Balanced Scorecard Analysis and Strategic Plan example for a health care organization

Balanced Scorecard Analysis and Strategic Plan example for a health care organization
FHOS balanced scorecard and strategic plan
Table of contents
Executive summary. 3
Environmental analysis of FHOS. 4
Strategic plan. 5
Balanced scorecard. 14
Communication plan. 18
Conclusion. 21
References. 22
Executive summary
An environmental analysis was conducted for FHOS using TOWS matrix that identified some opportunities and challenges unique to the internal and external environments. Strategic analysis determined that these challenges could be addressed and opportunities leveraged to improve the quality of care provided at the facility. This lead to the presentation of the strategic plan that offered actions that the facility can control and engage in to improve performance. Plan determined that focus should be on the administration and finance departments, as well as medical department with the actions planned to be carried out over a two year period. Even as the plan is presented, a balanced scorecard is necessary to determine whether the strategic plan achieved the set objectives in the set time of two years. The balanced scorecard was based on four quadrants presented as financial perspective and shareholder value, patient value perspective, process and internal operations perspective, and personnel learning and growth perspective. In addition, a communication plan was presented to identify the value of formal and informal communication approaches to the strategic plan implementation to include the importance of feedback.

FHOS balanced scorecard and strategic plan
Environmental analysis of FHOS
Florida Hospital Orland South (FHOS) is identified as a medical facility that has been operational since 1908 as a nonprofit organization. It currently handles 106,024 emergency cases every year along with 55,301 inpatients, and 176,086 outpatients. It has 336 critical care beds and 1,414 licensed beds run by approximately 8,000 personnel who include about 2,000 physicians. Its extensive internal and external mechanisms are responsible for ensuring that the facility continues to function and survive even as it meets its objective of achieving longer, healthier, happier lives for the community that patronizes its health services. A review of the facility’s environment using TOWS analysis shows that the facility can leverage its services for better performance.
A review of the external environment identified factors influencing the facility. Firstly, evaluating the political factors showed that the government support and political stability presents opportunities for the facility. Secondly, the prevailing economic conditions present some challenges in terms of balancing between income, expenditure, and profits. Thirdly, the existing social and cultural factors presents opportunities for the facility, particularly when addressing the ever-increasing healthcare needs of the population. Finally, the prevailing legal and ethical factors present some challenges, particularly the factors concerning medical records access, protection, and confidentiality, as well as treatment consent (Morrison, 2016).
A review of the internal environment identified factors that influence the facility’s capacity to deliver care. Firstly, the facility’s mission statement, vision, and purpose present a formal principles that declare the range of activities that the facility can engage in. Secondly, a review of the facility’s technological capabilities shows that it needs to make an additional investment in technology, particularly in terms of facilitating the management of patient records with regards to access and confidentiality. Thirdly, a review of the supply chain shows that there is a need for improvements, particularly in terms of costs reduction and improved efficiency. Finally, an evaluation of the facility’s information system shows that there is a need for investment in improving the current system to improve quality of care and data security while avoiding possible legal sanctions under confidentiality laws (Jaana, Teitelbaum & Roffey, 2014). Given the results of the internal and external environmental analysis for FHOS, it is clear that the facility has opportunities for growth through addressing the existing shortcomings and leveraging the identified strengths (Arthur, n.d.).
Strategic plan
The environmental analysis based on TOWS matric identified some challenges that the facility is facing, and which would be best addressed through strategic actions that include:

Increasing the number of patients who patronize the facility.
Building the capacity of the personnel employed by the facility.
Acquiring and offering modern medical equipment.
Prudently managing the facility’s financial resources.
Identifying and strengthening weak management systems and structures.
Improving the sharing of information within the facility and with stakeholders.
Improving monitoring and evaluation efforts.
Strengthening research efforts.
Expanding services and efforts.
Subsidizing medical services to make them affordable by looking for alternative funding sources.
Improving the satisfaction levels of the patients who patronize the facility.
Collaborating with funding partners who include both governmental and non-governmental organizations.
Improving the adequacy of relevant policies to include the standard operating procedures that influence the delivery of services, strategies for mobilizing resources, strategies for communication, procurement policies, and finance manual.
Addressing staff turnover and understaffing concerns since they affect service delivery.
Adequate job description.
Strengthening the organization structure.
Strengthening the facility’s information management system.
Creating an asset register.
Expanding services and facilities to meet the increasing demand.
Improving the ICT infrastructure.
Improving security and safety within the facility.
Getting representation in health management and planning committees to direct policy development and implementation to be in line with the facility objectives.

To address the identified strategic issues, a strategic direction was determined that would be implemented over the next two years with the focus being on six key areas. Firstly, focus will be on improving the patients’ satisfaction levels by addressing any shortcomings they may have identified. Secondly, putting measures in place to improve the security and safety of the patients and facility. Thirdly, improving health information system. Fourthly, providing modern medical facilities and equipment. Fifthly, improving physical infrastructure in the facility. Finally, strengthening the facility’s institutional capacity.
The proposed direction will be implemented in two departments as identified in Tables 1 and 2.
Table 1. Strategic direction for FHOS administration and finance departments

Priority areas for the next two years
Strategic goals

Strengthening FHOS’ institutional capacity.
To strengthen the facility’s administration.
·   Recruit a professional security agency to address the facility’s security concerns.
·   Offer a conducive working environment for personnel.
·   Offer work incentives that include insurance cover.

To effectively manage the facility’s assess.
·   Review the procurement instructions and implement changes to improve activities.
·   Develop a policy to dispose non-useful assets even as useful assets are acquired.
·   Prepare a register of all the assets.
·   Strengthen the management of the facility’s procurement procedures.

To increase the facility’s revenue by 20%.
·   Increase the patients’ satisfaction levels so that they continue to patronize the facility’s services even as they encourage others to do the same.

To strengthen the facility’s financial management.
·    Develop strategies for collecting debts.
·    Developing and implementing annual budgets.
·    Reviewing the financial controls applied internally.
·    Encouraging sensible financial management.

To strengthen ICT use that facilitates the efficiency of service delivery.
·    Procure ICT systems and equipment.
·    Develop ICT policies.

To strengthen the facility’s human resource capacity.
·    Implement a performance management system.
·    Build staff capacity. Recruit personnel to address shortages.
·    Review the human resource manual and enforce it.
·    Strengthen human resource capacity.

Waste and sanitation system management
To improve sanitation and waste management.
·    Establish a biogas system that gets rid of the waste while supplementing energy supply.

Strengthen records management
To strengthen the management of records.
·    Strengthen how data is collected, analyzed and disseminated.
·    Train facility’s personnel on how to manage records.
·    Procure and install better records management systems that include an updated hospital information system.
·    Review the current system for managing records to identify and address shortcomings.

Develop the facility’s infrastructure
To expand the hospital’s infrastructure to handle a larger number of patients and address more medical conditions.
·    Procure medical equipment based on need and funds availability.
·    Expand health facilities.

Table 2. Strategic direction for FHOS medical department

Priority areas for the next two years
Strategic goals

Community outreach programs
Community outreach programs
To promote community outreach programs.
·    Increase access to high quality medical care services.

Doctors, clinicians and nurses
Establish new medical units
To establish new medical units.
·    Private wards to be established.
·    Establish emergency and casualty wings separately.

Construct ad expand wards
To construct and expand nursing stations and wards.
·    Construct and expand nursing stations and wards.

Procure medical equipment
Procure and install medical equipment in the facility’s wards.
·    Procure medical equipment.

Strengthen the facility’s medical staffing capacity
To strengthen the facility’s staffing capacity.
·    Train personnel.
·    Recruit personnel.

Mortuary expansion
To expand the mortuary unit’s storage space.
·    Expand the mortuary working area and storage space.

Procure mortuary equipment
To procure and install mortuary equipment.
·    Procure mortuary equipment.

Strengthen the facility’s mortuary staffing capacity
To strengthen the facility’s staffing capacity.
·    Train personnel.
·    Recruit personnel.

Procure theatre equipment
To procure and install theatre equipment.
·    Procure theatre equipment.

Strengthen the facility’s theatre staffing capacity
To strengthen the facility’s staffing capacity.
·    Train personnel.
·    Recruit personnel.

Expand the pharmacy unit
To expand the pharmacy’s working space.
·    Expand the pharmacy’s working area.

Procure equipment for the pharmacy unit
To procure and install an information management system that integrates with the facility’s systems.
·    Procurement of information management equipment

Strengthen the facility’s pharmacy staffing capacity
To strengthen the facility’s staffing capacity.
·    Train personnel.
·    Recruit personnel.

Procure equipment for the radiology unit
To procure and install diagnostic imaging equipment.
·    Procurement of imaging equipment based on need, as well as furniture.

Expand the radiology unit
To expand the radiology’s working space.
·    Expand the radiology unit’s working area.

Strengthen the facility’s pharmacy staffing capacity
To strengthen the facility’s staffing capacity.
·    Train personnel.
·    Recruit personnel.

Redesign and expand the laboratory
To redesign and expand the working space.
·    Redesigning and expanding the laboratory working area.

Balanced scorecard
A balanced scorecard refers to a strategic planning and management tool that is used to monitor performance against strategic goals, while improving external and internal communication, and aligning business activities with the organization’s strategy and vision. In fact, it suggests that exclusive use of traditional measures are myopic and ill-advised since they are an account of past events. In essence, it is a performance measurement framework that managers can use to gain an understanding of the facility’s performance in both the financial and non-financial arenas. This implies that it retains the traditional tools for measuring performance even as it includes other factors critical to success, which include relationship with stakeholders (such as patients and medical personnel) and capabilities. To facilitate the whole performance measurement, the balanced scorecard as applied for the FHOS case views the business model from four perspectives to include: learning and growth (personnel) perspective; process (internal operations) perspective; patients’ value perspective; and financial perspective (Kerin, Hartley & Rudelius, 2014). The present analysis makes use of a balanced scorecard to evaluate the strategic model for use by FHOS.
Table 3. FHOS balanced scorecard quadrants

Financial perspective and shareholder value
1.     Market share: improve market share by 30% over the next two years through aggressive marketing and innovative medical services based on perceived local needs.
2.     Revenues and costs: Improve revenues while reducing costs so that profitability increases by 15%. This would occur through expenditures review that focuses on profitable ventures as costs are reduced.
3.     Profitability: Improve profitability by 15% through better spending reviews.
4.     Competitive position: Invest 10% of profits on research activities to facilitate the development of innovative medical services.
Patient value perspective
1.     Patient retention or turnover: Ensure that 70% of patients repeatedly patronize the facility by offering a wider range of related medical services.
2.     Patient satisfaction: Create a patient care center that is staffed by knowledgeable medical personnel capable of handling patient related issues. Additionally, evaluating the quality of all medical services in terms of comparisons with other medical facilities before offering them.
3.     Patient value: creating a public relations office dedicated to addressing all the patients’ issues so that they feel a part of the facility.

Process and internal operations perspective
1.     Measure of process performance: developing feedback systems that match facility performance to the set objectives.
2.     Service or productivity improvement: engaging knowledgeable and experienced personnel who can direct the facility operations to achieve the set objectives.
3.     Operations metrics: engaging personnel in developing realistic matrices that measure actual performance.
Personnel learning and growth perspective
1.     Personnel satisfaction: reviewing remuneration packages to match responsibilities using competitive figures based on the industry standards.
2.     Personnel turnover or retention: creating a system that collects personnel opinions and addresses them to improve their satisfaction levels. The target is 5% annual retention to include retirees.
3.     Level of organization capability: organizing regular training programs for personnel so that they are aware of the latest advances in the healthcare industry as measured through the number of persons who successfully complete the training programs.
4.     Nature of organizational culture or climate: adopting technological advances to augment personnel input as measured through medical industry reviews such as updating the information system to facilitate access to patient records.

The first perspective is the financial perspective, which reinforces the need for traditional financial data in evaluating the performance of any business entity. Any business model would recognize that accurate and timely data is always a priority, making it clear that this need cannot be overemphasized and adding that there can never be enough processing and handling of data of any kind. By implementing a database and cloud-based system for medical data, FHOS intends to automate and centralize data related activities. The point is that the financial perspective has been given the same emphasis as the other three perspectives to result in a balanced situation, although there are situations when the financial perspective will be overemphasized, particularly when analyzing cost-benefits and risk assessment (see table 3; Kerin, Hartley & Rudelius, 2014).
The second perspective is the patient perspective. It recognizes the increasing importance of patients and the need to satisfy them to ensure FHOS growth and success. With this in mind, the strategy applied at the facility must include indicators of patient satisfaction such as an understanding that failure to satisfy the patients will cause them to switch to other medical facilities that are able to meet their needs. As such, good performance within the patient perspective will act as an indicator that FHOS has a good future within the highly competitive healthcare industry, while poor performance in the patients perspective will act as an indicator that decline is likely to occur in the future even though the current performance figures paint a favorable picture. In developing the patient satisfaction matrix, FHOS must recognize that there are different patient groups who have diverse medical services needs (see table 3; Kerin, Hartley & Rudelius, 2014).
The third perspective is the internal business processes perspective that will allow the managers and other supervisors to know how well the facility is being run, and whether it is in line with the stated mission and vision, as well as strategic objectives. This perspective would focus on whether the facility’s services conform to the requirements stated by the patients and industry expectations as stated by regulators. It includes matrices that have been prudently deliberated and presented by the facility’s personnel most knowledgeable about the operations since external consultants would be unable to develop effective matrices (see table 3; Winston et al., 2013).
The final perspective is the learning and growth perspective whereby the facility is expected to make provisions for the inclusion of personnel training geared towards improving performance. This is based on the understanding that personnel are the most important knowledge repository. The rapid technological advances have made it necessary for FHOS personnel to be in a continuous learning mode thereby heightening personnel importance as a knowledge repository. In addition, the model includes a matrix that aids managers in allocating funds towards training activities that are anticipated to result in the most benefit for FHOS as a business. In any case, learning constitutes the foundation for success for the facility even as it anticipates to grow and succeed. It is important to note that training is only one aspect of learning, which includes other facets in the form of technical tools (such as computer systems and classroom environments), tutors and mentors, as well as facilitating good communication that allows FHOS personnel to get aid whenever problems arise (see table 3; Winston et al., 2013).
The balanced scorecard facilitates performance measurement by focusing on four perspectives that include learning and growth perspective, process perspective, patient value perspective, and financial perspective. Overall, it is anticipated that applying the formulated balanced scorecard will allow FHOS to successfully meet the set strategic objectives.
Communication plan
Even as the strategic plan is prepared and applied, there is a need to prepare and apply a communication plan. The communication plan is intended to complement the strategic plan by improving information exchange within the facility. It recognizes that the strategic plan is intended to offer benefits to the facility by improving operational efficiency and effectiveness to achieve better patient outcomes. The facility will benefit from the communication plan since it allow the personnel to practice high-quality communication strategies and skills. This is based on the understanding that communication aids the facility to meet its goals and objectives (Ellis, 2016). In addition, the facility must have the capacity to manage and resolve conflicts that could arise when the strategy is implemented, reducing the misuse of informal communication by the stakeholders, and improving willingness to provide the facility’s management with constructive feedback. In essence, it ensures that informal organizational communication is not misused by the personnel through actions such as gossiping and peddling of rumors about the strategic plan intentions since such communication is unethical, decreases coordination and cooperation, destroys trust between relational partners, is likely to undermine interpersonal relationships and is not appropriate in a working environment. The official communication would be considered as the only reliable source of information to reassure personnel and prepare them for impending changes. For instance, the intention to hear more personnel must be addressed in terms of reassuring the present personnel that their jobs is not in jeopardy and some of them could even  be up for promotions or better employment terms when transferred to the new department (Kreps, 2011).
The principal motivation for controlling and enhancing informal communication lines is to motivate personnel; particularly where rumor is concerned and involved. In order to enhance informal communication lines, the management is expected to unequivocally notify other personnel and stakeholders that immoral and unethical messages and communications will not be accepted since this could disrupt the strategic plan implementation in the facility. The facility’s personnel and stakeholders will have an occasion to report any cases of immoral and unethical informal communication anonymously with punitive action initiated against the violators. The punitive action may include forcing the offender to attend a training session on organizational ethics and morals. Even though it could be difficult to maintain control over informal communication for the strategic plan’s implementation, the upper management personnel must protect the quality of information flowing through the facility’s rumor mill (Abigail & Cahn, 2011).
As has been established, the strategic plan intends to enhance communication within the facility. This will occur by focusing on refining both the formal and informal communication lines between all the personnel and stakeholders. Formal communication lines are significant for the reason that they are the principal conduit for all personnel to exchange work-related information such as the intended changes, involvement and implications. The main motive for enhancing formal communication lines is to buoy up the facility’s personnel to deliver constructive feedback to the management to improve the strategic plan and present their understanding of what is intended. Feedback – criticism – is important in the facility’s communication, since, it is the mainstay of effective communication. Short of feedback, both the message senders and receivers are unlikely to accomplish a common understanding of the message (Abigail & Cahn, 2011).
In order to implement feedback within the facility’s communication structure, the management will have to provide some form of compensation for personnel who deliver relevant, timely, and honest feedback as a strategy. This will be achieved by starting a recompense program whereby personnel who provide the most relevant, timely and honest feedback can be rewarded with a certificate of recognition that can later be redeemed for financial gratuity. Another strategy for promoting feedback will involve instituting an open communication policy between the upper level and lower level personnel. For instance, the managers must avail themselves to listen and respond to any criticisms from other personnel, with the whole exchange done without any victimization. In order to institute an open communication policy, the managers must display active listening skills that allow them to fully comprehend the messages that other personnel are attempting to communicate to them (Trenholm, 2011). In this respect, the communication plan focuses in ensuring that there is effective communication that opens up the communication channels without creating an occasion for abuse so that it ends up supporting the implementation of the strategic plan.
One must accept that based on the environmental analysis, FHOS has opportunities for improving its capacity to offer higher quality medical care. In addition, one must acknowledge that a strategic plan actualizes the facility intentions to improve performance by identifying areas that require improvements and changes. Also, it is clear that even with the strategic plan, a balanced scorecard is necessary to assess the strategic plan’s implementation in terms of achieving the set intentions. Besides that, a communication plan is necessary since it informs personnel and other stakeholders about the strategic plan while offering an opportunity for feedback that facilitates changes to the strategic plan for better performance.
Abigail, A. & Cahn, D. (2011). Managing conflict through communication (4th ed.). Boston, MA: Allyn & Bacon Publishers.
Arthur, L. (n.d.). The implications of environmental analysis on strategic plan. Houston Chronicle. Retrieved from
Ellis, P. (2016). Evidence-based practice in nursing (3rd ed.). London: Learning Matter/SAGE Publications Ltd.
Ginter, P., Duncan, W. & Swayne, L. (2013) . Strategic management of health care organizations (7th ed.). San Francisco, CA: Jossey-Bass.
Jaana, M., Teitelbaum, M., & Roffey, T. (2014). IT strategic planning in hospitals: From theory to practice. International Journal of Technology Assessment in Health Care, 30(3), 289-297.
Kerin, R., Hartley, S. & Rudelius, W. (2014). Marketing (12th ed.). New York, NY: McGraw-Hill Education.
Kreps, L. (2011). Communication in organizations. San Diego, CA: Bridgepoint Education Publishers.
Morrison, M. (2016). PEST/ PESTLE analysis Introduction. RapidBI. Retrieved from
Trenholm, S. (2011). Thinking through communication (6th ed.). Boston, MA: Allyn & Bacon Publishers.
Winston, W., Stevens, R., Sherwood, P. & Dunn, J. (2013). Market analysis: assessing your business opportunities. London: Routledge.
Assessment 5 needs to go along with Assessment 1,2,3,and 4….

Assessment 5
Balanced Scorecard Analysis and Strategic Plan

Create an integrated strategic management and implementation plan for a health care organization that incorporates instructor and real world feedback into a final balanced scorecard analysis and strategic plan.

Note: The assessments in this course are presented in sequence and must be completed in order. You may not begin this assessment until you have completed and received feedback from your instructor for each of the previous assessments in this course.

The successful implementation of a strategic plan requires effective communication and a thorough understanding of not only the role of the organization within the greater community, but the role of leadership within the organization. By effectively engaging stakeholders and understanding the philosophy of strategic management, leaders can mitigate challenges and hurdles that face those directing change.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Analyze organizational structure, design, culture, and climate in relation to environmental forces.
Analyze potential long-term opportunities and operational components in the strategic planning process.
Competency 2: Develop a strategic organizational plan that provides human and financial resources to support targeted organizational outcomes.
Analyze the effect of the strategy formulation on human, financial, and technical resources.
Competency 3: Recommend an organizational structure and design to optimize a strategic plan.
Apply strategic planning tools and research to determine alternative strategies for a health care organization’s future success.
Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration.
Incorporate feedback from stakeholders and colleagues in the construction of an integrated strategic plan.
Assemble a professional final report that meets the needs and expectations of a specific audience.
Competency Map
Use this online tool to track your performance and progress through your course.
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In the workplace it is essential to periodically measure outcomes of key performance indicators on the strategic plan in order to meet the overall goals of the organization.

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Questions to Consider
To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of the business community.

What is the purpose of the balanced scorecard?
How do key performance indicators in the four perspectives affect the department, service line, or strategic business unit in which you currently work or desire to work?
From the time that a new vision and directional strategy are defined, what are the logical steps that you as a healthcare leader can take to assure that your actions align with the needs of the organization?
How do you, your team, your department, et cetera, add value in a measurable way to the organization?
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Suggested Resources
The following optional resources are provided to support you in completing the assessment or to provide a helpful context. For additional resources, refer to the Research Resources and Supplemental Resources in the left navigation menu of your courseroom.

Capella Resources
Click the links provided to view the following resources:

Using Kaltura [PDF].
APA Paper Template.
APA Paper Tutorial.
Skillsoft Tutorials
If you feel you need help using PowerPoint the following resources will help you expand your skills.

Search Capella Tutorials for PowerPoint tutorials.
Library Resources
The following e-books or articles from the Capella University Library are linked directly in this course:

Ballé, M., Morgan, J., & Sobek, D. K. (2016). Why learning is central to sustained innovation. MIT Sloan Management Review, 57(3), 63–71.
Daly, R. (2014). The structure of value. Healthcare Financial Management, 68(1), 56–63.
Gingrass, J. (2015). Changing the channel: Strategies for expanding patient access. Healthcare Financial Management, 69(4), 64–68.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2013) . Strategic management of health care organizations (7th ed.). San Francisco, CA: Jossey-Bass.
Mangelsdorf, M. E. (2016). Mastering strategy. MIT Sloan Management Review, 57(2), 67–71.
Sheffi, Y. (2015). Preparing for disruptions through early detection. MIT Sloan Management Review, 57(1), 31–42.
Course Library Guide
A Capella University library guide has been created specifically for your use in this course. You are encouraged to refer to the resources in the MHA-FP5010 – Strategic Health Care Planning Library Guide to help direct your research.

Assessment Instructions
This assessment is the culmination of your work in the course. It includes the analyses you made of your selected organization, details of your proposed strategic plan, and recommendations for implementing your plan. An important aspect of this assessment is providing the rationale used when you incorporate feedback from stakeholders and/or colleagues (instructor, mentor…) into your integrated final report.

To successfully complete this assignment, you will be expected to:

Use strategic management and knowledge management theory and research to analyze the current environment of a health care organization.
Apply strategic planning tools and research to determine alternative strategies for a health care organization’s future success.
Synthesize operational and


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