Rural Performance Management - Balanced Scorecard Initiative

The history of the Balanced Scorecard dates back to 1987 when Arthur Schneiderman created the scorecard concept at Analog Devices, a mid-sized semiconductor company. The concept has evolved considerably since then, and expanded exponentially within the private and public sectors. The Rural Performance Management (RPM) program, developed by Stroudwater Associates of Portland, Maine, is a performance improvement system developed specifically for small rural hospitals. The RPM on-line program utilizes the Balanced Scorecard concept as a framework for helping hospitals link strategic objectives to its Performance Improvement program with the goal of aligning hospital staff and clinician activities with the hospital's goals.

Popularized by Robert Kaplan and David Norton, the Balanced Scorecard has become a widely popular management tool that is designed to link strategy with action, and to establish the cause and effect relationships among an organization's strategic objectives. The Balanced Scorecard asserts that an organization's value should be measured in multiple areas (finance, customer, learning and growth, etc.) as a means to identify key performance drivers. A sample of a small rural hospital Balanced Scorecard is presented in Appendix A.

The Balanced Scorecard is not a measurement system and it is not driven by benchmarking.  Rather, the Balanced Scorecard is a framework for organizational change that helps bring strategic plans to life by aligning employee behavior with an organization's goals.  The Scorecard offers a means of defining the relationship between performance improvement and quality improvement. The RPM involves hospital administrators, medical personnel, and board members in the development of a strategy map that flows from the hospital strategic plan.  It involves data collection, data reporting, data analysis, and benchmarking progress within hospital departments, and also externally among collaborating hospitals.     

Through the use of inter-disciplinary teams, the Stroudwater consultants work closely with small rural hospitals to integrate existing strategic plans and performance improvement programs into the Balanced Scorecard framework. The end result of the consulting support is a system for linking, expressing and measuring hospital specific goals and objectives.

So far, in Arizona, the following Critical Access Hospitals are using RPM or are about to start:

• Benson Hospital, Benson
• Copper Queen Community Hospital, Bisbee [new]
• Little Colorado Medical Center, Winslow
• Southeast Arizona Medical Center, Douglas
• Wickenburg Community Hospital, Wickenburg [new]

If you have any questions or would like addition information about the Rural Performance Management - Balanced Scorecard Initiative, call Joyce Hospodar at (520) 626-2432 or e-mail her at hospodar@u.arizona.edu.