“Balanced Scorecard – Regulatory Style” Jan Robinson, Registrar College of Physiotherapists of Ontario 2006 Annual ConferenceAlexandria, Virginia Council on Licensure, Enforcement and Regulation Expect the Unexpected: Are We Clearly Prepared?

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 2 Objectives Reasons for initiative Vision for Accountability Building the Scorecard Success and learning

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 3 Impetus Culture change External environment High performing organization

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 4 Regulatory organizations are public organizations entrusted to professions Trust is earned

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 5 One of Four Strategic Objectives To demonstrate public accountability through performance measurement.

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 6 Value for Public Accountability By 2007  Effective measurement system indicates College performance meets, exceeds or is “best practice”  Staff & Council quickly identify and resolve areas of concern  Evaluate & CQI embedded in culture

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 7 Vision for Public Accountability By 2007,  Stakeholders know performance versus targets  High level of accountability + higher trust relationships  New projects screened for performance impact  The College is in a leadership role

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 8 To demonstrate public accountability through performance measurement Indicators  Key measures are identified and monitored regularly  Programs set in an evaluation framework  Accountability results reported externally

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 9 Project Define what, why and how College will evaluate its performance.

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 10 Tactics Select evaluation framework and adapt it to regulatory environment Define and select “programs” Identify measures that demonstrate public accountability

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 11 Performance Measurement Balanced Scorecard selected 2004 Type:  Navigational – monthly, forward facing, internal focus

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 12 Quadrants of Balanced Scorecard StakeholderFinance ProcessLearning & Growth

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 13 Corporate Balanced Scorecard Governance Scorecard Operations Scorecard - Program Scorecard

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 14 Indicator Development Layers relevant to the role & function –Council - critical few for governance –CEO - higher level / global operations –Manager / Director – program details

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 15 Program Definition and Selection Entry to Practice Quality Management Professional Practice Professional Conduct

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 16 Rapid Scorecard Development Strategy Map & Definitions Core processes and current projects Indicator selection & collection process Templates for Reporting

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 17 To protect and serve the public interest by ensuring that physiotherapists provide high quality, competent and ethical services Register Competent Practitioners Assure Quality PT Practice v1 Use Resources Effectively Enforce Practice Standards Deliver Effective Registrant Resources Demonstrate Public Accountability Sustain a High Performance Standard Maximize Business Partnerships Ensure High Staff & Board Competence Leverage Technology Celebrate Collaboration & Innovation

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 18 Core Processes Process that is ongoing and relates to input, output and outcomes. 15 Core processes identified.

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 19 Projects & Activities Undertaken to close a performance gap Line up to domains on the strategy map Weighting and ranking process

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 20 CEO monitors themes monthly Customer service Case management Systems improvement Fiscal effectiveness Stakeholder engagement Program implementation Staff performance

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 21 CEO monitors monthly Volumes Workload trends Outcomes Variance

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 22 Examples of CEO Indicators Case management  initiation to disposition meets timeline  notice time met  # appeals  College decision upheld on appeal  timely posting on public register  remediation outcomes

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 23 Examples of CEO Indicators Stakeholder engagement  practice advice volume and quality  response to registrant material validation (#, satisfaction)  % electorate voting  # presentations requested / delivered

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 24 Staff report to CEO Monthly / quarterly Performance in identified areas Analysis & recommendation

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 25 Staff report to CEO What So What Now What

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 26 Table Format for Scorecard Indicator Title DefinitionTargetRational e ScoreAnaly sis 3 word title What is in / out Perform ance standard Rational e for standard How we did What So What Now What

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 27 Operations Scorecard Indicator Title DefinitionTargetRationaleScoreAnalysis Case Disposition # of cases closed within established standard for case type / all cases closed in quarter (aggregate view of Exec. Registration, QM, Complaints) Green- all compliant Yellow – 1 area not at standard Red- 2areas not at standard and / or 1 area not at standard 2 nd consecutive quarter or more Complaint with statutory requirement & high performance What: So What: Now What:

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 28 Rationale for Setting the Target  Statutory requirement  Council direction  Industry benchmark  Standard that reflects a high performance organization

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 29 Color Coding Green – fully compliant with target Yellow – 1 area not compliant with target; some concern Red – 2 areas not compliant; or 1 area not compliant for second quarter; recovery plan required.

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 30 Operations Dashboard Stakeholder INDICATORQ2Q3Q4Q1Q2

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 31 Corporate Balanced Scorecard Operations Scorecard Focused on operational activities Monthly to CEO & quarterly to Council Council receives compiled CEO & staff indicators Governance Scorecard Focused on governance activities Quarterly to Exec Com & Council Council receives all indicators

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 32 Accountabilities Operations Scorecard Council CEO CEO & staff Governance Scorecard Council President & Exec Committee CEO

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 33 Evolution Commitment to quality improvement Indicators can change Targets can change Active role working in partnership

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 34 Key Success Factors Key participants must understand performance measurement Critical few indicators Right discussion at right level Tools Integrate into day to day work life Buy in

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 35 Definition of Success The College of Physiotherapists is an organization publicly known for its strategic leadership in professional self- regulation. It is governed and staffed by a competent and capable team that thrives in best practice and accountability environment. The College is a model for others and partners are satisfied with its current performance and future vision.

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 36 Definition of Success (cont’d) The College is viewed as fair and cost effective within its mandate. Physiotherapists actively use the College resources in practice; the public consistently recognizes the College as advocating and investing in safe, quality physiotherapy practice.

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 37 Next Steps Complete one full year cycle Stakeholder consultation on reporting Full public reporting

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 38 Learnings Keep it simple consider key areas already reviewed. Be flexible “red is not “bad” Just get started

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 39 Resources  Kaplan, Robert S. and Norton, David – Having Trouble with your Strategy? Then Map it Harvard Business Review September – October 2000  Niven, Paul R. - Balanced Scorecard Step-By-Step for Government and Nonprofit Agencies (2003)  CCAFReporting Principles: Taking public Reporting to a New Level (2002)  Institute on Governance –  Ontario Hospital Association – Guide to Good Governance  Canadian Policy Research Network (CPRN)- Series of papers on Accountability in Health Care Website: http//  pm2 Performance Measurement and Management

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 40

Presented at the 2006 CLEAR Annual Conference September Alexandria, Virginia 41 Speaker Contact Information Speaker Name: Jan Robinson, Registrar Organization: College of Physiotherapists of Ontario Address: 375 University Ave. Suite 901 Toronto, Ontario, M5G 2J5, Canada Phone, Fax : / (fax) Website: