In the discussion the focus is on Duke Children's Hospital Balanced scorecard according to the research carried out by a group of authors who studied the development strategies used by this firm that has three major departments (CQI, 2008). The departments include: Duke University Hospital which can accommodate one thousand patients on bed, Raleigh Community Hospital that can serve two hundred and thirty clients with bed facilities and Durham Regional Hospital which has the ability to serve three hundred and ninety-one patients with bed facilities. The hospital also serves more than thirty thousand clients through out-patient services. The apartment employs more than eight thousand people every year providing job opportunities to the residents Niven, 2010).
The company faced a very difficult economic downfall in the year 1996 probing the managers to look for alternatives to help the hospital retain its economic status. The system which was used is what is called a balanced-scorecard. This strategy was employed to develop a link between the nurses, physicians, clients and the business administrators. The relationship among the stakeholders was necessary to help raise the net margin up to $15000, 000 and lower the cost rate to $30,000,000. This also intended to improve outcomes plus employee satisfaction. During this economic crisis, some employees were to be left out of the premises. This caused a negative reaction from other members of the staff.
When there is an economic constraint, each person would look for means and ways to come out of the mess. The Duke Children's Hospital management realized that the business process could not work without integration of all the stakeholders to move towards the same destiny. Due to this strong point they came up with a structure of organization that enabled the nurses the physicians and the financial administrators to work in harmony. For instance nurses were expected to provide better services to attract more clients; physicians determined the duration and the type of medicine to be given to the patient then they were also expected to accept referrals that could increase revenue and the financial administrators to determine the cost of all the services that were provided to the client. All these changes were made to provide an alliance that could allow all the employees focus to the success of the hospital and lower the gap among different department (CQI, 2008).
The changes that were started by the Duke Children's Hospital really affected all the participants and non-participants altogether. These changes were both negative and positive. The nurses were given special duty to provide care to the patients but in coordination with both the financial administrators and the physicians. The other stakeholders were also expected to provide their services to their level best (Niven, 2010). This program also allowed the workers to deal with what they could control and leave what they could not handle. This was a great relief to reduce confusion in the hospital. The negative changes were not so much felt due to the prosperity that was realized later. This only affected employees who were left out in the sense of reducing the cost of the hospital's expenditure (Niven, 2010). The other category of gainers was the patients where they were able to receive better heath care from the hospitals better performance. They could also pay according to the services that were offered to them. The proprietors also gained much due to the increase in the outcome as seen in the increase of the net margin after the changes were effective. The implementation of the balance-score can be seen as a major achievement to all the parties involved. The hospital, the workers, the patients and the proprietors all benefited through the implementation of the score-card.