Serviço RegiOnal de Saúde Balanced Scorecard Overview

1. Serviço RegiOnal de SaúdeBalanced ScorecardOverview POC: Maj Alex Baird, (703) 695-9245 Maj Chris Priest, (703) 681-6057

2. MHS Strategic Planning - Balanced Scorecard At the highest level, the Balanced Scorecard is a framework that helps organizations translate strategy into operational objectives that drive both behavior and performance.

3. Why the MHS is Using the Balanced Scorecard • Translates a strategy into operational terms • Ensures that the components of the strategy—the objectives, measures, & initiatives are aligned and linked • Communicates the strategy throughout the MHS • Forms the basis of an effective and integrated strategic management process

4. Objectives Measures Targets Initiatives Stakeholder Perspective "To satisfy our stakeholders, what objectives must we accomplish?” Stakeholder To Meet our Stakeholder’s Expectation “To satisfy our stakeholders, what Financial/ Budgetary objectives must we accomplish?” "To achieve our stakeholder objectives, what customer needs must we serve?” Customer Perspective Budgetary/Financial Perspective Objectives Measures Targets Initiatives Objectives Measures Targets Initiatives Budgetary/Financial Customer Drive Financial Responsibility... To Deliver Customer Satisfaction... Internal Perspective Objectives Objectives Measures Targets Initiatives “To satisfy our customers, and stakeholders, in which internal business processes must we excel?" Internal To Build the Strategic Capabilities.. Learning & Growth Perspective Objectives Measures Targets Initiatives " To achieve our goals, how must our organization learn and innovate?” Learning & Growth Equip our People... Balanced Scorecard Framework

5. Strategic Objectives Form a Theme Through a Set of Cause and Effect Relationships To provide patients, families and physicians with the best, most compassionate care possible Stakeholder Perspective Financial/ Budgetary Improve patient satisfaction Reallocate to increase staff Customer Perspective Be “Kid– Friendly” Decrease supply cost Improve access (Customer Value Theme) Internal Perspective Reduce waiting times Implement practice guidelines Learning Perspective Improve marketing of CPGs and best practices

6. Balanced Scorecard Components Strategy Map: Diagram of the cause-and-effect relationships between strategic objectives Objectives:Statement of what strategy must achieve and what’s critical to its success Measures: How success in achieving the strategy will be measured and tracked Targets:The level of performance or rate of improvement needed Initiatives:Key action programs required to achieve objectives Strategic Theme: Increase Customer Value Financial/ Budgetary Customer Improve patient satisfaction Reallocate to increase staff Be “Kid– Friendly” Improve access Decrease supply cost Objective Measure Target Initiative Internal Reduce waiting times • Average emergency room wait time • 30 minutes • Emergency room expansion • Reduce waiting times Implement practice guidelines Learning Improve marketing of CPGs and best practices Children’s Hospital Case (example)

7. Translating the Strategy to Operational Terms Making Strategy a Continuous Process • Strategy Maps • Balanced Scorecards • Link Budgets and Strategy • Strategic Learning • Analytics and Information Systems Aligning the Organization to the Strategy Making Strategy Everyone’s Job • Corporate Role • Business Unit Synergies • Support Unit Synergies • Strategic Awareness • Personal Scorecards?? The Ultimate Goal is to Become a Strategy Focused Organization Executive Leadership 1 • Mobilization • Governance Process • Strategic Management 2 5 Formulate STRATEGY Communicate Navigate Execute 4 3

8. MHS Strategic Plan

9. Mission and Vision Mission • To enhance DoD and our Nation’s security by providing health support for the full range of military operations and sustaining the health of all those entrusted to our care Vision • A world-class health system that supports the military mission by fostering, protecting, sustaining and restoring health. Destination • 24-star endorsement of medical program

10. Strategy Map for Transforming the MHS Stakeholder Perspective To enhance DoD and our Nation’s security by providing health support for the full range of military operations and sustaining the health of all those entrusted to our care Financial Perspective External Customer Perspective Build healthy communities Obtain appropriate resources Deliver high quality care anywhere Deliver a fit, healthy, and medically protected force Improve customer service Determine and account for readiness costs Optimize stewardship of resources Culture of Transformation Internal Perspective Readiness Quality Efficiency Identify & prioritize requirements Improve patient safety Provide a medically ready total force Enhance system productivity Increase patient-centered focus Provide a ready medical capability Improve interoperability with partners Improve health outcomes Learning & Growth Perspective (Internal Customers) Patient/provider focused information systems which enhance capability Recruit, retain, and develop personnel Enhance jointness Leverage science and technology

11. Theme Sponsors Dr. Winkenwerder, Mr. Wyatt, Maj Gen Randolph, RADM Mateczun Stakeholder Perspective Mr. Wyatt, Ms. Embrey, Dr. Tornberg Mr. Spruell, RADM Carrato Mr. Wyatt, Mr. Ford, Lt Gen Taylor, LTG Peake, VADM Cowan External Customer Perspective Financial Perspective Internal Perspective Ms. Embrey, LTG Peake, RADM Mateczun Dr. Tornberg, VADM Cowan Mr. Ford, Lt Gen Taylor Readiness Quality Efficiency Mr. Reardon, LTG Peake, Dr. Zimble Learning & Growth Perspective (Internal Customers)

12. MHS Strategy Architecture Stakeholder Perspective:Our stakeholders are the American people, expressed through the will of the President, Congress, and the Department of Defense External Customer Perspective:Our customers are the Armed Forces and all those entrusted to our care Financial Perspective:Accomplish our mission in a cost effective manner that is visible and fully accountable Readiness ThemeFocus on activities to enhance readiness of military forces and the medical assets that support them Quality Theme Ensure benchmark standards for health and health care are met Efficiency ThemeObtain maximum effectiveness from the resources we are given Internal Perspective Learning and Growth Perspective (Internal Customers):Our people and our support systems are critical to giving us the capabilities to execute on all we set out to achieve.

13. Learning & Growth Perspective:“In Order to Execute Our Internal Processes, With What Skills and Tools Must We Equip Our People?” Objectives Patient/provider focused information systems which enhance capability Enhance jointness Recruit, retain, and develop personnel Leverage science and technology

14. Internal Perspective: Readiness Theme Objectives Provide a ready medical capability Provide a medically ready total force

15. Internal Perspective: Quality Theme Objectives Improve patient safety Increase patient-centered focus Improve health outcomes

16. Internal Perspective: Efficiency Theme Objectives Enhance system productivity Identify & prioritize requirements Improve interoperability with partners

17. External Customer Perspective:“What Do Our Customers Expect of Us?” Objectives Deliver a fit, healthy, and medically protected force Deliver high quality care anywhere Improve customer service Build healthy communities

18. C-2 Clinical Quality Metrics

19. C-4 Healthy People 2010 Index Tobacco Reduce Tobacco Use <15%; 20% for Active Duty Members Family Planning Reduce pregnancies aged 15-17 to <50/1000 girls; no AD - Unintentional Injuries Reduce unintentional injury hospitalization rate < 754/100,000 Environmental Health Reduce asthma hospitalizations <160/100,000 Maternal and Infant Health Increase Visit in 1st Trimester >90% Reduce Low Birthweight Rate < 5%; no AD Reduce Infant Mortality Rate < 7/1000; no AD Heart Disease and Stroke Increase to 75% cholesterol screening rates Cancer Increase mammography (<24 mos.,aged >50) rate > 60%; no AD Increase Pap Smear (<36 mos., aged > 18) Rate > 85% Clinical Preventive Services Increase population with specific source of primary care >95%

20. Financial Perspective:“What Do Our Stakeholders Expect of Us?” Objectives Determine and account for readiness costs Obtain appropriate resources Optimize stewardship of resources

21. Stakeholder Perspective:“What Does Our Stakeholder Expect of Us?” Objectives To enhance DoD and our Nation’s security by providing health support for the full range of military operations and sustaining the health of all those entrusted to our care

22. Questions?