Role of the Hospital Trust Board within the Public Newcroft Hospital Trust - Literature review Example

First and Business report The purpose The following report is presented to summarize the key information on the process of implementing a balanced scorecard initiative in the hospital setting and to represent the benefit of hospitals Trust Board on the concept of a balanced scorecard. The BSC applied should also be connected with the role of the hospital Trust Board within the public Newcroft Hospital Trust that is funded by the government and self- governed by the Department of Health of UK and its represents usefulness for the hospital. Background to the Trust Board Gibson, Martin and Singer (2004) consider the main difficulties regarding the decisions making within any health care organization are those that deal with the choosing which services are provided, where and how they are arranged and ensuring of these services to be responsive, safe, effective toward patients and their needs. These core difficulties can also be connected with the significant resource allocation challenges. Therefore, it is vital for any healthcare organization to ensure these services were well led and here the Trust Board is the best body that provides leadership in the areas of quality and safety to all people engaged into the healthcare organization (Parand, Dospon, Renz & Vincent, 2014). The Institute of Medicine defines that the best quality in healthcare can be provided by patient-centered, safe and timely, effective and unprejudiced dimensions (Epstein & Street, 2011). The public Newcroft Hospital Trust Board follows the mission statement where its patients are at the heart of everything the Board does. Its aims are to provide a high quality of care herewith ensuring value for money of taxpayers who provide the funding for the hospital indirectly. The Trust Board is responsible for developing and establishing strategies that along with the quality and safety goals bring high hospital performance. While its role is supervisory and strategic, the Board defines objectives for the hospital and agrees plans for managing performance and, if necessary, give corrective actions. The task of Trust Board is also to ensure financial responsible administration, high standards of corporate and clinical governance and appropriate behavior of personnel. The Board appoints, appraises and recompences executives. Millar, Mannion, Freeman and Davis (2013) consider that the Trust Board is the intermediary between the external bodies and the local community. It is also engaged in the structured quality audits that involve executive, non-executive and representatives of patient. Definition of a Balanced Scorecard Balanced Scorecard as the traditional financial measures enables organizations to measure the performance from their customers, internal business processes and learning and growth perspectives (Kaplan & Norton, 2007). It makes possible organizations to manage their financial results, monitor progress and obtain intangible assets needed for the growth in the future. According to Harvard Business Review article (2007), the scorecard lets managers introduce new management processes for establishing long-term strategic objectives with the actions of short-term lasting. Within an organization, it drives organizational improvement toward the chosen goals that keeps management of the progress of measures (Balanced scorecards for small rural hospitals: Concept Overview & Implementation Guidance, n.d.). Report on the concept of a Balanced Scorecard in the hospital According to Culica and Prezio (2009), the boards play an important role in the financial well-being of health care institutions. Moreover, an effective hospital Trust board is connected to the high financial performance since they are responsible for specification of financial objectives, reviewing and aligning of the management financial plan with the set objectives, increasing of the creditworthiness, providing capital to be effectively allocated and monitoring financial statement. Since the hospital governance is supported by the operations of the organization and the board decisions, the last should perform effective financial oversight, which includes appropriate committees and access to the reviewed information. The concept of Balanced Scorecard within the health care institution requires such prerequisites as a strategic plan supported by the Board, accountability for implementation that retains interest and oversight, support from individuals and departments that provide resources and to hold each other accountable results. The concept also requires that the achievable and unambiguous measures of success were selected, management mechanisms were accessible and regular, the process was simple, affordable and achievable (Balanced scorecards for small rural hospitals: Concept Overview & Implementation Guidance, n.d.). With such main roles of Trust Board of public Newcroft Hospital as setting the policy making, decision making and oversight, there is a great impact of the concept of balanced scorecard in such dimensions as organizational, executive, quality and financial within such healthcare provider. To be successful, hospitals should also develop strategies to balance their energies, resources, and performance. The Board utilizes the framework for evaluation of the health programs, quality of care and the improvement of projects, clinical pathways and the performance measurement. It is important for the hospital that its Board accepted such generations in the Balanced Scorecard development as the collection of the measure in such areas as financial, patients, internal processes, innovation and learning. Moreover, the Board is able to recognize the inherent weaknesses in the concept of Balanced Scorecard. In addition, the Board utilizes more informed approaches with strategy mapping for clearer communication of the results of the strategy (McDonald, 2012). Despite the recent studies founding showed the widespread deficiencies in the quality of health care such challenges can be well managed by the effective implementing of quality-improvement programs, which the Trust Board of the hospital can arrange (Glickman, Baggett, Krubert, Peterson and Schulman, 2007). Thus, through the organizational attributes, the Board can use its responsibilities to manage processes within the hospital in order to obtain good outcomes. Management and organizational structures in the hospital should also be developed in order to ensure each member to obtain the product and service with the best quality. A Balanced Scorecard is adapted by the Trust Board in order to generate the corporate commitment to the quality of services and to provide the framework in order to enable the service-level teams to optimize quality of health care (Hwa, Sharpe & Wachter, 2013). Utilizing the tool of Balanced Scorecard, it will become possible for the Board to communicate the strategic decisions across all the involved people in hospital. Moreover, it will give the measurement system to evaluate performance from their clients and patients, internal business processes and learning and growth (Bisbe & Barrubes, 2012). While the Trust Board of public Newcroft Hospital uses the Balanced Scorecard approach, it enables its members to influence quality and safety of clinical outcomes, processes and hospital performance. After the processes are evaluated, there are activities that determine the quality of performance and the goals and strategy are established in order to improve care, setting the quality agenda and organizational resources for quality. The positive actions include the establishment of a Board quality committee that develops a quality performance measurement report with quality and safety benchmarks indicated in it, performance evaluation is also attached to quality and safety (Parand, Dospon, Renz & Vincent, 2014). Trust Board of public Newcroft Hospital Balanced Scorecard framework makes an important incentive into the process of strategy translation and measurement development within the hospital. Implementation of the Balanced Scorecard While the healthcare industry faces the increasing challenges which mean the cutting of budgets, increased government regulations, declining of reimbursement and the aging population, they still are called to provide the highest-quality of patient care. That requires health organizations to adapt themselves to the new conditions that need health care institutions to find a balance between the quality and customer satisfaction with adequate financing and long-term goals. In order to cope with such challenges, healthcare leadership along with the Boards are implementing their professional performance through using such management tool as the Balanced Scorecard (Syed, Bresson & Moskowitz, 2007). Lin and Durbin (2008) speak about the Balanced Scorecard as a performing-monitoring framework that applied in province of Ontario to monitor the quality of care for the inpatients in five service areas. Their report studies the mental health sector with framework relevance, underlying strategic goals and indicator selection issues. While they state that Balanced Scorecard provides an image of businesss progress and a guide for targeting interventions, indicators measure organization performance, However, there are only few published case examples of the mental health and addictions sectors that adopted the Balanced Scorecard concept. Such need occurred in the 1990 when the initiative to develop the inpatient scorecards for emergency, rehabilitation and complex care was launched. The decision to add mental health and addictions inpatient care to the suite was made upon the results of used Balanced Scorecard concept. However, one can observe the great challenge in applying the Balanced Scorecard to such area as mental health and addiction, since the care is long-standing one for the performance measurement and still there is a need to deliver the high-quality mental healthcare. Lin and Durbin (2008) state about the dilemma in choosing and developing an appropriate approach to mental health performance monitoring between the Mental Health Statistical Improvement Program and Balanced Scorecard. The MHSIP gives the common language and provides generally accepted toolkit and framework within the mental health community. The Balanced Scorecard risks poor credibility with mental healthcare providers. Despite that, the Balanced Scorecard provides an opportunity for mental health and addictions to share common language along with other healthcare measurement strategies. In their article Sánchez, Broccardo, Sampedro and Pires (n.d.) focus on the Balance Scorecard applied in health institutions should be the health of the patient and which is not always the reality. They state that most public health organization use many indicators to identify the most critical for developing and implementation and control of the strategy applied along with the Balanced Scorecard. The article is focused on the financial and non-financial indicators that are not incorporated, those indicators that place the cause-effect relationship between these indicators and strategic objectives. For that purpose the Balanced Scorecard is used to demonstrate the connection between the indicators and the strategy. Balanced Scorecard is also considered as the concept that serves for the purpose to describe the strategy and implement it. Single communication will not be effective in changing behavior of the organization. While the article focuses on the analysis of the application of Balanced Scorecard in healthcare of three different countries, the findings reveal that the potential use of the Balanced Scorecard in Spain in healthcare sector is not valued. Moreover, it is given the small number of articles published. The research in Italy gave possibility to consider that the studies focus mainly on theoretical aspect of Balanced Scorecard and their practical implementation is examined. The application of Balanced Scorecard in Portuguese healthcare institutions is considerable lower than in the previous indicated countries with recommendations to change the mentality of the people, defining of the strategy and making the financial perspective in implementing the Balanced Scorecard concept. Portugal is alco considered to implement the Balanced Scorecard concept in its healthcare sector in some years only. As stated in the article of Lin and Durbin (2008), there is necessity to modify the Balanced Scorecard to the industry and organizational validity. The role of inpatient care and the concept of Balanced Scorecard applied in it imply a strong coordination between the system-level and hospital-level strategic objectives. There is a considerable similarity of Balanced Scorecard application in the inpatient sector of the health care and the general use of Balanced Scorecard in the countries studied in the article of Sánchez, Broccardo, Sampedro and Pires. There is a lack of a clear strategy within the healthcare system of Italy, Spain and Portugal and there are no success factors for Balanced Scorecard to be implemented in the strategies of healthcare organization. The other similarity of the both articles is that Balanced Scorecard needs to be adapted to national healthcare systems, which establish their objectives with their specific strategies. Works cited Balanced scorecards for small rural hospitals: Concept Overview & Implementation Guidance, n.d. Mountain States Group, Inc., US Department of Health and Human Services, Program Support Center. Web. 19 March 2015. Bisbe, J. and Barrubes, J. 2012. The Balanced Scorecard as a Management Tool for Assessing and Monitoring Strategy Implementation in Health Care Organizations. Rev Esp Cardiol. Vol. 65 Num.10. Web. 19 March 2015. Culica, D. and Prezio, E. 2009. Hospital Board Infrastructure and Functions: The Role of Governance in Financial Performance. US National Library of Medicine  National Institutes of Health. Vol.6(3). Web. 19 March 2015. Epstein, R. and Street, R. 2011. The values and value of patient-centered care, The US National Library of Medicine National Institutes of Health. Vol.(9)2. Web. 19 March 2015. Hwa, M., Sharpe, B. and Wachter, R. 2013. Development and Implementation of a Balanced Scorecard in an Academic Hospitalist Group. Journal of Hospital Medicine. Society of Hospital Medicine. Web. 19 March 2015. Gibson, J., Martin, D. and Singer, P. 2004. Setting priorities in health care organizations: criteria, processes, and parameters of success. BMC Health Services Research. Web. 19 March 2015. Glickman, S., Baggett, K., Krubert, C., Peterson, E. and Schulman, K. 2007. Promoting quality: the health-care organization from a management perspective. The International Society for Quality in Health Care. Web. 19 March 2015. Kaplan, R. and Norton, D. 2007. Using the Balanced Scorecard as a Strategic Management System. Harvard Business Review. Web. 19 March 2015. Lin, E. and Durbin, J. 2008. Adapting the Balanced Scorecard for Mental Health and Addictions: An Inpatient Example. US National Library of Medicine  National Institutes of Health. V.3(4). McDonald, B. 2012. A Review of the Use of the Balanced Scorecard in Healthcare. BMcD Consulting. Web. 19 March 2015. Millar, R., Mannion, R., Freeman, T. and Davis, H. 2013. Hospital Board Oversight of Quality and Patient Safety: A Narrative Review and Synthesis of Recent Empirical Research, The US National Library of Medicine National Institutes of Health, Vol.91(4) Web. 19 March 2015. Parand, A., Dospon, S., Renz, A. and Vincent, C. 2014. The role of hospital managers in quality and patient safety: a systematic review.  BMJ Open. Volume 4, Issue 9. Web. 19 March 2015. Sánchez, M., Broccardo, L., Sampedro, E. and Pires, A. n.d. The Balanced Scorecard in Healthcare: Italy, Spain and Portugal. A review of recent literature. Instituto Politecnico De Braganca. Syed, Bresson & Moskowitz, 2007. IT Framework for the Implementation of Balanced Scorecard in Healthcare Systems. SAS Institute Inc. Web. 19 March 2015. Read More