1. 11 th International Conference Health Promoting Hospitals Florence 2003 EFQM and BSC - instruments of New Hospital Governance? Mag. theol. Elimar Brandt Prof. Dr. Dr. Werner Schmidt HNM ® Kristina Donath Dr. Ralf Dziewas Diakonische Einrichtungen der Evangelisch-Freikirchlichen Gemeinde Berlin-Schöneberg K.d.ö.R.

2. 2 Overall view 1.Problem area – question 2.Concept of the WHO Pilotproject „HPH“/EFQM/BSC“ 3.EFQM-Excellence model 3.0The model 3.1Preparation and implementation of the self-assessment 3.2Utilization of the self-assessment 3.2.1Intern (Example Hospital 1) 3.2.2Extern 4. Balanced Scorecard (BSC) 4.0The BSC Model 4.1Strategy development 4.2Strategy map 4.3HPH Frame Strategy map 5. Summary © DEEFG Florenz 2003

3. 3 1. Problem area – question „New Governance“: Models and instruments to increase the partizipation of institutions, network and citizens in decision-making processes Conference program: „How can hospitals improve staff an patient participation in hospital decision making?“ Strategy development and – implementation are fundamental and far-reaching decision-making processes Our question: Are the EFQM Model and the BSC useful instruments for „New Hospital Governance“? © DEEFG Florenz 2003

4. 4 2. Concept of the WHO-Pilotproject „HPH/EFQM/BSC“ EFQM Excellence Model Balanced Scorecard (BSC) Health Promoting Organi- sationel Structure & Culture of the hospital HPH Policy © DEEFG Florenz 2003

5. 5 7© 1998 EFQM Results Orientation; Customer Focus; Leadership and Constancy of Purpose; Management by Processes and Facts; People Development and Involvement; Continuous Learning, Innovation and Improvement; Partnership Development; Corporate Social Responsibility © EFQM 2003 3. EFQM Excellence Model 3.0 EFQM Model © DEEFG Florenz 2003

6. 6 7© 1998 EFQM HPH Policy Periodical self-assessments of the Corporate quality Systematically analysis of the strenghts and the improvement potentials Possibility of the systematically implementation of the HPH-Policy into the corporate quality © DEEFG Florenz 2003

7. 7 3.1 Preparation and implementation of the EFQM self-assessments in 5 hospitals with 996 Beds and 1659 employees in Berlin and Brandenburg Information and motivation of the leaders Information of the employees („Pilot news“, staff meetings, CEO Information letter) Vocation and empowering „Criteria-Teams“ for self assessments (40 Criteria-Teams with 192 members) Workshops, Training, Handbook „HP/QM“, Files with forms for Criteria-Teams Result: Comprehensive valuation of the Corporate quality (strenghts and improvement potentials) for the 5 hospitals © DEEFG Florenz 2003

8. 8 3.2.Utilization of the self-assessments 3.2.1Utilization (intern) Hospital 1 (Exemple) 1 2 3 4 5 6 7 8 9 Criteria Strengths Improvement potentials Example: Hospital 1 © DEEFG Florenz 2003

9. 9 Strengths Improvement potentials 3.2.1Utilization (intern) Hospital 1 (Example) © DEEFG Florenz 2003

10. 10 3.2.1Utilization (intern) Hospital 1 (Rated according to frequency of mention) 8 priorities of the strengths and the improvement potentials Strengths:1.Motivated staff 2.optimal contact with partners 3.Structure: Location of the house, specialisation 4.Patient orientation through empowerment 5.Connection to other houses belonging to the Baptist health centers 6.Interdisciplinary working groups 7.Data processing offers optimal conditions for networking 8.High problem-solving activities on the management level © DEEFG Florenz 2003

11. 11 3.2.1Utilization (intern) Hospital 1 8 priorities of the strong points and the improvement potentials Improvement potentials: Potentials: 1.Improved transparency on decisions, perfomance and results 2.Optimal information paths and the installation of complaints management 3.Inclusion of staff and development of a suggestion system 4.Training on leadership tasks and innovation 5.Systematizing the communication of visions, targets and results 6.Total concept for external representation 7.Expansion of patient orientation to include pre- and post- stationary treatment 8.Data processing – regular coaching by specialists, creation of emergency procedures © DEEFG Florenz 2003

12. 12 3.2.2Utilization of the self-assessments Establish one‘s priorities Self-assessments reports from 5 Hospitals internextern Common workshops Plan for improvements © DEEFG Florenz 2003

13. 13 Shareholder Value Wachstum Profitabilität Initiativen Zielwerte Meßgrößen Zielsetzunge n Finanzielle Perspektive Preis/Kosten Service Image Initiativen Zielwerte Meßgrößen Zielsetzungen Kundenperspektive Produktivität Qualität Cycle Time Initiativen Zielwerte Meßgrößen Zielsetzungen Interne Perspektive Geistiges Eigentum Kontinuierliches Lernen Markt- innovation Initiativen Zielwerte Meßgrößen Zielsetzungen Lernperspektiven The Vision Financial Customer Internal Learning & Growth The Balanced Scorecard Converts Strategy Into an Integrated System Defined Across Four Business Perspectives ©2001 Balanced Scorecard Collaborative, Inc. 4.0 The BSC Model © DEEFG Florenz 2003

14. 14 4.1Strategy development BSC-Core Team:vocation and empowered (12 Executive, Quality manager and CEO) 10 Strategic orientations (directions) work out on this foundation: 4 Strategic key themes lay down:  Health gain through comprehensive patient orientation  Process optimization and quality management  Partnerships and development of health centres  Developing health promoting corporate culture 18 Corporate values define and discuss with staff © DEEFG Florenz 2003

15. 15 agreement disapproval partly agreement 4.1 Strategy development Results of staff questioning to the value: 246 Employees react to the value draft Value draft revised and from May 1 2003 obligatory © DEEFG Florenz 2003

16. 16 4.2Strategy map Strategic destination (2005) 20 Senior consultants (department physician heads) Statements in strategic destination Workshops. „Possible strategic objectivs“ (181) 20 Strategic objectivesOperationalStrategic Objectivsinitiativs Integration in the 4 BSC-perspectivs (strategic map) Reason – effect relationship © DEEFG Florenz 2003

17. 17 4.3 HPH Frame Strategy Map (Exercise-Example) Draft 15.04.2003 W. Schmidt / E. Brandt Financial Customer Process Innovation Improvement of health gain of hospital services Improvement of health Impacts of hospital setting Development of a health Promoting management in hospital F 2 F 1 F 3 F 4 C 1 C 2 C 3 C 4 C 5 C 6 C 7 C 8 P 1 P 3 P 2 P 4 P 5 P 6 P 7 P 8 P 9 P 10 I 1 I 2 I 3I 4 I 5 Strategic Theme Perspective © DEEFG Florenz 2003

18. 18 F 1Economy & Liquidity secure F 2Increase Patient Loyalty F 3HP-Marketing develop F 4Effective and efficiency employment of resources assess on health gain C 1Empowerment of patients for HP-Selfreproduction C 2Empowerment of patients for HP-Coproproduction in treatment and care C 3Empowerment of patients for HP desease management and life style development C 4Develop hospital into a h.p.setting for patients and visitors C 5Develop hospital into a h.promoting setting for community C 6Improve staff satisfaction C 7Pay attention HP – expectations of Shareholders C 8Improve hospital image in community P 1Patient needs identify and respect P 2HP informations in patient pathway integrate and in patient records documenting P 3Health literacy activities for desease management and healthy lifestyle are established P 4HP-aspects in patient discharge and posthospitalisation integrate P 5Staff empowering for managing consequences of occupational deseases P 6Guidelines and procedures for material and sociocultural workplace are etablished P 7Optimise material and socio-cultural environment for population in the community P 8Leadership Excellence P 9HP in QM-System implemented P 10HP in personell development integrate I 1HP Competencies for staff develop („Strategie skills“) I 2Develop hospital into a health promoting and empowering setting for staff („Healthy workplace“) I 3Staff motivation for participation in HP-Quality improvement („Climate for Action“) I 4HP in IT infrastructure install I 5Strategic HP-Cooperation build up Legend on 4.3 Based on drafts WHO-WG „Strategy“ and „Standards“ © DEEFG Florenz 2003

19. 19 5. Summary EFQM and BSC: Are they instruments of New hospital governance? YES THANK YOU FOR YOUR ATTENTION © DEEFG Florenz 2003