R E H A B I L I T A T I O N - Ontario Hospital Association

A BALANCED SCORECARDWHAT IS ABALANCED SCORECARD?Providing care in a health care facility is a complexactivity involving a multitude of skills, experiencesand technologies. No single aspect of the systemcauses poor or excellent hospital performance. Forthis reason, performance-measurement activities mustinclude measures that provide insights into multipledimensions of a hospital’s performance. The balancedscorecard approach describes performance across fourdimensions or quadrants critical to the strategic successof any health care organization. These quadrantsinclude: System Integration and Change, ClientPerspectives, Clinical Utilization and Outcomesand Financial Performance and Condition.Performance measures for each of the four quadrantsare provided at the hospital-specific level, along withaverage scores by LHIN and the province as a whole.While all hospitals’ values are used in calculatingaverage results by LHIN and the province, hospitalspecificvalues are shown for hospitals that hadsufficient data and agreed to have their resultspublished for quality improvement purposes. Thisyear, 57 out of 58 (98%) hospitals with designatedrehabilitation beds participated in at least onequadrant and 37 (64%) hospitals participatedin all four quadrants of the report.Using a balanced scorecard format, this report providesa summary of performance scores for 23 indicatorsacross four areas of performance.System Integration and ChangeSYSTEM INTEGRATION AND CHANGEThis quadrant focuses on indicators that assess efforts and investments that hospitalsneed to make in order to improve the delivery of adult inpatient rehabilitation services.It measures the extent to which best practices and the involvement of different players arenecessary for making decisions about care, and implementing a client-centred approachto service delivery. [9 indicators]Client PerspectivesCLIENT PERSPECTIVESThis quadrant describes clients’ perceptions of the care they received during inpatientrehabilitation. For participating hospitals, surveys were mailed to clients following theirdischarge from hospital asking them to rate the care they received related to severalcomponents of client-centred rehabilitation, including participation in decision-making andgoal-setting, evaluation of outcomes from the client’s perspective and family involvementin care. [8 indicators]Clinical Utilization and OutcomesCLINICAL UTILIZATION AND OUTCOMESThis quadrant presents indicators that evaluate hospitals’ clinical performance for clientsthat are cared for in designated adult inpatient rehabilitation beds. The indicators, fromthe National Rehabilitation Reporting System, describe changes in the Total FunctionScore i as measured by the FIM TM instrument, length of stay and length of stay efficiency.Indicators are reported for the following Rehabilitation Client Groups (RCGs) ii : All RCGs,Stroke and Orthopedic Conditions. [3 indicators]Financial Performance and ConditionFINANCIAL PERFORMANCE AND CONDITIONThis quadrant describes selected measures of efficiency and productivity in hospitals withdesignated rehabilitation beds. [3 indicators]i. Total Function Score referenced in this document is based on data collected using the FIM TM instrument.The 18-item FIM TM instrument referenced herein is the property of Uniform Data System for MedicalRehabilitation, a division of UB Foundation Activities, Inc.ii.Each of the three indicators are reported for the following Rehabilitation Client Groups (RCGs): All RCGs, Strokeand Orthopedic Conditions. Rehabilitation Client Groups (RCGs) adapted with permission from the UDSMRimpairment codes. Copyright 1997 Uniform Data System for Medical Rehabilitation, a division of UB FoundationActivities, Inc., all rights reserved. PAGE 4