Embedding the technology in PHC

THE scoreboard technology has been adapted to the Philippine Heart Center (PHC) organization and its internal operating processes to such an extent that it can be considered as PHC’s own. While the technology has been taken—as a concept—from governance principles and best practices that ISA has been spreading, still it had to be tweaked and fitted into the specific circumstances of PHC, such that in actual practice it has become home-grown. In many respects, it has taken on a proprietary character relative to PHC.

It has allowed PHC to travel along its governance and transformation pathway, leaving in its trail a stream of awesome, potentially game-changing results. To cite but a few:

• Patient satisfaction has been a primary concern of the PHC performance scorecard. Some 58% of unit breakthrough goals of the different units have identified this as one element in the enterprise performance scorecard to which they have committed to contribute. The performance target set for PHC for the period up to 2016 was 93%. By June of 2015, the reported patient satisfaction rate was already 97% (8).

• PHC has been very conscious of another performance metric, that of “surgical cardiac mortality rate.” The baseline figure for 2011 was 3.6%; and the target set for 2014 was for 3.0%. By the end of 2014, the reported rate was down to 2.6% (9).

• Another major concern of PHC is the “healthcare-associated infection rate.” The baseline figure for 2011was 2.8%, and the target for 2014 was set at 2.3%. The actual number reported for 2014 was 2.1% (9).

Partly on the basis of these performance improvement indicators, PHC was given the “Gold Award by Accreditation Canada International” in 2014 (10).

The PGS (performance governance system) in order to live up to its billing must help install a system that allows the enterprise to deliver high level performance. Indeed, PHC’s enterprise performance metrics—made possible because of the week-by-week reporting using the scoreboard technology— show significant over-performance relative to pre-committed targets, such as in “increase in volume of laboratory out-patient tests,” “increase in the number of new patients,” “number of clinical pathways implemented” (11), and finally in “increase in additional funds generated from government and non-government sources” (12). There is little doubt that PHC has become the “main referral center for cardiac diseases in the country,” obtaining “55% of the market share among the top hospitals in the country” (for cardiac cases), and “benchmarking” its performance records “with the Cleveland Clinic” (13). The homegrown scoreboard technology of PHC has delivered performance outcomes for which PHC has been justifiably recognized.

Furthermore, PHC has been smart enough to link its scoreboard technology with the requirements of other offices in the Philippine bureaucracy. These include the Strategic Performance Management System (SPMS) of the Civil Service Commission and the PerformanceBased Bonus (PBB) of the Department of Budget & Management. Furthermore, several of the strategic programs of PHC, for the simple reason that they have been formulated and are actively being pursued, have received support for capital expenditures under a separate Department of Health and Department of Budget and Management funding scheme (14).

In this light, PHC can claim a genuine governance breakthrough: Whereas before, the budget was driving whatever strategy would be imposed upon it, now it is the PHC strategy map that is beginning to drive not only its budget but also its multi-faceted hospital operations.