Performance data scorecard

Performancedata scorecard

Belowis an example of a performance data scorecard in NICU.

Critical success factors




Target (December 2016)


Neonate death

To prevent all neonate deaths

Degree of the neonate that survives in NICU



Development guidelines for taking care of neonates in critical conditions

Disability rates

To reduce disability cases

Degree of neonates that leaves the NICU without any disability case



Develop guidelines for taking care of the neonates born before the 28th week.

Length of hospital stay

Reduce the length of hospital stay

The length of time the neonates spends in the NICU



Develop guidelines for reducing the length of hospital stay

Re-admission rates

Reduce re-admission rates

The number of neonates re-admitted after discharge from NICU



Develop guidelines for making sure that only the neonates who have fully recovered are discharged



NeonatalIntensive care Unit (NICU)

Section 2

Performancedisability and re-admission

QualityMortality rates

Patientsafety length of time the neonate spends in the hospital.

Employeeengagement the number of nurses in the NICU


Neonatedeath: This is when the baby dies before completing one month thefirst 28 days of life. Several factors may lead to the death of achild. The most common causes of neonatal death are birth defects,low birth weights and birth defects (Lawn et al., 2010). Most oftheir body organs are not well developed to adopt the newenvironment. Their breathing system may not be in a position toperform well. Therefore, they may face oxygen shortages. At the 37thweek, the digestive system is not also in a position to digest andabsorb the mother’s milk. The new environment is always a challengeto a child born before the due date.

Lowbirth weight: In the United States, one out of every 12 babies bornis underweight, that is, weighs less than 5 pounds. This leads tomany health problems in most of the babies leading to death. A babymay be born with low birth weight because of premature births, fetalgrowth, and restrictions. Most of the body parts of a baby bornbefore the 37th week are not well developed and. Therefore, the childis most likely not to have reached the recommended weight. Somebabies fail to gain the recommended weight due to limited growth. Thegrowth of a fetus is determined by factors such the size of theparents and things that may stop growth in the womb. It is evidentthat 10 percent of the babies in Neonatal Intensive Care Unit haverestricted growth. However, this problem should be identified by thehealthcare at the prenatal care unit and provide the necessaryadvice.

Disabilityrates: Babies born before the due date may not survive well. The morethe baby survives to the due date in the womb the more the chances ofsurvival after birth increases. Neonatal disability can be groupedinto three categories: Severe disability these are disorders orconditions that are not reversible and may force the baby to have afull-time caretaker, for instance, blindness and cerebral palsy. Mostof them cannot be corrected and therefore the child has to be afull-time caretaker. Mild disability this includes impairments thatdo not necessary interfere with the child’s everyday life (Lawn etal., 2010). Mild disabilities do not affect the child’s life, andtherefore the child leads a normal life. An example of milddisability is slow learning. Moderate disability moderate disabilityis evident in children who are at least independence, for instance,those with lower IQ than the average and those suffering fromcerebral palsy but can still walk.

Lengthof patient stays in the hospital: The length of stay is mostlydetermined by the underlying neonate’s condition. Infants whoimprove faster are discharged early while a neonate who improvesslowly spends more time. The nurse’s competency also determines thelength of stay. It is advisable to discharge a neonate immediatelyafter improvement to avoid nosocomial infections.

Nursinghour per neonate: A nursing manager should check whether the numberof hours spent on each neonate is per the set standards. The neonatesshould be given attention depending on the underlying conditions. Thenursing leader should prepare duty rosters that ensure that eachneonate gets enough attention from the nurses on duty. However, careshould be taken to ensure that the nurses are not overworked sincethis could lead to poor delivery of services. It is recommended thatnurses in NICU work for six hours only in a day. Nurses who work fora few hours in a day have proved to work better. A locating a largenumber of patients to one nurse leads to poor service delivery(Pillay et al., 2011). Individual nurse characteristic affects thequality of services that a nurse offers in the wards. A nurse leadershould also ensure that only nurses who have good qualities work inthe newborn unit. A nurse manager should identify specific timeframes to ensure that all the neonates in NICU receive the bestservices. Having enough number of nurses across all shifts is vital.


Settingobjectives and outlining means to solve them: A performance datascorecard in the NICU developed help in setting objects and outliningthe means to solve them. The NICU management can set objects andmeans to solve all the arising issues. For instance, the quality ofservices offered by the Neonatal Intensive Care Unit, in this case,stands at 90 percent. Therefore, the hospital or the NICU managementboard can come up strategies that can help to improve the quality ofthe services offered by the Unit (Bisbe &amp Barrubés, 2012). Thenurse leader can come up means to improve service delivery. In thiscase, the management can improve service delivery by ensuring thatthe NICU has the recommended number of qualified nurses andaccommodates the recommended number of neonates per room.

Qualityimprovement: The scorecard helps the management to recognizelimitations and offer solutions. The score card is vital in reviewingthe newborn’s death. In this case, the management can review allthe processes that take place in NICU from the length of hospitalstay among others. After noting the areas of weaknesses, themanagement recommends strategies for improving the service delivery(Bisbe &amp Barrubés, 2012). Though mortality case in the abovescored is not very high, the performance data will be in a positionto recommend changes, for example, the management can increase thenumber of nurses par shift if the lower number of nurses orunderstaffing is one of the factors that leads to high mortalityrate.

Ongoingreview of clinical practices: The scorecard is essential because towill assist the management to evaluation all the clinical services inthe neonate unit and spot weaknesses. The developed values and targetvalues obtained will help in restructuring the neonate unit, forinstance, if the number of deaths in the Neonate Unit is attributedto poor service delivery, the nurse leader can come up with means ofimproving serving delivery. Proper care of wounds is among theclinical practices that can be improved to reduce neonate deaths(Bisbe &amp Barrubés, 2012).



Opencommunication among health workers. Currently, most of the hospitalsand health care institutions are encouraging proper communicationbetween the health care workers and the management. In largehospitals or health care institutions with hundreds of workers,communication among all the staff members may not be easy. However,there is the need to keep all the workers informed of what ishappening in the hospital or the health care institution. Therefore,the hospital manager should invest in proper means of communicationthat can reach workers in all departments. Most of the hospitals haveinvested in Information Technology systems that facilitatecommunication from one department to another through computersystems. The manager can pass information from one department toanother by just sending emails or notifications. Intranet solutionshave made communication easier in most of the hospitals. ChiefExecutive Officers can also communicate directly with the staffmembers through weekly messages and bi-weekly blogs. The patientexperience the hospitals depends on communication strategies inplace poor communication leads to poor service delivery.


Investingin employee development: Most hospitals have adopted measures todevelop employees. This measure includes offering a scholarship foradvanced studies, giving incentives and promoting employees of highintegrate. Paying school fees for a staff that proves capable ofdoing better in special areas like surgical operations has helped tocreate a strong bond between the hospital management and theemployees. Employees who receive such offers are likely to work intheir respective hospitals or departments for a long period withoutlooking for or seeking transfers (Tooksoon, 2011). The newlyacquired skills by an employee who has undergone advanced trainingare not only vital to the employee but also to the hospital and thepatients. Also, staffs trained through management funds are likely toserve their patients better. It is important for all healthcareinstitutions to engage their employees and listen to their needs.Most of the hospitals are ready to improve their areas of weaknessesas per the employees’ recommendation. This makes the employees feellike a part of the hospital management and therefore work harder.Another way of developing the employees is by putting up a libraryfor them. This can be an online library whereby they can readeducative materials from their phones and computers of a library inone of the hospitals building where the staff members can accessbooks for more information. Funding research: The hospitals candevelop the employees by funding their research projects. Most of theresearch projects are very expensive and therefore some staff membersmay not be a position to meet their cost. Funding such projectsdevelops the employees.


Inall hospitals and health care organizations, improving patient carehas been the top priority however, the outcomes have been tieddirectly to the employees. In a case study that was done using aroundtwenty thousand healthcare workers, it was revealed that employeeengagement is directly related to patient satisfaction. This casestudy showed that: more than three-quarter of the engaged employeesgenuinely care for their patients, around ninety-two percent of thehealthcare workers recognized their institutions of work as committedto patient care and seventy-five percent of the employees werecomfortable with being served at their place of work as clientswhenever they feel sick. Team building in the hospitals leads tostaff engagement (Staff, 2014). Hospitals should encourage itsemployees to work together for high-quality results. There is theneed for proper coordination among all the hospital departments rightfrom the reception to the wards. Engagement leads to goodcommunication hence better service delivery. Managers should allowworkers to exercise their creativity and carry out properinitiatives. To some extent, it is the role of the managers to offereducation to their employees (Staff, 2014). This helps them toperform better. Team building enables the employees to learn moreabout each other and build a sense of engagement within socialgroups. The managers should create a conducive environment thatenables the staff members to engage in team-based activities. Thehealthcare workers can help improve social programs that call forteamwork. For instance, the healthcare workers can help advance theconcentration set to patient meals preferences


Nursingdepartments have records for all the social events and welfareactivities that take among the nurses. The nurse leaders can getinformation on what takes place during these events. There is a clearrecord of all the social events that take place among the nurses.This enables the nurse leadership to sponsor some of these events(Mendes &amp Stander, 2011). Through complaints and suggestions, thenurse leadership is in a position to learn about is going on amongthe staff members. For instance, a patient may report on how thenurses in one department are not communicating well or are exposingtheir disagreements on patient management in front of the patients.With such information, the nurse leadership can come up with ampledata enough data on employees’ engagement and offer solutions.Currently, the nurses in all the departments have clear records ofthe social events that take place among themselves on a regularbasis. The minutes of all the events that take place are recordedthus enabling the management to get the information that it may needin future. Nurses engage in Continuous Medical Education (CME) on aregular basis. CMEs helps the nurse managers to learn more about howthe nurses are interacting or engaging with each other since theyprovide an opportunity for the nurses to refresh and learn new skillsthat arise.



Theplan will focus on the areas of environment and organizationalvalues. Real Talk Sessions: In hospitals, real talk sessions offeravenues for discussing issues in private and strengtheningcommunication between nurses (Breevaart et al., 2013). The Engagementteam will plan and organize sessions that address the main issuesaffecting nurse’s performance in the hospital. The sessions will beconducted at least four times in a year. The main functions of thesessions will be cement the relationship between the nurses, ensurethat the nurses maintain confidentiality and create ways for goodcommunication among the nurses. This will enable the nurses to sharethe challenges they face in the course of their duties, to encouragecommunication among the nurses and to enhances skills transferbetween the senior and the junior nurses.

Managingby inspecting or going around the facility this will be the nurseleaders to get first-hand information on what is going on in theirorganization (Breevaart et al., 2013). The managers should make surethey go around the wards and all the hospital departments on thedaily basis. While going around the facility, the manager is in aposition to note mistakes and make recommendations where necessary.One on one communication with the nurses enables the manager to learnthe challenges faced by the nurses on their operations. The nurseleader’s presence also motivates them. Under such conditions, themanager should offer guidance. The manager should not be quick injudging situations it is good to watch and listen whatever is goingon before making any decision. The manager should also deliver goodnews when making rounds in the facility. He or she should inform thenurses of the positive achievements the facility is making out offtheir hard work. The nurse leaders should not always criticizewhenever he or she notes mistakes it is advisable to call the personwho made the mistake in a private room and informed him or her andfinally offer solutions.


OfferingIncentives: The leaders should present incentives to their workerswho show great performance and results. Before giving out incentives,then the manager should identify what makes his or her employeesmotivated (Nelson, 2012). Proper communication: Most the employeesprefer managers who talk to them or delegates duties in a polite way.Employees are always ready to listen to and follow instructions froma friendly manager. Harsh and rude managers are likely to face muchopposition from the workers. Trust: As a leader, one should createtrust between him and the employees. It is important to deliverpromises in time failure to which the employees will lose trust inthe manager. Trust encourages the workers to work accordingly evenwhen their leader is away. On the other hand, the manager should onlypromise what is possible to deliver otherwise the employees will losetrust. Timely delivery of promises builds trust between the workersand the manager thus creating a healthy working environment. Lettingthe staff make their Decisions: A good manager should appreciatepositive decisions from the employees and implement them. Thismotivates the employees even to work harder for better results. Somestaff members may come up with new strategies that can help grow theinstitution to higher levels. Teamwork: The manager should encourageteamwork among his or her employees. Teamwork leads to betterperformance. Teamwork also enables the employees to appreciateother’s effort and work even harder.


Bisbe,J., &amp Barrubés, J. (2012). The balanced scorecard as amanagement tool for assessing and monitoring strategy implementationin health care organizations. Revista Española de Cardiología(English Edition), 65(10), 919-927.

Breevaart,K., Bakker, A., Hetland, J., Demerouti, E., Olsen, O., &amp Espevik,R. (2013). Daily transactional and transformational leadership anddaily employee engagement. J Occup Organ Psychol, 87(1), 138-157.

Lawn,J. E., Kerber, K., Enweronu-Laryea, C., &amp Cousens, S. (2010,December). 3.6 million neonatal deaths—what is progressing and whatis not?. In Seminars in perinatology (Vol. 34, No. 6, pp. 371-386).WB Saunders.

Mendes,F., &amp Stander, M. W. (2011). Positive organization: The role ofleader behavior in work engagement and retention. SA Journal ofIndustrial Psychology, 37(1), 1-13

Pillay,T., Nightingale, P., Owen, S., Kirby, D., &amp Spencer, A. (2011).Neonatal nurse staffing and delivery of clinical care in the SSBCNewborn Network. Archives of Disease in Childhood- Fetal and NeonatalEdition, fetalneonatal-2011.

Staff,T. (2014). How an Increase in Employee Engagement Improves PatientCare. HealthcareSource from quality-patient-care/

Tooksoon,H. M. P. (2011). Conceptual framework on the relationship betweenhuman resource management practices, job satisfaction, and turnover.Journal of Economics and Behavioral Studies, 2(2), 41-49.