annual operational goals with the institution’s overall strategy, goals, and processes, to improve operational efficiency, drive down costs and improve access and patient experience. Methods: The first step to develop the scorecard was to identify metrics that could be measured across all centers under each key strategic goal: financial, productivity, process, and satisfaction. The next step was to set target goals with a standard improvement percentage based on previous year’s performance. The result is a monthly overall trend score for each center. Lastly, a two-way communication process for reporting and recording the metrics was established. Results: The ultimate benefit of the scorecard is to positively impact patients and oncology care by not only delivering quality patient care, but doing it efficiently and cost effectively. The tool is transparent to all center directors and promotes accountability and sharing of best practices. Centers are actively engaged in the achievement of metrics by continuous monitoring and improving processes. The impact of improvement initiatives is easily identified via trends on the scorecard. Specific results include increased billed activity per FTE, reduced access time for new patients, increased exam room utilization and increased patient satisfaction. Within the past year, one center reduced access time for new patients by 50% from 15.59 days to 7.75 days, another center increased room turns by 5.7% from 4.01/hour to 4.25/hour. Conclusions: The value of the balanced scorecard comes from the transparent reporting and continuous owner pursuit of improvement within each of the four strategic areas. It aids in the challenge of balancing clinical care measured outcomes, patient access and throughput, and satisfaction with the business processes so that MD Anderson can continue to provide quality patient care.