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Whatever is measured tends to improve. Keeping this in mind, Apollo Hospitals Group has devised and introduced ACE @ 25 – a balanced scorecard focusing on clinical excellence that addresses provision of evidence-based quality care, that offers safe environment to our patients and strengthens the functional efficiency of our hospitals, stimulating quality improvement while reducing variations.

Concept

ACE @ 25 is a clinical balanced scorecard focusing on clinical excellence, and incorporates parameters which are mission critical for the clinical milieu of our organization. Every parameter is benchmarked with the international institution that is considered best-of-class in the respective parameter. Benchmarks have been chosen from the world's best institutions including Cleveland Clinic, Mayo Clinic, National Healthcare Safety Network, Massachusetts General Hospital, AHRQ US, Columbia University Medical Center and US Census Bureau.

Methodology

For the purpose of ACE @ 25 reporting, the Group hospitals have been divided into three groups depending on their bed strengths, location and services offered as Group A, B and C. Each indicator has been lucidly defined and the numerators and the denominators have been clearly delineated. Benchmarking defines our Group expectations with weighted scores for the outcomes. The scoring system ensures that the segments measure up to a statistically significant range of figures which are further color coded as green, orange and red. The cumulative score achievable is capped at 100.

Architecture

The ACE @ 25 balanced score card has been developed online, with live capabilities using our Apollo Lighthouse platform for monthly inputs with relevant data, using the Dot Net architecture hosted out of a central server at one of our locations. The mechanism is so devised to maintain the integrity and confidentiality of data with respect to each of the Apollo Hospitals.

Few indicators are given below as examples:

Indicator Benchmark Range Score
CABG mortality rate 0.60% <0.80 4
Cleveland Clinic 0.81-1.2 3
  1.21-1.6 2
  1.61-2 1
  >2 0
Ventilator Associated Pneumonia (VAP) 0.9 <0.9 4
National Healthcare Safety Network 0.91-2.5 3
2012 2.51-4.1 2
  4.11-5.7 1
  >5.7 0

Implementation

The monthly summary of the performance is reviewed by the Oversight Committee and the individual hospitals draw action plans on improving scores in parameters that they are scoring low. Trends in scores in individual parameters are identified every quarter, every six months and annually. This helps in looking for consistency in good or poor performance, identifying improvement or decline and irregular fluctuations. Consistent low performance, decline or fluctuation in scores for any parameter becomes the focus area of the hospital and is aggressively worked upon for improvement.

Accolades

ACE@25 was chosen for presentation at the ISQua Conference, 2011 and Conference of the Royal College of Physicians, 2014. Besides this, it has also been published as a case study by the Richard Ivey School of Business and won the FICCI Healthcare Excellence Award 2011.

Outcomes tracking using ACE @ 25

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