TOPIC: ASSESSMENT OF THE RADIOLOGY SERVICES AT HOSPITAL USING BALANCED SCORECARD OBJECTIVES OF THE STUDY 1) Study of functioning of radiology

department in terms of infrastructure, manpower, process flows and outcome. 2) To apply Balanced Scorecard Technique to measure performance of Radiology Department across four perspectives viz. Financial: To analyze the return on investment done. Customer/patient: Analysis through patient satisfaction (IPD&OPD) through different parameters. Internal Business Processes: Analysis of on time delivery of services through process mapping & process cycle time, Utilization of equipment, wastage of films Learning and Growth: Analysis of employee satisfaction ,retention of employee 3) To identify the areas of improvement and develop recommendation in coordination with the organization, for strengthening and improving the quality of the system. HYPOTHESIS

Balance scorecard can be used as a performance measurement tool for measuring the overall performance of hospital and every perspective of hospital including financial, learning, satisfaction and process can be balanced against each other
METHODOLOGY Keeping in the mind the achievement of the aim and objectives of the present study the methodology has been designed, consisting of several sequential steps as follows: 1. STUDY SETTING: Hospital, 2. STUDY DESIGN: Descriptive observational & record based study 3. STUDY AREA: Radiology departmentSTUDY SPAN: 40Days(1 May-June 10) 4. STUDY POPULATION: Patients associated with Radiology services. Employees of the Radiology Department. 6. PREPARATION FOR STUDY: 1|Page

An observational study was carried out to understand the study area. 7. METHOD FOR DATA COLLECTION: Primary data: By direct observation. By means of questionnaire for employees. Feedback forms & interview for patients. Secondary data: From records. Literature review
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SAMPLE SIZE : Employees: 27 Patients: 200 for internal business process Patients: 200 for patient satisfaction CONDUCT OF STUDY: General study about radiology department Specific study about radiology services

Assessment of radiology services through balanced scorecard method.

A) FINANCIAL PERSPECTIVE
1) Return on investment for the radiology department for the financial year 2009 Total Revenue Received (X-ray,CT Scan,MRI)_______ Total Expenditure Incurred Staff cost, Consumable cost, Communication expenses, CSSD cost, HK cost, Laundry, Power, Water, Insurance, Repair Maintenance cost Total amount of capital employed 2|Page

Building Plant & Machinery Office equipment Fixture & Furniture Annual maintenance Medical Equipment Total: ________ = PROFIT BEFORE INT. & TAX.*100 CAPITAL EMPLOYED ROI: Return on investment

ROI

Profit = Revenue Generated Total Expenditure Incurred Profit = RETURN ON INVESTMENT = Return on investment for the radiology department for the financial year 2010 Total Revenue Received Total Expenditure Incurred Total amount of capital employed: Building Plant & Machinery Office equipment Fixture & Furniture Annual maintenance Medical Equipment Total . ROI CAPITAL EMPLOYED = PROFIT BEFORE INT. & TAX.*100 ROI: Return on investment Profit = Revenue Generated Total Expenditure Incurred Profit = RETURN ON INVESTMENT = 2)NET INCREASE IN TOTAL REVENUE ( FY 2009 FY 2010) Total Revenue in FY 2009: Total Revenue in FY 2010: .. 3|Page

NET INCREASE IS - Total Revenue in FY 2009- Total Revenue in FY 2010= % INCREASE: Net Increase/Initial Revenue = 3) NET INCREASE IN TOTAL EXPENDITURE INCURRED (From FY 2009- FY 2010) Total expenditure incurred in FY 2009: .. Total expenditure incurred in FY 2010: .. NET INCREASE IS = Total expenditure incurred in FY 2009-Total expenditure incurred in FY 2010= % INCREASE: Net Increase/Initial Expenditure=.
Sr.No. 1 2 3 4 5 6 7 8 Radiology X Ray-10 Fluoroscopy Ultrasound Bone Density Mammography CT Scan MRI Scan Others SubtotalRadiology Revenue in Lakhs (2009-10) Revenue in Lakhs (2010-11) % Increase

B) PATIENT PERSPECTIVE
Total Sample Size .. 1) IN- PATIENT 2) OUT-PATIENT INPATIENT SATISFACTION SURVEY OUT PATIENT SATISFACTION SURVEY

C) INTERNAL BUSINESS PROCESS

PROCESS CYCLE 4|Page

Measures for Internal Business Process Perspective 1) PROCESS MAPPING 2)WAITING TIME
PROCEDURE Average time taken in registration Average waiting time before the procedure Average time taken in the procedure Turnaround Time TIME (mins) % of turnaround time

3) AVERAGE WAITING TIME BEFORE THE PROCEDURE FOR DIFFERENT CATEGORY OF PATIENTS:
S.No. 1 2 3 Category of Patients OPD (With Appointment) OPD (Walk-In) IPD Time (mins)

4)REPORTS WITHIN STIPULATED TIME: Report turnaround time 5)AVERAGE NO. OF PATIENTS/DAY IN DIFFERENT CATEGORIES:
CATEGORY OPD (Appointment) OPD (Walk-In) IPD EMERGENCY TOTAL TOTAL PATIENTS AVERAGE NO. PATIENTS/DAY OF

6)UTILIZATION OF ULTRASOUND MACHINE

MACHINE AVERAGE HRS. MACHINE WORKED/DAY HOURS ALLOCATED/DAY (8:00am-6:00pm) UTILIZATION (%)

7)WASTAGE OF FILMS 5|Page

 OBJECTIVE: To monitor wastage of films in radiology department METHODOLOGY: Total no. of films used & wasted was collected

from the department logs from March 2010-February 2011 on a monthly basis.
SPECIALITY March Grand Total April Grand Total May Grand Total June Grand Total July Grand Total August Grand Total September Grand Total October Grand Total November Grand Total December Grand Total January Grand Total February NO. OF FILMS USED NO. OF WASTED FILMS % WASTAGE

Grand Total 8)ERRORS/MISTAKES DUE TO RADIOLOGY DEPARTMENT

D) EMPLOYEE PERSPECTIVE
1) EMPLOYEE SATISFACTION Sample Size (doctors & technician) 2) EMPLOYEE TURNOVER Employee Turnover is defined as the no. of employees left an organization in a specific period of time. Calculation of Employee Turnover Rate The turnover rate can be calculated by dividing the no of employees who have left in a given period by the average no of employees in a given period & multiply the result by 100. Employee turnover rate in radiology department No of employees left in a given periodx100 Average no of employees in a given period 6|Page

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