Balanced scorecard as a framework for driving performance in managed care organizations.

Managed care organizations in a highly competitive environment constantly face the pressure of improving their financial performance. At the same time, customers of the organization expect the organization to deliver high-quality outcomes and improve customer service. Payers expect the organization to develop innovative new products to meet their needs. This article presents an approach called "Balanced Scorecard" for measurement, development of strategy, and performance improvement in a managed care organization.

Using quality improvement as a system-building strategy.

When leaders at Henry Ford Health System (HFHS) in Detroit decided to integrate the various components of their system eight years ago, they not only had to overcome numerous barriers, such as lack of strategic alignment among HFHS's 11 business units, but also had to change the system culture and develop a new approach to managing care. Key strategies used in making the shift included revamping the governance process, implementing quality management, and linking financial performance to compensation. In this article, HFHS executives discuss their sometimes-tumultuous journey and give tips for other organizations considering integration.

Evolution of hospital industrial engineering: from scientific management to total quality management.

Industrial engineering applications in the hospital industry first began in 1910. This paper traces the evolution of hospital industrial engineering in five distinct phases. For each of the major phases, this paper presents the contributions made by industrial engineers. Many of the techniques advocated by industrial engineers are now being taught to hospital employees as hospitals introduce total quality management (TQM) within the health-care industry. TQM introduction has meant a new role for industrial engineers, as that of a teacher, coach, and a facilitator. This new role holds much promise for the improvement of quality and productivity in health care.

The role of CQI in the strategic planning process.

This article describes the strategic planning process used to define the health care needs of a region and to prepare Henry Ford Health System (HFHS) to meet the needs of the 21st century. It presents key applications of continuous quality improvement in the development and implementation of the strategic plans for HFHS; explains how HFHS adapted the Deming/Shewhart cycle of continuous improvement for the purpose of improving its planning process; and delineates how the strategic planning, financial planning, and quality planning processes have been integrated.

The quest for quality and productivity in health services.

The leaders of health care organizations across the country are facing significant pressures to improve the quality of their services while reducing the rate of cost increases within the industry. Total Quality Management (TQM) has been credited, by many leaders in the manufacturing industry, as an effective tool to manage their organizations. This article presents key concepts of TQM as discussed by quality experts, namely, Deming, Juran, and Crosby. It discusses 12 key concepts that have formed the foundation of TQM implementation at Henry Ford Health System. The process of implementation is presented in detail, and the role of TQM in clinical applications is discussed. Success factors and visible actions by senior management designed to reinforce the implementation of TQM in any organization are presented.

Issues in designing, implementing and administering a successful employee-suggestion program in health care.

This paper discusses the critical issues that must be addressed when designing, implementing and managing an employee suggestion program in a health-care organization. The issues presented include a discussion of the basic structure of the plan, participation eligibility, the scope of eligible suggestions, administration of the program, types of awards, size of the awards, evaluation of suggestions, distribution of awards, promotion of the program, and top management support. Specific recommendations are made for designing employee suggestion programs that work.

Managing the acquisition, installation and benefit realization of microcomputer based systems in healthcare.

This paper discusses the critical issues which must be addressed when facing the decision to acquire and implement new microcomputer based systems. The first issue is the process for developing a range of alternatives at various levels of sophistication. A second key issue is the development of a full cost analysis which includes such costs as cost of parallel operation, cost of back up systems, training costs and initial system modification costs. The third critical issue is the development of a benefit realization plan which has the support of both top management and line management.

Quality improvement process: the foundation for excellence in health care.

The health care industry has come under increasing pressure to define, measure and improve the quality of health care services delivered. To set the framework for this discussion, the quality philosophies espoused by the leading experts from the industrial sector, namely, Crosby, Deming and Juran are presented. The differences as well as common themes presented by these experts are discussed. This paper reviews the role of management in a quality improvement process that results in the development of a successful organization.

Productivity management: facing competition.

Most managers faced with decisions which affect productivity react from one decision to another without a framework to improve productivity. This article provides such a framework for health care installations under a competitive environment. Defining product mix, the service delivery process, and specification of performance level standards are addressed.