Strategic performance measurement systems: next step after dashboards

This article has summarized work being done at the leading edge of strategic performance measurement. Initiatives that today seem ivory-towerish tomorrow may represent the mainstream. Compared with the organizations profiled here, other health systems may be smaller, be less automated, or lack expertise in statistics and graphic presentation. Such differences should not prevent any hospital, medical group, HMO, or integrated delivery system from embracing in its own way the essential aspects of strategic performance measurement: Developing--as the cornerstone for measurement--a clear mission, vision, and strategy based on the organization's core values, core competencies, and customer expectations. Developing high-level performance measures of the organization's current performance and progress toward its strategic vision. Cascading measures throughout the entire organization, from the governing board and senior management down to operating clinical and administrative units. Expanding measures beyond internal operations to include measures of community or population health, systemwide measures along the continuum of care, and environmental scanning of key external trends. Using measurement actively throughout the organization to drive strategic planning and continuous improvement. Such efforts are not an "add-on" to busy board and executive agendas; they are an integral part of them. When measures on performance reports are reflective of organizational reality--like the speed and compass gauges on a jetliner's instrument panel--knowledgeable leaders will use them with ease. Even such complex constructs as spider diagrams, says Dr. Berman, are putty in a board's hands when the measures are pertinent and directors are educated about them. "They're useful decision-making tools because they're easy for our board members and managers to understand," he sums up. "They provide a snapshot of our organization."