The Internal Business Process Perspective

Introduction Businesses struggle to maintain their market share despite stiff competition, global economic recession and other factors that interfere with their performance. In addition, investors hire qualified staff and acquire modern equipment to ensure they have high chances of dominating local and foreign markets.Advertising We will write a custom essay sample on The Internal Business Process Perspective specifically for you for only $16.05 $11/page Learn More However, these efforts do not sometimes yield the expected results due to unforeseen challenges (Kaplan and Norton 2000). These problems may be internal or external and affect business performance throughout its existence. This essay is a case study that examines how the Duke Children’s Hospital managed to create a balanced scorecard and its effects on the staff, patients and state. Analysis The stakeholders at Duke Children’s Hospital will remember 1996 as a year full of darknes s and unforeseen future in its operations. The hospital received very little medical allowance while revenues declined due to an increase in patients with capitated compensation. Children’s services became very expensive and sky rocketed to $ 14,889 from the initial $ 10,500 in 1993. All healthcare organisations have objectives that ensure they generate profits for investors, offer employment opportunities to nurses and physicians and provide quality heath services to patients (Meliones, Ballard, Liekweg and Burton 2001). However, this hospital was not able to achieve these objectives due to poor performance. As a result, the net margin decreased by nine million dollars between 1993 and 1996. In addition, it was necessary to eliminate some programmes and reduce the services offered to clients. This also marked a decrease in staff productivity from the initial 80% to 70% range. However, this hospital adopted the balanced scorecard methodology to transform these challenges into opportunities for growth. Application of the Balanced Scorecard Methodology The balanced scorecard methodology is a complex approach that helps investors and all stakeholders to deal with challenges facing their businesses. A healthcare institution is a dynamic organisation that provides various needs to physicians, patients and investors (Kaplan and Norton 2000). The role of a healthcare institution is represented in a three pillar diagram that indicates the needs of all stakeholders as shown in the diagram below. Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More When one of the above processes fails to achieve its target the whole process will fail leading to a crisis as described in the introductory remarks. The balanced scorecard approach ensures that the interests of all stakeholders are put into consideration in implementing the functions of a business. This hospital had totally negle cted the needs of its employees. However, it realised its mistakes early and implemented radical changes that transformed its image. The following ways were used to implement the balanced scorecard approach. Patients, physicians and investors are connected by the outcome of the services offered by health institutions. Quality Information The institution realised the need to communicate accurate information to physicians and patients as a way of improving performance. This hospital has a mission, vision, objectives and motto that guide its operations (Meliones, Ballard, Liekweg and Burton 2001). However, it seems the staff had not realised the need to put into practice the words conveyed by these aspirations. The implementation of this performance methodology ensured the hospital staff communicated relevant, appropriate, accurate, site specific and clear messages amongst themselves. This hospital had many sources of both primary and secondary data that was never used to improve its p erformance (Zelman 2009). The information given to physicians and nurses differed although it was meant to gauge and develop their performance in an intellectual manner. Bridging Gaps This hospital is a mega investment with three departments namely the Raleigh Community Hospital, Duke University Hospital and Durham Regional Hospital. DUKE Children’s Hospital is a department under the Duke University Hospital and receives about 6,000 and 30,000 inpatient and outpatient annually in its 135 bed capacity (Meliones, Ballard, Liekweg and Burton 2001). It integrated the quality clinical and business outcomes in 1996 to improve its performance. This perspective had significant impacts on the performance of the hospital through the following ways. First, the institution realised the need to balance between its expenses and needs. It noted that decreasing the number of nurses will reduce expenses in terms of salaries and allowances. However, this will reduce the labour required to prov ide quality services to patients (Zelman 2009). In addition, it noted the need handle patients in a healthy manner and also emphasised on the importance of learning and growth of its staff. Lastly, it ensured there was a balance between the internal business and services offered. Essentials for Building a Scorecard This institution realised the urgent need to implement various changes to ensure employees remain focused to solve the challenges facing them. It adopted a three tier approach in dealing with this issue by highlighting the importance of establishing links to get connected, analysing performance to get results and gaining knowledge to become smart to deal with organisational challenges (Meliones, Ballard, Liekweg and Burton 2001).Advertising We will write a custom essay sample on The Internal Business Process Perspective specifically for you for only $16.05 $11/page Learn More The need to establish connections ensures all stakeholders work tow ards achieving the goals, objectives and mission of the institution. This brings them together to ensure they maintain focus and deliver results that reflect their purposes. They defined key performance indicators, developed staff satisfaction strategies and established a regulatory arena that ensures all activities reflected nursing and health requirements. Performance was analysed in terms of the quality of services offered by physicians and nurses. This also involved the opportunities for growth like the use of modern equipment to improve quality and staff motivation to boost performance. Information was collected on a regular basis from various departments and analysed to evaluate the performance of this institution. This was also accompanied with fast and frequent communication to ensure everyone everywhere gets appropriate information. Knowledge generation was also an important tool in improving this hospital’s performance. The scorecard was constantly reviewed and revi sed depending on the immediate needs of the hospital (Zelman 2009). This was an important arena to develop future plans to deal with challenges that may face this institution. All medical practitioners must develop their skills and enrich their knowledge through practice. Therefore, they must be exposed to environments that offer them opportunities to learn various issues through experience or observation (Kaplan and Norton 2000). This hospital n\became a knowledge generation institution as nurses continued to gain knowledge regarding various health issues. Conclusion The integrated module enabled the hospital to reduce the cost per case by about $ 5,000 (about $ 30 million) between 1996 and 2000. The net margin shifted positively by about + $15 million during the period mentioned above. All programmes that were supposed to be eliminated or reduced were not affected since there was a general improvement in performance. Patient satisfaction index increased by 0.4 on a 5.0 scale (from 4.3 to 4.7 where p=0.05). The nursing units improved their performances to 100% in 2000 from the initial 70% in 1996. Staff satisfaction was the highest gainer with an increase of 2.0 on a 5.0 scale from the initial 1.5 to 4.0. References Kaplan, R. S. and Norton, D. P. (2000). Strategy Focused Organization. Boston: Harvard Business School Press.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Meliones, J. N., Ballard, R., Liekweg, R. and Burton, W. (2001). No Mission No Margin: It’s That Simple. Journal of Health Care Finance, 3, 21-29. Zelman, W. N. (2009).Financial Management of Health Care Organizations: An  Introduction to Fundamental Tools, Concepts and Applications. New York: Jossey-Bass. This essay on The Internal Business Process Perspective was written and submitted by user Na0m1 to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.