Using Balanced Scorecard to Improve the Performance at an Emergency Department

• Main Authors: Huang, Shu-Hsin, 黃淑馨
• Other Authors: Chang, Wen-Yin
• Format: Others
• Language: zh-TW
• Published: 2002
• Online Access: http://ndltd.ncl.edu.tw/handle/42517417996392670805

碩士 === 台北醫學院 === 護理學研究所 === 90 === Facing the increasing in competition in health care, it is needed for hospitals, especially for an emergency department to have a comprehensive performance evaluation tool to obtain competition advantages. A Balanced Scorecard (BSC) is one of the effective performance evaluation tools for hospitals to transform business strategies into concrete actions. The aims of the BSC are to put strategies into effects, to reach goals, and to achieve hospital visions. The purposes of this study were to build the BSC at an emergency department and to compare the differences before and after the BSC was implemented. The research design was descriptive and comparative. A purposive sampling was used to collect data from an emergency department at a district hospital in Chi-I. A structured questionnaire was used to collect data from all the staff and visited patients at this emergency department. Data were collected from February 10, 2002 through May 15, 2002. 250 questionnaires were sent out for patients who visited emergency department at study period and resulted 204 valid questionnaires. 87 questionnaires were sent out for all staff and resulted 80 valid questionnaires. The BSC was implemented on February 15, 2002 and included four domains: 1) learning and growth: including practicing standard courtesy training, communication and telephone skills training, and designing cash award scheme for job performance, 2) internal business process: including making the standard process for laboratory tests, and one-way delivery service; 3) financial: including planning cost concept training, revising material cost sheets, practicing standard counting process, and enacting appointing system; and 4) customers: including setting special telephone line for complains and find ways for improvements. Gender, age, marriage status, education level, occupation, income level, past and total experience at an emergency department, laboratory return rate, incomplete test within 30 minutes, number of services, and financial growth rate, continuing education hours, and complain rates were analyzed using descriptive analyses. The job satisfaction by all staff was analyzed with paired-t test. An independent-t was used for patient satisfaction. The results showed that job satisfaction was increased from 70.8% to 82.3% during 3-month study period. Continuing education hours were increased from 4.3 hours to 9.7 hours per person every month in learning and growth domain. In internal business process domain, the rate of incomplete biochemical test within 30 minutes was decreased from 12.8% to 8.3%, blood test decreased from 4.7% to 1.6%, urine test decreased from5.6% to 1.7%, and culture return rate decreased from 3.5% to 2.1%. In financial domain, revenue of emergency unit was increased from 1.44% to 3.27%. In customer domain, patient satisfaction was increased from 76.3% to 86.8%, and the rates of patient complain decreased from 0.28 to 0.1%. The result indicated that all performance indicators were improved obviously after the BSC was implemented. Hopefully, the results can be as a reference for hospital administrators, district hospitals to improve performance at emergency departments and even be used in other departments. Key words : Balanced Scorecard (BSC), Emergency department