KSNS
E-SUBMISSION
Articles
- Page Path
- HOME > J Korean Acad Nurs > Volume 38(5); 2008 > Article
-
Original Article
- Development of Nursing Key Performance Indicators for an Intensive Care Unit by using a Balanced Scorecard
- Yun Jeong Choi1, Ji Young Lim2, Young Whee Lee2, Hwa Soon Kim2
-
Journal of Korean Academy of Nursing 2008;38(5):656-666.
DOI: https://doi.org/10.4040/jkan.2008.38.5.656
Published online: October 12, 2008
1Headnurse, Intensive Care Unit, Inha University Hospital, Incheon, Korea
2Professor, Department of Nursing, Inha University, Incheon, Korea
1Headnurse, Intensive Care Unit, Inha University Hospital, Incheon, Korea
2Professor, Department of Nursing, Inha University, Incheon, Korea
- Address reprint requests to : Lim, Ji Young Department of Nursing, Inha University, 253 Younghyeon-dong, Nam-gu, Incheon 402-751, Korea Tel: 82-32-860-8210 Fax: 82-32-874-5880 E-mail: lim20712@inha.ac.kr
• Received: April 30, 2008 • Revised: May 4, 2008 • Accepted: September 30, 2008
Copyright © 2008 Korean Society of Nursing Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
-
Purpose
- The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC).
-
Methods
- This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs.
-
Results
- Two main visions of nursing service for ICUs were established. These were ‘realization of harmonized professional nursing with human respect’ and ‘recovery of health through specialized nursing’ respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC.
-
Conclusion
- The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.
Table 1.Nursing Visions of ICUs
Table 2.Nursing Practical Strategies of ICUs based on BSC
Table 3.Nursing KPIs of ICUs based on BSC
- American Association of Critical Care Nurses. 2005;AACN standards for establishing and sustaining healthy work environments: A journey to excellence. American Journal of Critical Care. 14:187–197.ArticlePubMedPDF
- Bak W.S. 2002.The relationship between leadership, empowerment, and nursing performance. Unpublished doctoral dissertation. Kyunghee University; Seoul.
- Chern I. P., Jeng H.J. 2000;Translating strategy into action. Accounting Research Monthly. 183:44–73.
- Choi, B. H., & Korean BSC Research Association. 2006.BSC: Strategic performance management system. Seoul: Hangook Hak-sul Jungbo Co.
- Chow C. W., Ganulin D., Teknica O., Haddad K., Williamson, J. 1998;The balanced scorecard: A potent tool for energizing and focusing health care organization management. Journal of Healthcare Management. 43:263–280.ArticlePubMed
- Dixon, S. 2001;What will be the costs of a quality emergency service? Journal of the Royal Society of Medicine. 94:54–56.
- Drucker P., Eccles R. G., Ness J. A., Cucuzza T., Simons R., Dabila A., et al. 2007.Measuring corporate performance. Seoul: 21 Century Books.
- Forgione D.A. 1997;Health care financial and quality measures: International call for a ‘‘balanced scorecard’’ approach. Journal of Health Care Finance. 24:55–58.PubMed
- Griffith J. R., King J.G. 2000;Championship management for health care organizations. Journal of Emergency Medicine Taiwan. 22:34–38.Article
- Holt, T. 2001;Developing an activity-based management system for the army medical department. Journal of Health Care Finance. 27:41–46.PubMed
- Hong Y. M., Hwang K. J., Kim M. J., Park C.G. 2008;Balanced scorecard for performance measurement of a nursing organization in a Korean hospital. Journal of Korean Academy of Nursing. 38:45–54.ArticlePubMed
- Huang S. H., Chen P. L., Yang M. C., Chang W. Y., Lee H.J. 2004;Using a balanced scorecard to improve the performance of an emergency department. Nursing Economics. 22:140–146.PubMed
- Jang B.H. 2000.A study on critical care nursing practice and development of standard for critical care nursing practice. Unpublished master’s thesis. Yonsei University; Seoul.
- Jones M. L., Filip S.J. 2000;Implementation and outcomes of a balanced scorecard model in women’s services in an academic health care institution. Quality Management in Health Care. 8:40–51.Article
- Kang K.H. 2003.Development of performance measure indicators on hospital nursing units. Unpublished doctoral’s dissertation. Yonsei University; Seoul.
- Kang S.S. 2005.A study on collaborating balanced scorecard with enterprise resource planning for hospital management performance evaluation. Unpublished doctoral’s dissertation. Dongguk University; Seoul.
- Kaplan R. S., Norton D.P. 1992;The balanced scorecard-measures that drive performance. Harvard Business Review. 70:71–79.PubMed
- Kim H.J. 2006.A study on indicator development to evaluate hospital system: Based on balanced scorecard method. Unpublished master’s thesis. Yonsei University; Seoul.
- Kim H. K., Sung E.S. 2006.Strategic performance management BSC (Balanced scorecard). Seoul: Sigma Insight Com.
- Kim Y.S. 2005.Development of performance measurement indicators for nursing on delivery units. Unpublished master’s thesis. Yonsei University; Seoul.
- Ko Y. K., Lee T. W., Lim J.Y. 2007;Development of a performance measurement scale for hospital nurses. Journal of Korean Academy of Nursing. 37:286–294.ArticlePubMedPDF
- Luttman R.J. 1998;Next generation quality, part 2: Balanced scorecards and organizational improvements. Topics in Health Information Management. 19:22–29.PubMed
- Niven P.R. 2002.Balanced scorecard step by step: Maximizing and maintaining result. Seoul: Sigma Insight Com.
- Oliveira, J. 2001;The balanced scorecard: An integrative approach to performance evaluation. Healthcare Financial Management. 55:42–45.
- Pink G. H., McKillop I., Schraa E. G., Preyra C., Mongomery C., Baker G.R. 2001;Creating a balanced scorecard for a hospital system. Journal of Health Care Finance. 27:1–20.
- Sahney V.K. 1998;Balanced scorecard as a framework for driving performance in managed care organization. Managed Care Quarterly. 6:1–8.
- Sung Y., Song M. S., Park, J. 2007;Estimation of nursing cost by a patient classification system(PCS) in ICU. Journal of Korean Academy of Nursing. 37:373–380.PubMed
- Voelker K. E., Rakich J. S., French G.R. 2001;The balanced scorecard in healthcare organization: A performance measurement and strategic planing methodology. Hospital Topics. 79.
- Sung Y., Song M. S., Park, J. 2007;Estimation of nursing cost by a patient classification system(PCS) in ICU. Journal of Korean Academy of Nursing. 37:373–380.PubMed
- Voelker K. E., Rakich J. S., French G.R. 2001;The balanced scorecard in healthcare organization: A performance measurement and strategic planing methodology. Hospital Topics. 79:13–24.Article
- Yang M. C., Tung Y. C.. 2006;Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: The case of a public hospital system in Taiwan. Health Care Management Review. 31:280–288.ArticlePubMed
- Yoo J.I. 2001.Development of a performance measurement system for the perioperative nursing using the balanced scorecard (BSC). Unpublished maser’s thesis. Yonsei University; Seoul.
- Yang M. C., Tung Y.C. 2006;Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: The case of a public hospital system in Taiwan. Health Care Management Review. 31:280–288.ArticlePubMed
- Yoo J.I. 2001.Development of a performance measurement system for the perioperative nursing using the balanced scorecard (BSC). Unpublished maser’s thesis. Yonsei University; Seoul.
- Sahney V.K. 1998;Balanced scorecard as a framework for driving performance in managed care organization. Managed Care Quarterly. 6:1–8.
- Sung Y., Song M. S., Park, J. 2007;Estimation of nursing cost by a patient classification system(PCS) in ICU. Journal of Korean Academy of Nursing. 37:373–380.PubMed
- Voelker K. E., Rakich J. S., French G.R. 2001;The balanced scorecard in healthcare organization: A performance measurement and strategic planing methodology. Hospital Topics. 79:13–24.Article
- Yang M. C., Tung Y.C. 2006;Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: The case of a public hospital system in Taiwan. Health Care Management Review. 31:280–288.ArticlePubMed
- Yoo J.I. 2001.Development of a performance measurement system for the perioperative nursing using the balanced scorecard (BSC). Unpublished maser’s thesis. Yonsei University; Seoul.
REFERENCES
Figure & Data
REFERENCES
Citations
Citations to this article as recorded by 
Cite
XML DownloadDevelopment of Nursing Key Performance Indicators for an Intensive Care Unit by using a Balanced Scorecard
Figure 1. Research process of this study.
Figure 1.
Development of Nursing Key Performance Indicators for an Intensive Care Unit by using a Balanced Scorecard
Nursing Visions of ICUs
| Nursing Vision Statement of ICUs | Validity score M (SD) |
|---|---|
| Preliminary 11 nursing visions of ICUs | |
| Differential nursing care based on teamworks | 2.76 (0.36) |
| Professional nursing related to patient’s recovery | 2.93 (0.27) |
| Scientific & professional nursing role player according to patient’s characteristics | 3.23 (0.27) |
| Support patients & their families’ quality of life based on human respect | 3.03 (0.27) |
| Leading domestic nursing cares of ICU based on creative educations & researches | 3.10 (0.34) |
| Serving specialized optimum level of nursing cares for patient’s health promotions | 3.20 (0.39) |
| ICUs based on trust between the staffs & patients and their families | 3.10 (0.34) |
| Realization of professional nursing with human respect | 3.13 (0.61) |
| Nursing with vitality | 1.93 (0.25) |
| Energetic nursing | 2.00 (0.35) |
| Nursing with clients | 2.26 (0.48) |
| Final 2 nursing visions of ICUs | |
| Realization of harmonized professional nursing with human respect | 4.00 (0.00) |
| Recovery of health through specialized nursing | 4.00 (0.00) |
Nursing Practical Strategies of ICUs based on BSC
| Perspective | Practical Strategies | Agreement rate (%)* | Agreement rate (%)† | Validity score M (SD) |
|---|---|---|---|---|
| Finance | Offering and maintaining safe environment to prevent an accident/infection | 100.0 | 100.0 | 3.44 (0.71) |
| Managing ward through efficient decision making | 83.3 | 66.6 | 3.16 (0.80) | |
| Improving outcome through participation in policy making on critical patient’s treatment | 100.0 | 100.0 | 3.44 (0.51) | |
| Customer | Observation of ethic code/ethical nursing | 100.0 | 6.6 | 3.40 (0.65) |
| Technical and smooth communication | 100.0 | 6.6 | 3.56 (0.51) | |
| Nursing with critical patient’s family | 83.3 | 100.0 | 3.36 (0.64) | |
| Creation of healing environment | - | 100.0 | 3.52 (0.51) | |
| Internal business process | Nursing provision using a nursing process | 83.3 | 66.6 | 3.48 (0.51) |
| Improvement and accomplishment of evidence based nursing through the research/QI | 100.0 | 100.0 | 3.48 (0.59) | |
| Standardization and accomplishment of critical nursing principle/practice | 100.0 | 66.6 | 3.68 (0.48) | |
| Learning & Growth | Development of nurse’s ability and career | 100.0 | 100.0 | 3.64 (0.49) |
| Standardization of nurse’s skillful process and evaluation of practice ability | 83.3 | 100.0 | 3.76 (0.44) | |
| Completion of special nursing program/continuous education | 83.3 | 100.0 | 3.44 (0.51) |
*Rate of agreement for content validity of nursing practical strategies to achieve nursing visions of ICUs;
†Rate of agreement for classification validity of nursing practical strategies according to 4 perspectives of BSC.
Nursing KPIs of ICUs based on BSC
| Perspective | Key performance indicators | Agreement rate (%)* | Validity score M (SD) |
|---|---|---|---|
| Finance | Application rate of an article, instrument and equipment | 83.3 | 3.24 (0.52) |
| Maintenance rate of an adequate stock quantity | 66.7 | 3.24 (0.52) | |
| Reduction rate of prescription omission | 83.3 | 3.25 (0.61) | |
| Turn over rate of career nurse | 66.7 | 3.08 (0.64) | |
| Customer | Performance rate of patient’s right | 66.7 | 3.20 (0.65) |
| Patient/family’s satisfaction | 100.0 | 3.56 (0.71) | |
| Rate of hospital infection | 66.7 | 3.42 (0.78) | |
| Rate of medication error | 83.3 | 3.44 (0.71) | |
| Length of stay | 66.7 | 3.20 (0.65) | |
| N/A, not applicable Internal business process | Number of problem solving using a nursing process | 83.3 | 3.17 (0.64) |
| Number of nursing accident occurrence | 83.3 | 3.42 (0.50) | |
| Hours of direct nursing care | 66.7 | 3.54 (0.59) | |
| Number of standard development of nursing process | 83.3 | 3.42 (0.65) | |
| Number of patient accident occurrence | 66.7 | 3.38 (0.58) | |
| Rate of bed circulation | 66.7 | 2.75 (0.79) | |
| Error rate of malfunction of medical devices | 83.3 | 2.87 (0.87) | |
| Number of error and omission on nursing record | 100.0 | 3.39 (0.58) | |
| Learning & Growth | Rate of in-service education participation | 100.0 | 3.44 (0.64) |
| Rate of research participation | 83.3 | 3.21 (0.59) | |
| Nurse’s educational satisfaction | 66.7 | 3.33 (0.82) | |
| Hours of continuing education | 66.7 | 3.00 (0.76) |
*Rate of Agreement for classification validity of nursing KPIs according to 4 perspectives of BSC; KPIs=key performance indicators.
Table 1. Nursing Visions of ICUs
Table 2. Nursing Practical Strategies of ICUs based on BSC
Rate of agreement for content validity of nursing practical strategies to achieve nursing visions of ICUs; Rate of agreement for classification validity of nursing practical strategies according to 4 perspectives of BSC.
Table 3. Nursing KPIs of ICUs based on BSC
Rate of Agreement for classification validity of nursing KPIs according to 4 perspectives of BSC; KPIs=key performance indicators.
