“Balanced Scorecard – Regulatory Style” Jan Robinson, Registrar College of Physiotherapists of Ontario 2006 Annual ConferenceAlexandria, Virginia Council

“Balanced Scorecard –Regulatory Style”

Jan Robinson, RegistrarCollege of Physiotherapists of

Ontario

2006 Annual Conference

Alexandria, Virginia

Council on Licensure, Enforcement and Regulation

Expect the Unexpected: Are We Clearly Prepared?

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

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Objectives

• Reasons for initiative• Vision for Accountability• Building the Scorecard• Success and learning


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Impetus

• Culture change• External environment• High performing organization


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• Regulatory organizations are public organizations entrusted to professions

• Trust is earned


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One of Four Strategic Objectives

• To demonstrate public accountability through performance measurement.


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Value for Public Accountability

• By 2007Effective measurement system

indicates College performance meets, exceeds or is “best practice”

Staff & Council quickly identify and resolve areas of concern

Evaluate & CQI embedded in culture


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Vision for Public Accountability

• By 2007,Stakeholders know performance

versus targetsHigh level of accountability + higher

trust relationshipsNew projects screened for

performance impactThe College is in a leadership role


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To demonstrate public accountability through

performance measurement

• IndicatorsKey measures are identified and

monitored regularlyPrograms set in an evaluation

frameworkAccountability results reported

externally


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Project

Define what, why and how College will evaluate its performance.


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Tactics

• Select evaluation framework and adapt it to regulatory environment

• Define and select “programs”

• Identify measures that demonstrate public accountability


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Performance Measurement

Balanced Scorecard selected 2004

•Type:Navigational – monthly, forward

facing, internal focus


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Quadrants of Balanced Scorecard

Stakeholder Finance

Process Learning & Growth


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Corporate Balanced Scorecard

Governance Scorecard

Operations Scorecard- Program Scorecard


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Indicator Development

• Layers relevant to the role & function

– Council - critical few for governance– CEO - higher level / global operations– Manager / Director – program details


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Program Definition and Selection

Entry to PracticeQuality ManagementProfessional PracticeProfessional Conduct


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Rapid Scorecard Development

• Strategy Map & Definitions

• Core processes and current projects

• Indicator selection & collection process

• Templates for Reporting


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To protect and serve the public interest by ensuring that physiotherapists provide high quality, competent and ethical services

Register Competent Practitioners Assure Quality PT Practice

v1

Use Resources Effectively

Enforce Practice Standards

Deliver Effective Registrant Resources

Demonstrate Public Accountability

Sustain a High Performance Standard

Maximize Business Partnerships

Ensure High Staff & Board Competence Leverage TechnologyCelebrate Collaboration &

Innovation

2020

1010

4545

2525


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Core Processes

• Process that is ongoing and relates to input, output and outcomes.

• 15 Core processes identified.


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Projects & Activities

• Undertaken to close a performance gap

• Line up to domains on the strategy map

• Weighting and ranking process


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CEO monitors themes monthly

• Customer service• Case management• Systems improvement• Fiscal effectiveness• Stakeholder engagement• Program implementation • Staff performance


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CEO monitors monthly

• Volumes

• Workload trends

• Outcomes

• Variance


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Examples of CEO Indicators

Case managementinitiation to disposition meets timelinenotice time met# appeals College decision upheld on appeal timely posting on public register remediation outcomes


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Examples of CEO Indicators

Stakeholder engagement practice advice volume and quality response to registrant material

validation (#, satisfaction) % electorate voting # presentations requested /

delivered


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Staff report to CEO

• Monthly / quarterly

• Performance in identified areas

• Analysis & recommendation


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Staff report to CEO

• What

• So What

• Now What


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Table Format for Scorecard

Indicator Title

Definition

Target Rationale

Score

Analysis

3 word title

What is in / out

Performance standard

Rationale for standard

How we did

What

So What

Now What


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Operations ScorecardIndicator Title

Definition Target Rationale Score

Analysis

Case Disposition

# of cases

closed within

established standard for case type / all casesclosed in quarter

(aggregate view of Exec. Registration, QM, Complaints)

Green- all compliant

Yellow – 1 area not at standard

Red- 2areas not at standard and / or 1 area not at standard2nd consecutive quarter or more

Complaint with statutory requirement & high performance

What:

So What:

Now What:


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Rationale for Setting the Target

Statutory requirement

Council direction

Industry benchmark

Standard that reflects a high performance organization


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Color Coding

Green – fully compliant with target

Yellow – 1 area not compliant with target; some concern

Red – 2 areas not compliant; or 1 area not compliant for second quarter; recovery plan required.


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Operations DashboardStakeholder

INDICATOR Q2 Q3 Q4 Q1 Q2


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Corporate Balanced Scorecard

Operations Scorecard

Focused on operational activities

Monthly to CEO & quarterly to Council

Council receives compiled CEO & staff indicators


Focused on governance activities

Quarterly to Exec Com & Council

Council receives all indicators


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Accountabilities

Operations Scorecard

• Council

• CEO

• CEO & staff


• Council

• President & Exec Committee

• CEO


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Evolution• Commitment to quality improvement

• Indicators can change

• Targets can change

• Active role working in partnership


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Key Success Factors

• Key participants must understand performance measurement

• Critical few indicators• Right discussion at right level• Tools • Integrate into day to day work life• Buy in


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Definition of Success

The College of Physiotherapists is an The College of Physiotherapists is an organization publicly known for its organization publicly known for its strategic leadership in professional self-strategic leadership in professional self-regulation. It is governed and staffed by regulation. It is governed and staffed by a competent and capable team that a competent and capable team that thrives in best practice and thrives in best practice and accountability environment. The College accountability environment. The College is a model for others and partners are is a model for others and partners are satisfied with its current performance satisfied with its current performance and future vision.and future vision.


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Definition of Success (cont’d)

The College is viewed as fair and cost effective within its mandate. Physiotherapists actively use the College resources in practice; the public consistently recognizes the College as advocating and investing in safe, quality physiotherapy practice.


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Next Steps

• Complete one full year cycle

• Stakeholder consultation on reporting

• Full public reporting


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Learnings

• Keep it simple consider key areas already reviewed.

• Be flexible• “red is not “bad”• Just get started


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Resources Kaplan, Robert S. and Norton, David – Having Trouble with

your Strategy? Then Map it Harvard Business Review September – October 2000

Niven, Paul R. - Balanced ScorecardStep-By-Step for Government and Nonprofit Agencies (2003)

CCAF Reporting Principles: Taking public Reporting to a New Level (2002)

Institute on Governance – www.iog.ca

Ontario Hospital Association – Guide to Good Governance

Canadian Policy Research Network (CPRN)- Series of papers on Accountability in Health Care Website: http//www.cprn.org

pm2 Performance Measurement and Management

http://www.iog.ca/


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Speaker Contact Information

Speaker Name: Jan Robinson, RegistrarOrganization: College of Physiotherapists

of OntarioAddress: 375 University Ave. Suite 901Toronto, Ontario, M5G 2J5, CanadaPhone, Fax : 416-591-3828 / 416-591-3834 (fax)E-mail: [email protected]: www.collegept.org

Documents

“Balanced Scorecard – Regulatory Style” Jan Robinson, Registrar College of Physiotherapists of Ontario 2006 Annual ConferenceAlexandria, Virginia Council