2019
This is an Awardee of the Government Best Practice Recognition Awards
Title
Sustaining Business Excellence through Unit Scoreboards as Execution Mechanism for Increased Individual Performance and Breakthrough Results
Organization
Philippine Heart Center
Best practice Focus Area(s)
Strategic planning and deployment, Strategic performance management, Process management, and improvement
Year Implemented
2011
Summary
The Philippine Heart Center (PHC) has implemented the Performance Governance System (PGS) since 2013 as a strategic plan to bring about transformative development and increase hospital operational efficiency. The unique implementation of PGS is having a Unit Scoreboard per division in all services – Medical, Nursing, and Administrative. A unit scoreboard is aligned with the Institutional Scoreboard of increasing the number of patients served and increasing patient satisfaction. In a scoreboard, a breakthrough target commitment is attained through 2 lead measures which recruit 90% compliance to a performance from all members. In 6 months, hospital breakthrough results were attained.
Background and Problem
In 2011, the developmental challenges for PHC were real: (1) competition from private hospitals; (2) competition from stand-alone diagnostic laboratories; (3) decreased government support for charity services, and (4) decreased compounded annual net growth rate. Thus, appropriate strategies should be formulated and implemented for improvements to mitigate the threat of competition from other hospitals and capture back lost market shares.
A total of 78 Unit scoreboards were launched on July 3, 2013, as part of the 2nd phase or Compliance phase of PGS implementation. The objectives of the Unit Scoreboards are: (1) to encourage increased breakthrough alignment to the Institutional scoreboard ; (2) to recruit individual increase performance of the lead measure; and (3) to monitor consistent outstanding monthly results. The unit scoreboard’s targets were increased by 10% yearly. The Office of Strategy Management (OSM) was created as the Scoreboard Tracker – a ranking of scoreboard accomplishments attached to the Performance Based-Bonus.
Solution and Impact
PGS was the strategy. Unit Scoreboard was the execution mechanism. On July 3, 2013, 78 Unit scoreboards were inaugurated – 1 scoreboard per division, closely monitored by the OSM. OSM made sure that at least 1 scoreboard was linked to each of the Balanced Scorecard (BSC) measures directly or indirectly depending on the division core function – Customer satisfaction, Patient care, and timeliness of care for Nursing and Medical Services, finance or internal processes for Administrative Services. PHC target of increase in number of patients served was achieved within 6 months and sustained with outstanding accomplishment. Also, the PHC target of increase in patient satisfaction rating was achieved and results were sustained.
How did PHC achieve this? (1) 50% (18/37) of Division Scoreboards in the Medical Services aligned to increase procedures in all services with 90% to >130% accomplishment. (2) 56.7% (21/37) Scoreboards in Medical Services, 100% of Nursing and Administrative Services Scoreboards were aligned to increase patient satisfaction: Increased communication strategies in all nursing units; Credit and Collection – Cashier Section: Queuing time at the cashier was decreased from 30 mins. (2012) to 5 mins in 2017 with 166.7% Accomplishment. Nutrition and Dietetics Division – gourmet food for hospital admitted patients increased from 40% to 85% in 2017 with 115% accomplishment. Social Service Division- increase in new OPD patients evaluated and assisted from 70% in 2013 to 94.7% by December 2017.
Scoreboards were also developed to improve patient outcomes: Overall mortality rate for cardiac surgery remained low with an overall survival rate of 96.4% to 97.0%; Hospital Associated Infection Rate also remained low at <2.0%; the Mortality rate for Coronary Bypass decreased to 0.8-1.2%. Unit Scoreboards were drafted yearly with targets approved by the Executive Committee. The new Strategy Refresh Map Beyond Better (2019-2022), was again executed through Unit Scoreboards.
Milestones
In PHC Strategy Refresh 2016-2022 Beyond Better Strategy Map,2 Unit Scoreboards per division were required to align with the Strategic Positions. By December 2018, 14/18 advanced cardiac procedures had outcomes at par with global standards and prevention programs adopted for Policy from 3 to 5. Overall Accomplishment was outstanding at 153%. Hospital Gross income increase was 14.9% by December 2018, and 17.3% by March 2019. PHC PGS initiative won in 2014 Hospital Management Asia for Innovations in Hospital Management and Governance and at present PGS as a hospital strategy has been cascaded to over 55 government hospitals since 2017.