RENAL DEPARTMENT: Quality Objectives Utilizing a Balanced Score Card

FINANCE

QUALITY OBJECTIVE

To increase the
profitability of the kidney
unit from last years
income without
compromising quality
health care through
increasing patient volume
while maximizing budget.
QUALITY OBJECTIVE

To improve safety and

integration of services for
kidney patients through
an increased
understanding of the
linkages and
interrelationships
between acute care
services and primary
health care.

PERFORMANCE
MEASURE
OUTCOME/TARGET

Budget growth less than

patient population
growth
Net budget surplus from
the actual expenditures.

INITIATIVES

Leverage opportunities for costs savings by limiting personnel

adequate for the delivery of services in the unit.
Continue to enhance and further develop a Management Model
necessary for both adult and pediatric patients with kidney
disease, which aligns incentives and patient outcomes in a
fiscally responsible manner.
Continued analysis of funding model and opportunities for fiscal
efficiencies and improvements.

PEFORMANCE MEASURE
OUTCOME/TARGET

INITIATIVES

1. The level of kidney

function (median eGFR)
at time of CKD
registration to establish
earlier referral to
increase likelihood of
successful interventions.
2. Occupancy rate by
dialysis unit setting.
3. Rate of catheter-related
infections per patient
year (HD)

1. Initiate tracking of nephrology consultation waiting time.

Referral from GP and others, recognition of the condition (i.e. lab
strategy), access to nephrologists. Build on strength of
established Health Authority Renal Programs based on standards.
2. Review ongoing trends and innovations re: planning, nursing
models, and patient demographics.
Support of project managers to facilitate change in culture and
facilitation of movement of patients to units, in addition to
potential commencement of dialysis in those units.
3. Involves actions to increase percentage of permanent access
(fistulas and grafts) will decrease the rate of infections by
decreasing the number of catheters.

HONEY LEE G. GONZAGA, RN

Financial and Legal Aspects of Nursing Administration

INTERNAL

PROCESSES

RENAL DEPARTMENT: Quality Objectives Utilizing a Balanced Score Card

QUALITY OBJECTIVE

To define patient
outcomes that rely on
integrated services and
work with hospital
authorities to ensure the
best patient and health
care system outcomes.
Continue modify and

PEFORMANCE MEASURE
OUTCOME/TARGET

Validated patient self reporting survey,

developed by the McColl
Institute to measure the
care experience of
chronic patients will be
used to assess patients
perception of their care

HONEY LEE G. GONZAGA, RN

Financial and Legal Aspects of Nursing Administration

INITIATIVES

The multidisciplinary staff members of the dialysis unit will

conduct survey. Purpose of the survey is to establish a baseline
regarding clinic organization, community linkages, Hemo sheet
data entry, level of patient self-management support, process for
decision support for care goals, and the clinical team design.

These results will drive specific actions/strategies at the

regional/program level, although the survey results will influence

RENAL DEPARTMENT: Quality Objectives Utilizing a Balanced Score Card

management and
alignment with the
chronic care model.

provincial strategies for maximizing the effectiveness of the predialysis interactions

COSTUMER

FOCUS

implement a consolidated
renal/kidney disease
management system.

QUALITY OBJECTIVE

To ensure that education

and research endeavors
align to enhance care
delivery and demonstrate
accountability and fiscal
responsibility, while
ensuring state-of-the-art
care for patients with
kidney disease and to
develop and implement
recruitment, retention,
and succession plans for
health care professionals
and allied health care

PEFORMANCE MEASURE
OUTCOME/TARGET
Itemized initiatives that
involve change from
existing practice or
implementation of new
practices to improve
care quality, efficiency,
effectiveness and
outcomes.
List of formal events for
health care
professionals at the
provincial, regional, and
institutional levels (as
available) reported for

HONEY LEE G. GONZAGA, RN

Financial and Legal Aspects of Nursing Administration

INITIATIVES

Increasing awareness of the potential for research

collaboratively; increasing integration of policy and health
research by supporting Fellowships in Health Administration
directly for nephrology trainees.
Continue to provide a supportive and positive environment that
fosters commitment and a sense of meaningful contribution.
Continue support and organization of educational events.

L E A R N I N G AND G R O W T H and R E S E A R C H

RENAL DEPARTMENT: Quality Objectives Utilizing a Balanced Score Card

professionals.

the period of Q1 Q4.

Reference: http://s3.amazonaws.com/zanran_storage/www.bcrenalagency.ca/ContentPages/985450972.pdf Retrieved June 19,

2016
http://www.bcrenalagency.ca/resource-gallery/Documents/BCPRA-2007-Update.pdf Retrieved June 19, 2016

HONEY LEE G. GONZAGA, RN

Financial and Legal Aspects of Nursing Administration

RENAL DEPARTMENT: Quality Objectives Utilizing a Balanced Score

Card

Although health care system is a complicated industry, change in the

health system is subject to a linked chain of effect that connects individual
patients, communities and clinicians with small, naturally occurring front line
units, with countless large and small host organizations all of which exists in a
modulating policy, legal, social, financial and regulatory environment.
Oversimplification of the health system is as common as it is foolhardy.
(Nelson et al, 2001, p18
It is widely recognized that effective healthcare delivery involves
providing high quality patient-centered care that is safe and evidence-based.
Achieving this is a major challenge for health systems throughout the world.
Most people involved in implementing the Balanced Scorecard in the
healthcare sector would say that while there are many common elements
compared with implementation in other sectors, there are some quite unique
challenges in health.
RENAL UNIT is one department that is independent and it could stand
alone catering specialized care in renal system with its own management. It
has its staffing requirement that needs tedious training in the clinical and
technical aspect of operationalizing machines. The BC Renal Agency, among
other dialysis units delivers accurate projections of the funding needs for a
growing patient population. Together with the existing Renal Programs, it
consistently deliver on budget and continue to expand access to services:
Including an increased in dialysis chairs and a four-fold increase in number of
patients. It offer various services related to renal therapies:
Vascular Access Services: Inter hospital, multidisciplinary approach to
improvements in VA. It includes use of PROMIS/CQI indicators, development
of provincial guidelines, VA clinics & best practices and Tertiary referral
processes.
Drug Utilization: Development of project framework and
implementation strategy for an initiative aimed at reducing overall variation
in drug utilization across HA programs
Provincial Disaster Plan Together with the leading committee to
develop comprehensive provincial plan for renal services (linked with overall
strategies).
Renal Patient Satisfaction Survey Survey to be based on a standard,
patient-focused approach. It will incorporate knowledge gained from past
surveys, established surveys and info from Agency for Health Care Research
and Quality in a monthly distribution to patients.
Pharmacy Partnership Program This will renew and/or award new,
contracts to pharmacies. Consignment method ensures consistent approach
to patient care. There is an opportunity for pharmacists to get involved in
specialty care reqd by nephrology patients
PD Supplies Contract (e.g., Baxter): The renal community is now using
a third-party software called i-Sight (provided by MedBuy) to report and track
service and product issues related to these two contracts links the customer
(renal programs), the contracting agent (Medbuy) and the vendor (Fresenius
and Baxter) so problem reports and resolutions are transparent to all.
Health Innovation Fund: Models of Coordinated Specialty Care Project
funding grant to develop coordinated specialty care models in selected BC
HONEY LEE G. GONZAGA, RN
Financial and Legal Aspects of Nursing Administration

RENAL DEPARTMENT: Quality Objectives Utilizing a Balanced Score

Card

communities Aimed at improving care for people with > 2 of diabetes, heart
disease and kidney disease, and reducing system redundancies and
inefficiencies Despite evidence of the strong linkages, prevention and
treatment efforts isolated.

HONEY LEE G. GONZAGA, RN

Financial and Legal Aspects of Nursing Administration

RENAL DEPARTMENT: Quality Objectives Utilizing a Balanced Score

Card

HONEY LEE G. GONZAGA, RN

Financial and Legal Aspects of Nursing Administration