MMHA 6111 Week 9 Change Evaluation Scorecard Example

Adoption, Outcome and Balancing Measures for the First Ninety Days of the Imaging Consolidation

Student Name

Walden University

MMHA 6111: Leadership and Organizational Change

Instructor Name

Month Day, Year

Adoption, Outcome and Balancing Measures for the First Ninety Days of the Imaging Consolidation

Introduction

Evaluation often arrives late in change plans, as a promise to monitor progress. This scorecard covers the first ninety days after Westside's patients, staff and MRI scanner arrive at the hospital department, July through September. Every measure is defined before the move, with a baseline period drawn from the months before it, so that results can be compared with something. The scorecard separates three kinds of evidence: adoption measures, which show whether the new way of working is being used; outcome measures, which show whether the service improved; and balancing measures, which watch for harm the change might cause elsewhere. Improvement guidance stresses that a set of measures should include all three, because a change can be adopted without improving anything, and can improve one thing while making another worse (Provost & Murray, 2011). All figures are illustrative.

The Scorecard

Table 1 sets out the measures.

Table 1

Ninety-Day Scorecard for the Imaging Consolidation

Adoption Measures

The adoption measures ask whether people are using the new arrangement. The first tracks whether Westside's former patients follow their care to the hospital department rather than going elsewhere or going without. If many do not, the consolidation will have reduced access for a group the plan promised to protect, whatever happens to wait times. The second tracks whether referring offices are using the new order routing; orders still sent to Westside's old fax line will be caught and rerouted, but each one is a delay and a sign that the office's awareness gap, identified in the impact grid, has not closed. ADKAR's reinforcement element suggests that new habits need early confirmation to hold (Hiatt, 2006), so the central scheduling supervisor will call any office still using the old route after the first month.

Outcome Measures

The outcome measures ask whether the consolidation delivered what it promised. Days to the third next available MRI appointment is a standard measure of access that is less affected by a single cancellation than the next available slot. The case for change promised that combining MRI capacity would shorten the outpatient wait from about twelve business days; this measure will show whether it did. Report turnaround tests whether one worklist helps radiologists, as the impact grid suggested it might.

Balancing Measures

The balancing measures watch for costs the change might shift. Technologist overtime could rise if the combined department's schedule does not yet match its volume, or if the merged on-call rotation spreads coverage too thin. Access complaints about parking and wayfinding test the concern Westside staff raised about older patients; if complaints rise, the plan's response, a volunteer escort from the parking structure, has not been enough. A change that shortened MRI waits while overtime climbed and older patients stopped coming would not be a success, and the balancing measures exist so that the manager would know.

Reading the Results

Results will be plotted over time against their baselines rather than read as single numbers, because a single month can mislead. Provost and Murray advise charting measures across time, because only a pattern over many points shows whether a process has truly shifted (Provost & Murray, 2011). For the weekly measures, a run of several weeks consistently better than baseline will count as improvement. For the monthly measures, ninety days gives only three points, so the scorecard will be extended to six months before any conclusion about report turnaround is drawn.

Setting Targets and Triggers

Each measure has a target and a trigger for action, set now so that results are not reinterpreted later. For former Westside patients completing exams at the combined site, the target is 85%; if the share falls below 75% in any month, the manager will review a sample of patients who did not return to learn why, whether transport, parking or a choice to go elsewhere. For new order routing, the goal is 95% of orders by late August; any office below 80% after the first month receives a call. For the third next available MRI, the target is under five business days by the end of September; if it has not fallen below ten by the end of August, the manager will review whether the relocated scanner's hours are fully scheduled. For overtime, the trigger is any pay period more than a fifth above baseline, which prompts a review of the merged schedule with both leads. For access complaints, any month with more complaints than the baseline monthly average prompts a review of the escort service. Triggers matter because they commit the manager to act on bad news rather than wait for it to improve.

Who Sees the Scorecard

The scorecard will be reviewed at the daily huddle in summary each Monday and in full at the monthly open forum, so that staff at both former sites see the results. Kotter argues that short-term wins must be visible and clearly related to the change to build momentum (Kotter, 2012); the first week in which the MRI wait falls below its baseline should be announced as exactly that. Problems will be shared as openly as gains, because staff who see only good news learn not to believe the scorecard.

References

Hiatt, J. M. (2006). ADKAR: A model for change in business, government and our community. Prosci Learning Center Publications.

Kotter, J. P. (2012). Leading change. Harvard Business Review Press.

Provost, L. P., & Murray, S. K. (2011). The health care data guide: Learning from data for improvement. Jossey-Bass.