USING BALANCED SCORECARD TO HELP IMPROVING THE QUALITY OF CARE AND SERVICE FOR THE PRIVATE CLINICS IN TAIWAN
Liu, Yi Ming
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Aesthetic as opposed to National-Health-Insurance-Bureau (NHIB) affiliated clinics are largely unregulated by healthcare authorities in Taiwan. Their management is mainly focused on financial performance. Consequently, the quality of care and services cannot be easily assessed or measured. Two aims and fifteen specific hypotheses were established at the start of the study design: Aim one, Examine whether the implementation of Balanced Scorecard (BSC) improves organizational performance; Aim two, Examine whether the implementation of BSC improves patient care. With two clinics of similar characteristics in size, medical and service personnel and customers, one serving as the intervention or experimental group, the other one as the non-intervention or comparison group, after defining the organization’s mission, core values, vision, and strategies, breaking down the strategies into its component parts through the objectives and measures, and articulating goals for time, quality, performance and service, and translate them into measures, we selected the Balanced Scorecard (BSC) as the measuring management tool, designing an implementation model for the experimental group only, with key performance indicators (KPIs) in each of the following perspectives: financial, customer, internal processes and learning and growth. Data were collected for six months in both groups or clinics, subsequent analyses yielding convincing results in the intervention group with increased BSC scores in Financial and Customer perspectives compared to the non-intervention group, optimistic and confident scores in the Internal processes, with increased BSC scores in employee satisfaction and staff turnover, mixed results in others concerning the Learning and Growth perspective. Based upon these scores and results, both aims and twelve out of fifteen hypotheses were confirmed and accepted. Influences of instrumentation, attrition and contamination were cited as internal threats, whereas Hawthorne effect was mentioned as external threats to validity. The main strengths of this study are that this is the first BSC study designed for aesthetic clinics which could serve as the guidelines of establishing regulation parameters to the healthcare authorities. Meanwhile, due to the lack of time and allocated resources, the small sample size and short duration of data collection were the most evident limitations; hopefully we can expand the scope of the study in the near future.