Managing complexity: Community balanced scorecards for public health

This paper will describe the application of Community Balanced Scorecards (CBSCs) to public health. CBSC is a new methodology based on the balanced scorecard, the popular organizational strategy tool used in the public and private sectors for over fifteen years. The author will build on his description of CBSCs in his chapters of "The Public Health Quality Improvement Handbook" (Public Health Foundation-American Society for Quality, expected April 2009) by showing how the Public Health Accreditation Board's new draft standards apply, and adding experiences from five public health organizations from across the U.S. participating in a new pilot program. Key questions addressed include: How can public health professionals manage the multi-sector, multi-organization collaborations crucial to community health? How can standards-based assessment data and quality improvement be translated into better health outcomes? The paper will describe how Community Balanced Scorecards enable the strategic use of data to manage the complexity of collaborations while maintaining a sharp focus on the ultimate goal of measurable, sustainable community health improvements. Other topics covered include: “Strategy mapping,” a process that clarifies the logical steps toward achieving outcomes while also communicating roles and purpose among collaborators; How CBSCs can make best use of standards-based assessments, accreditation, or collaborative planning (e.g., MAPP) to focus on improving health outcomes; How CBSCs help identify which quality improvement initiatives are most strategic to improving community health; Use of CBSCs for managing objectives, projects, and performance data in a collaborative environment; Use of “Community Compacts” to enhance accountability and help move the needle on priority health indicators.