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Applying the balanced scorecard to local public health performance measurement: deliberations and decisions.

Weir E, d'Entremont N, Stalker S, Kurji K, Robinson V - BMC Public Health (2009)

Bottom Line: What comparators do we use?An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants.Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

View Article: PubMed Central - HTML - PubMed

Affiliation: Public Health Branch, Community and Health Services Department, Regional Municipality of York, Newmarket, Canada. erica.weir@york.ca

ABSTRACT

Background: All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework.

Discussion: Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool?

Summary: An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

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Four quadrants of the ICES balanced scorecard for public health.
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Figure 1: Four quadrants of the ICES balanced scorecard for public health.

Mentions: In 2004 the Institute for Clinical Evaluative Science (ICES), based in Ontario, Canada, released a report, "Developing a BSC for Public Health" [8] that introduced a public health specific BSC framework for performance measurement. Public health's focus on prevention and health promotion, often for entire populations, distinguishes it from many other areas of healthcare that are more patient and treatment focused. The four quadrants were further adapted to include not only traditional measures of performance such as health status, but also measures relating to the structures and processes within the local public health unit (Figure 1).


Applying the balanced scorecard to local public health performance measurement: deliberations and decisions.

Weir E, d'Entremont N, Stalker S, Kurji K, Robinson V - BMC Public Health (2009)

Four quadrants of the ICES balanced scorecard for public health.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2684743&req=5

Figure 1: Four quadrants of the ICES balanced scorecard for public health.
Mentions: In 2004 the Institute for Clinical Evaluative Science (ICES), based in Ontario, Canada, released a report, "Developing a BSC for Public Health" [8] that introduced a public health specific BSC framework for performance measurement. Public health's focus on prevention and health promotion, often for entire populations, distinguishes it from many other areas of healthcare that are more patient and treatment focused. The four quadrants were further adapted to include not only traditional measures of performance such as health status, but also measures relating to the structures and processes within the local public health unit (Figure 1).

Bottom Line: What comparators do we use?An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants.Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

View Article: PubMed Central - HTML - PubMed

Affiliation: Public Health Branch, Community and Health Services Department, Regional Municipality of York, Newmarket, Canada. erica.weir@york.ca

ABSTRACT

Background: All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework.

Discussion: Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool?

Summary: An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

Show MeSH