USING PERFORMANCE DASHBOARDS TO MONITOR ORGANIZATIONAL ACHIEVEMENTS HÉCTOR COLINDRES MANAGEMENT SCIENCES FOR HEALTH

Transcription

1 USING PERFORMANCE DASHBOARDS TO MONITOR ORGANIZATIONAL ACHIEVEMENTS HÉCTOR COLINDRES MANAGEMENT SCIENCES FOR HEALTH

2 INTRODUCTION Family Planning and Reproductive Health organizations are working in difficult times. They have to face challenges on a daily basis in order to survive, grow and provide services to the most disadvantaged groups, with limited resources. Managing these organizations means making decisions that affect their survival and development. This is not an easy task, as it involves taking on a wide range of risks. The systematic use of information for decision making can reduce these risks. This is why managers and their teams need key information that is easy to interpret, accurate, and, above all, timely. With timely information, decisions can be made with less risk and with a higher probability of success. Organizations use a number of management approaches and tools to address these challenges. One such tool is the performance dashboard. Dashboards provide senior management, managers and their teams with key information to monitor the achievements of FP and RH programs. WHY USE A PERFORMANCE DASHBOARD? Managing an organization is like flying a very complex and expensive plane. The pilot relies on a series of modern instruments that will provide him/her with accurate, reliable information needed to make the right decisions. This information must be continuously visible and easy to understand and use during flight. What the pilot needs is a dashboard that will allow him to control the plane at all times. Organizations working in FP and RH and other types of organizations also need dashboards. Management teams use the information provided by the dashboard to plan and review performance and results at all levels, and to make decisions based on information to lessen risk and increase the probability of success. The systematic use of dashboards leads to effective and timely monitoring, which improves the quality of the decisions made and the impact of organizational results. BUT... WHAT ARE DASHBOARDS? Dashboards are instruments that provide managers and their teams with information on the performance of service delivery in a specific area, program, unit or the entire organization. Dashboards enable users to compare actual achievements with desired or expected achievements, as established in norms and programmatic and/or financial goals of the organization. Dashboards consist of an organized set of key indicators for a management area, program, unit or the entire organization. Each of these indicators corresponds to a critical factor for improving and monitoring performance (FP and RH service delivery, in our case). By enabling the analysis of results obtained against the norms and goals that the organization expects to achieve in each key indicator, dashboards provide for fast, objective monitoring of the organization s performance in developing FP and RH programs. Additionally, the regular, 2

3 systematic use of dashboards assists managers in developing participatory processes for continuous improvement and innovation in management and service provision. WHAT ARE THEIR CHARACTERISTICS? Dashboards are made up of an organized set of key indicators that can be used to monitor and verify the performance of FP and RH programs in a comprehensive and integrated manner. Dashboards are graphic representations that show the information needed to analyze results obtained against previously established goals and norms. They do so in an objective and measurable manner, facilitating the identification of gaps or variations, including their magnitude, in order to orient teams toward their probable causes so that they can adopt corrective measures or improve effectiveness, and, additionally, monitor their impact. WHAT ARE THEIR COMPONENTS? Dashboards are developed based on the essential aspects managers and their teams need to be informed about in order to make decisions that will improve the effectiveness and quality of management/service delivery of their FP and RH programs. These aspects relate to three general areas: (a) information on FP and RH services planned and delivered; (b) information on their cost and results in managing the budget (needed to evaluate how available resources are being used); and (c) information on the quality of service delivery. Performance dashboards show the achievements of FP and RH programs in one or all the areas mentioned above through the use of indicators. At the same time, results are compared to programmatic goals, financial goals and quality standards, facilitating objective, measurable and integral monitoring. The following figure illustrates the areas that can be included in the performance dashboard, specifically for monitoring the performance of FP and RH programs. 3

4 What does the Director/Manager and the team need to know? How does a Performance Dashboard measure this? What is the desired result? 1. The level of production: Number of units produced 2. The cost of the services and execution of the budget: What are the achieved levels in: Costs of services Efficiency: the relationship between production/ costs Level of budget execution 3. The quality of services What is the level of quality in service provision? Access and speed of care Efficiency in service delivery Security in management Continuity of services Comfort of services Treatment during service provision With the use of key indicators: Number of final products obtained % of programmatic goals achieved % of standard costs for products developed % efficiency % of budget execution according to plans % of cases rejected Average wait time % of cases resolved % compliance with norms/goals % of complications % of users who are satisfied with services Among others The goal to be achieved and the norms to follow: Established en the plans and operational programming and quality standards of FP/RH programs The expected rates of annual and monthly FP and RH service provision is included in the annual and monthly planning of the organization in the form of specific service provision goals for each service. These goals have a cost and must be met with a minimum level of quality, as measured by a set of quality standards. All these critical aspects can be identified and measured systematically through the use of indicators. The use of INDICATORS facilitates measurement and quantification. The first basic component to be considered when developing performance dashboards is a set of service provision, cost and quality indicators. As already mentioned, an organization can begin developing dashboards for one of these areas. Typically, an organization will start with service provision, as established in monthly and annual operating plans, and will then complement this with financial and quality indicators, as financial and quality assurance systems are developed. This enables managers and their teams to monitor FP and RH service provision, cost, and quality on a regular basis, as well as the financial impact this represents. It also enables them to identify any variation in performance and the areas where there is a need to act to achieve an impact. This approach provides an analytical logic that can be used to establish priorities and acceptable explanations or define corrective actions. The second component needed to develop and implement dashboards is the information required to document and verify compliance with each of the indicators. This information provides decision makers with the evidence they need to compare the actual situation with the desired situation, as set forth in the programmatic and financial goals and standards to be achieved. The 4

5 comparative analysis helps identify the differences, gaps, or variations that will guide corrective or improvement actions to eliminate or minimize their causes. Thus, dashboards have two overarching components: 1) FP and RH service provision, cost and quality indicators, and 2) regular information on the achievements and results obtained. 1 Component Service provision, cost, and quality indicators to monitor the performance and results of FP/RH programs Situación Desired Situation deseada 1. Goals 1. Convenios and norms de Gestión 2. Difference Diferencia or o variation! Variación n! 3. Causas Causes de of la variation variación Situación Actual Situatio actual 2 Component Information about performance and results of FP/RH services DESIGNING DASHBOARDS STEP 1: Selecting FP and RH services to be monitored. All services can be monitored or teams can select a few of the most critical and relevant service areas, e.g., Voluntary Surgical Contraception, Contraceptive Methods. STEP 2: Defining key FP and RH service indicators. You can select indicators related to the three areas already mentioned (Service Provision, Financial Management and Quality) or only one of these areas. Typically, organizations start with Service Provision indicators, based on the monthly service provision goals included in the operating plan. Examples include: Number of Voluntary Surgical Contraception (VSC) patients, Number of Contraceptive Methods distributed, etc. If the organization knows the unit cost of delivering each of these services, they can include it as another indicator in the group of financial indicators. Financial indicators can also include monthly budgetary goals established for service provision goals for each of the services being monitored by the organization. 5

6 Ideally, quality standards should also be developed. If the organization has implemented a quality assurance system, there will probably be a set of standards relating to the dimensions of quality for FP and RH services. For example, in the case of Voluntary Surgical Contraception: Technical Competency Dimension Standards: All VSCs will be performed by qualified personnel. An indicator to monitor compliance could be: % of VSCs performed by qualified personnel. Safety Dimension Standards: All VSCs will be performed using safe practices, in compliance with the organization s formal protocol. The corresponding indicator could be: % of VSCs performed according to the organization s formal protocol and % of VSCs with complications. Interpersonal Relationship and Treatment Dimension Standards: Users must be satisfied with the treatment received from personnel performing VSC. Suggested indicator: % of users satisfied with treatment received from personnel performing VSC. These quality standards can be developed for a specific service because of its strategic importance or for all FP and RH services provided by the organization. Dashboards can be used in both cases. It is important to note that some indicators will require a range, as an exact figure would be difficult to achieve. In contrast, other indicators cannot be shown as a range, as in the case of the % of VSCs performed according to the organization s formal protocol. The following example is a performance dashboard developed to monitor VSC achievement. Service: VSC Reporting Period: January No. Service provision / Cost / Quality Indicator Programmatic or Financial Goal / Threshold Min. Max. Number Achieved 1 0 Percent Completed # of VSCs performed during the month Average cost of VSCs, in US$ Monthly budget of income from VSCs performed, in US$ % of VSCs performed by qualified personnel % of VSCs with no complications % of users satisfied with treatment received from personnel performing VSC % 100% % 100% 90 6

7 This set of key indicators will enable managers to monitor and improve FP and RH services. A monthly average can also be obtained in order to identify the months of best/worst performance. STEP 3: Collecting data to document key indicators The data needed to monitor each of the key indicators must be collected on a regular basis. The information obtained is included in the dashboard under Value Achieved and is used to establish percent of achievement. As shown in the example above, the dashboard is color coded to easily identify indicators where improvement is urgently needed. Indicators in red (less than 60%) need urgent improvement; indicators in yellow (60% 80%) are unsatisfactory; and, indicators in green (80% 100%) are satisfactory. The dashboard is updated on a monthly basis, which allows for comparison with previous months in order to measure progress. If all indicators are green, performance is EFFECTIVE, EFFICIENT AND OF HIGH QUALITY. If the organization has the necessary resources, they can acquire specific software, such as Xcelsius, to transfer data from the formats of data collection to dynamic diagrams that are easy to use and interpret, and are generally presented in Power Point in real time. For organizations with no information available, we recommend using the following format to identify and plan the information to be collected on a regular basis in order to document the key indicators: Service provision, cost and quality indicators Information source to be consulted Collection technique to be used Sample Frequency Person Responsible Collection Tool WHY USE DASHBOARDS? Dashboards are very useful. They help us to monitor, in a measurable and simple manner, the performance of FP and RH organizations. Dashboards provide an integral schematic representation of performance in terms of compliance with standards and the achievement of FP and RH objectives, focusing only on key information to verify the degree of completion, progress, and results obtained. Dashboards facilitate the timely identification of errors, gaps, or deviations, as 7

8 well as the analysis of the factors leading to those variations in order to make the necessary adjustments and introduce improvements or develop new forms of intervention. Dashboards help organizations make evidence based decisions to adopt corrective measures or introduce improvements. They are excellent vehicles for learning; continuous innovation and improvement through team work, implementation of incentive systems, and service quality improvement. 8

9 REFERENCES: Kaplan, Robert and David Norton. The Balanced Scorecard: Translating Strategy into Action. Cambridge: Harvard Business School Press, Coppa Astorga, Enzo Fabio. Paradigmas del Control de Gestión Moderno. Club Tablero de Comando, 9