Using a balanced scorecard to improve the performance of an emergency department

Recognizing the pivotal role that emergency departments play in delivering care, forming first impressions, and driving operational flow, one organization utilized the balanced scorecard as a tool to focus on performance improvement. The balanced scorecard provides a framework for measuring internal business processes, customer perspectives, financial performance, and learning and growth. A multidisciplinary team selected the following measures on which to focus for the study period: laboratory test completion exceeding 30 minutes; laboratory specimen return rate; patient satisfaction; patient complaint rate; profit; staff satisfaction; and continuing education hours. All measures improved during the study period, albeit in varying degrees of statistical significance. In addition to selecting a careful array of measures, the implementation process of the measurement tool was accompanied by an educational process for the staff as well as a commitment to focus upon barriers and enablers to drive performance.