Montefiore Medical Center Case Analsisy Sample College Essay

This paragraph discusses the evaluation of the balanced scorecard’s strengths and weaknesses in a specific organization, Montefiore Medical Center. It also provides a brief summary of Montefiore Medical Center, highlighting its establishment in 1884 as a home for chronically ill patients and its subsequent agreement to operate the patient care facility of the Hospital of the Albert Einstein College of Medicine in 1963.

Both hospitals remained separate with their own administrations for the next 13 years. In 1986, Montefiore faced severe management and financial problems, resulting in the selection of Dr. Spencer Foreman as the new president. Dr. Foreman created a new leadership team and divided Montefiore into two sectors: operations and corporate services. He also changed the hospital’s mission to prioritize patient care, teaching, community service, and research. By 1995, MMC, which included two acute care hospitals, 31 community-based primary care centers, a home care agency, and an annual operating budget of $1 billion, once again experienced financial problems. Dr. Foreman promoted Elaine Brennan to senior VP of operations at the acute care division of MMC to address the crisis situation. Ms. Brennan implemented standard functions and eliminated management positions. She formed a strategic management team composed of MMC management at all levels and introduced the GRIP set of strategic imperatives. Ms. Brennan also reorganized and decentralized the acute care center into five clinical care centers and three support centers. Finally, she introduced the Balanced Scorecard. This approach is briefly summarized by R.W.The Hilton of Managerial Accounting book describes a Balanced Scorecard as a model that evaluates business performance in terms of financial measures, internal operations, innovation & learning, and customer satisfaction. This model assists managers in monitoring staff activities and the consequences of their execution. In today’s ever-changing and competitive business environment, every organization requires a balanced scorecard to remain viable. The advantages of using a balanced scorecard for MMC include addressing increased competition, lower payment arrangements, unsatisfied patients, and a $57 million shortfall that occurred during MS Brennan’s tenure as senior vice president of operations.

Ms. Brennan believed that the medical center could overcome its financial difficulties by implementing a balanced scorecard. This approach would create strategic initiatives that adhere to best practices principles, ensuring that the center continues to provide population-based healthcare and develop centers of excellence. By aligning key performance measures with strategy at all levels of the organization, a balanced scorecard would give management a comprehensive view of the center’s business operations. Previously, the medical center had separate functional organizations for nursing, operations, and clinical care, with doctors receiving support from five separate centralized groups.

Ms. Brennan’s decentralization and implementation of the balanced scorecard will provide a focus for expanding market shares and developing more capacity. This will promote communication and understanding of business goals and strategies throughout all levels of MMC, enabling the transformation of these goals and strategies into actionable behaviors.

The introduction of a balanced scorecard at MMC will promote cooperation, teamwork, and ultimately lead to the success of the organization. Ms. Brennan’s promotion came at a time when MMC consisted of 2 acute care hospitals, 31 community based primary care centers, a home care agency, and an annual operating budget of $1 billion. With the implementation of the balanced scorecard, the performances of all levels within MMC can be more easily evaluated. Additionally, the balanced scorecard will stimulate creativity, foster the generation of beneficial ideas, enhance innovation, and provide strategic feedback. Strategic initiatives will be continuously measured and evaluated against both the organization’s standards and those of competitors. Brennan’s balanced scorecard uses a nation-state-city metaphor to assess patient satisfaction, the cost, quality, and cycle times of clinical and administrative processes, with financials being only 10% of the measures.

Drawbacks and limitations of a balanced scorecard for MMC: As Brennan’s balanced scorecard was developed using a nation-state-city analogy, with the nation symbolizing the acute care division, the states representing the five care centers & three support centers, and the cities representing specific services, product lines, and departments within each center, the evaluation and measurement of Balanced Scorecard performance would be subjective. Unlike quality levels, which can be quantified, the assessment in this case would rely on surveys or management opinion.

Each manager at the national, state, and city levels of the balanced scorecard architecture will need to evaluate their staff’s performance individually, creating their own performance and evaluation scorecards. This is because Brennan did not require standardization of all balanced scorecards. However, it is important to involve the people who will be measured and managed by the scorecard, as creating one without their involvement defeats the purpose. Dr. Ravikumar, chair of the surgery department at MMC, provides a clear example of this.

The department’s balanced scorecard was created by Dr Ravikumar without involving his staff. When he submitted it to his staff, he expected comments or feedback, but none were received. His staff didn’t understand the significance of the balanced scorecard and feared for their job security. In contrast, Charles Balancia, vice president of facilities support services, involved his staff in creating their balanced scorecard, resulting in the fastest development and implementation of their city-level scorecards. A balanced scorecard typically does not include direct financial analysis or risk management, and its goal selections usually do not automatically factor in variables such as opportunity cost calculations.

As Elaine Brennan, I would present the balanced scorecard program to Dr. Foreman by acknowledging that it is limited to the acute care division of MMC. I would also be aware that Dr. Foreman prefers using intuition, experience, wisdom, and data over relying on the balanced scorecard.

My approach to presenting the balanced scorecard to Dr. Foreman involves providing him with data that will convince him of its value across all levels of the MMC, not just the acute care division. For example, I will demonstrate that the scorecard has instilled discipline and focused us on the drivers necessary for enhancing our financial performance in the acute care division.

Thanks to the implementation of the balanced scorecard, the Acute care division’s inpatient shares have increased by 8% this year, surpassing our target by 1%. Additionally, there is a projected increase of 5% for the following year. This has allowed us to shift our focus towards our patients and services, ultimately gaining significant credibility as we generate measures that hold us accountable. References: HBS’s Montefiore Medical Center, by Robert S.

Kaplan; Noorein Inamdar * Chapter 1: pg. 9-11 and Chapter 10: pg. 427-433 of Managerial Accounting: Creating Value In A Dynamic Business Environment, by Ronald W. Hilton * Balanced Scorecard – Advantages and Disadvantages, available at Accessed on 10/21/2012. * Benefits from using the Balanced Scorecard, available at Accessed on 10/21/2012

Ow Does Priestley Show That Tension Is At The Heart Of The Birling Family

How does Priestley show that tension is at the heart of the Birling family. ‘An inspector calls’ is a book overflowing with tension. Tension is an enormously powerful device that a numerous amount playwrights, including, ‘J. B Priestley’ uses to produce suspense and a sense of +dness between characters. Tension is also used to catch the attention of readers and makes characters be prominent and stand out due to their action and the way they speak. It is imperative as it illustrates the emotions and feelings of the characters. Tension was portrayed in various different ways in, ‘Act one’ of the inspector calls.

Examples can be through stage directions, the structure and form of sentences, the usage of punctuation marks etc. Also there was tension between classes which caused conflicts and disagreements. All these will be explained in the following paragraphs. Arthur Birling, a prosperous manufacturer, was holding a family dinner party in either to celebrate his daughter’s (Sheila’s) engagement to a rich man’s son named Gerald. Into this cozy scene intrudes the harsh figure of a police inspector investigating the suicide of a young working-class woman.

Under interrogation, it seems like Sheila, Mr. Birling, and Gerald all played a part in this young girl’s life. Tension in the household are portrayed immediately at the opening of the play. The household is being described as, “substantial and heavily comfortable by not cozy and homelike” which illustrates that although the Birling family attempted to decorate their residence to a standard that is equivalent to the expectancy of those times with their class, they did not succeed to create a atmosphere suitable for a “homelike” feel .

The words “not cozy and homelike” portray a cold, unwelcoming and inhospitable atmosphere, which as you progress through the play, reflects the characters themselves. Thesaurus Another piece of stage direction that adds to the point of tension is the sentence describing the lighting of the atmosphere in the room. This quote is, “The lighting should be pink and intimate until the inspector arrives and then it should be brighter and harder. Due to the room having “pink” lighting on the scene of dinner, provides the first impression that the scene is relatively innocent and calm, but also gives a mysterious feel and a sense of anticipation and expectation. Also, the colour “pink” could represent peace, so it shows that the family would like to block catastrophic events from occurring. Then, as soon as the Inspector arrives, the lighting in the room becomes, “brighter” and “harder”. This corresponds with the change of mood that occurs as soon as the inspector is present.

The fact that the lighting becomes harsher and redder (which normally represents negative feelings such as anger) could reflect how the mood automatically changes in the room. The inspector is not wanted especially after an unexpected arrival. Another point is that when something becomes brighter, it normally causes a person to shut their eyes to avoid the sinister gaze of the light. This may infact represent the sinister gaze of the inspector and how he entered their lives so rapidly.

Link Between Health And Wealth

Wealthy individuals are noticeably more content with their lives compared to those who are poor. The inquiry that arises is the reason behind this phenomenon. One possible explanation is the contrast between the health statuses of the affluent and impoverished. Wealthier nations generally experience better health and life expectancy rates in comparison to poorer nations. Numerous thesis statements can be established to connect wealth with physical well-being. Firstly, developed countries have successfully addressed primary health care problems, resulting in superior health care resources that distinguish them from less affluent regions.

In less developed countries, the presence of diseases like malaria and diarrhoea, caused by contaminated water, persists. Pakenham (2004 Pg42) asserts that approximately 80 percent of all illnesses are caused by contaminated water and inadequate sanitation. Conversely, wealthier nations face incurable diseases such as cardiovascular diseases (CVD) and cancer. The privileged individuals in affluent societies have access to a variety of options to protect themselves from basic illnesses, including proper vaccines and medications.

Rich individuals have the opportunity to attend fitness clubs and eliminate any excess calories and fats from their bodies, unlike the poor who lack knowledge about these concepts. In wealthier nations, improved awareness programs have somewhat controlled the prevalence of HIV and AIDS. However, in developing countries where funds are insufficient to conduct such programs, the issue of HIV and AIDS is rapidly escalating. Pakenham (2004 Pg45) states that in 2003, approximately 38 million people in developing countries were living with HIV/AIDS, accounting for 90% of all global infections. Additionally, the costs of treating major illnesses directly impact one’s overall health.

In developing countries, medical centers provide healthcare for major illnesses like cardiovascular diseases and cancer. However, these services are costly for the average person. These medical centers follow western traditions and adopt a similar approach to treatment. Pakenham (2004 Pg45) states that developing countries prioritize disease treatment after it has already developed, following the Western model. Therefore, improved medical facilities result in enhanced physical health.

Despite the belief that good physical health is tied to wealth, there are counterarguments. One such argument is that diabetes affects both rich and poor individuals regardless of their economic status. The treatment for this disease is similar for affluent and less privileged people alike. Furthermore, developing countries are striving to fight diseases like polio by providing equal access to vaccines for all. Several developing nations have already demonstrated the effectiveness of primary health care programs.

Pakenham (2004 Pg47) states that Cuba eradicated polio in 1972, preceding the United States. The notion that wealth and health are linked implies that affluent individuals generally enjoy better healthcare, resulting in longer and healthier lives. Conversely, impoverished individuals encounter difficulties in accessing even fundamental medical care.

The link between wealth and physical health is emphasized in the conclusion (Pakenham, 2004). Muhammad Furqan Khalid (FQ), a student in the Foundation Business Economics with Accounting course at INTO City University London, discusses this connection. The information was provided on November 30th, 2011 by Julian Ridler, the teacher of group FB2C.

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