Balance Score Card

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Scoring Ahead of the Game
Balanced Scorecard is purely mathematical and works on the principle of what cannot be measured, cannot be managed, informs Jayata Sharma. Balanced Scorecard or BSC, common to the corporate world, is now in demand even among the healthcare fraternity. And why? Because hospitals are realising that a tool, which takes into account the perspectives of learning and growth, internal business process, customer satisfaction, and financial gains and also improves the overall mechanism of an organisation must have something to it. A more rigorous regulation process, increasingly diverse customer needs and stiffer competition are some of the key reasons for hospitals to adopt BSC. BSC translates a business unit's mission and strategies into tangible outcomes and brings harmony between functions. The interconnection can be explained as: the focus of a hospital on training and development of staff will work towards an efficient and effective business process. Surely, usage of such a tool will lead to a motivated workforce and also delight patients and their relatives. And last, but not the least, financial objectives too are met, with a healthy top and bottom line. "Managers who learn methods of the patient management scorecard are in a better position to lead" - Rupak Barua

Chief Operating Officer
Calcutta Medical Research Institute (CMRI), Kolkata|
"Managers who learn methods of the patient management scorecard are in a better position to lead in future. They have the ability to think, plan and assess the success of their hospital," explains Rupak Barua, Chief Operating Officer, Calcutta Medical Research Institute (CMRI), Kolkata. CMRI has been using BSC for the past couple of years. "Before adopting BSC, the operations at our hospital were far from oriented. Embracing BSC has meant a straight 33 per cent improvement in our top line," says T Karunakar, General Manager-HR, Apollo Hospital, Hyderabad, which adopted BSC four years back. "Balanced Scorecard increases organisational alignment"

- Dr SK Biswas
Kolkata-based healthcare
management consultant|
What makes BSC accountable is that at the end of the implementation, a scorecard is prepared, which is similar to a report card and points are given to each department based on performance. "The report cards include a 'balance' of leading (performance drivers) indicators and lagging (outcome) indicators. It ensures that the leading indicators support the lagging ones on the scorecard," explains Dr SK Biswas, Kolkata-based healthcare management consultant. The points are allotted to the department heads, and they can further distribute them amongst their team members. There is no external body involved in the implementation and it is entirely up to the hospitals to tread the path. So, how is BSC better than other management tools? Dr Biswas has the answer: "Besides addressing a host of non-financial parameters, BSC concurrently links and addresses the financial objective of an organisation." BSC encourages improved performance and benchmarking, enhances communication and networking, supports continuous organisational improvement, and demands accountability and calls for action plans. "Since everyone in the organisation begins searching for their own indicators that support the organisation's strategic objectives, BSC increases organisational alignment," avers Dr Biswas. It emphasises that financial and non-financial measures must be part of the information system for employees at all levels. In other words, BSC stresses on the fact that financial gains is just one fourth of the total quality enhancement process of an healthcare organisation; and that every department has to play a role in attaining one of the above listed four perspectives. However, certain problems do arise in measuring healthcare processes in absolute terms. For instance, how can a hospital measure the performance of a surgeon during a surgery? Right now, although most...
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