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Choi, Lim, Lee, and Kim: Development of Nursing Key Performance Indicators for an Intensive Care Unit by using a Balanced Scorecard
Original Article

J Korean Acad Nurs 2008;38(5):656-666.

Published online: 12 October 2008

DOI: https://doi.org/10.4040/jkan.2008.38.5.656

Development of Nursing Key Performance Indicators for an Intensive Care Unit by using a Balanced Scorecard

Yun Jeong Choi1, Ji Young Lim2, Young Whee Lee2, Hwa Soon Kim2

1Headnurse, Intensive Care Unit, Inha University Hospital, Incheon, Korea

2Professor, Department of Nursing, Inha University, Incheon, Korea

Address reprint requests to : Lim, Ji Young Department of Nursing, Inha University, 253 Younghyeon-dong, Nam-gu, Incheon 402-751, Korea Tel: 82-32-860-8210 Fax: 82-32-874-5880 E-mail: lim20712@inha.ac.kr

Received 30 April 2008       Revised 4 May 2008       Accepted 30 September 2008

Copyright © 2008 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC).

Methods

This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs.

Results

Two main visions of nursing service for ICUs were established. These were ‘realization of harmonized professional nursing with human respect’ and ‘recovery of health through specialized nursing’ respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC.

Conclusion

The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

Keywords: Employee performance appraisal, Intensive care unit, Indicator

References

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Figure 1.
Research process of this study.
jkan-38-656f1.tif
Table 1.
Nursing Visions of ICUs
Nursing Vision Statement of ICUs Validity score M (SD)
Preliminary 11 nursing visions of ICUs
 Differential nursing care based on teamworks 2.76 (0.36)
 Professional nursing related to patient’s recovery 2.93 (0.27)
 Scientific & professional nursing role player according to patient’s characteristics 3.23 (0.27)
 Support patients & their families’ quality of life based on human respect 3.03 (0.27)
 Leading domestic nursing cares of ICU based on creative educations & researches 3.10 (0.34)
 Serving specialized optimum level of nursing cares for patient’s health promotions 3.20 (0.39)
 ICUs based on trust between the staffs & patients and their families 3.10 (0.34)
 Realization of professional nursing with human respect 3.13 (0.61)
 Nursing with vitality 1.93 (0.25)
 Energetic nursing 2.00 (0.35)
 Nursing with clients 2.26 (0.48)
Final 2 nursing visions of ICUs
 Realization of harmonized professional nursing with human respect 4.00 (0.00)
 Recovery of health through specialized nursing 4.00 (0.00)
Table 2.
Nursing Practical Strategies of ICUs based on BSC
Perspective Practical Strategies Agreement rate (%)* Agreement rate (%)† Validity score M (SD)
Finance Offering and maintaining safe environment to prevent an accident/infection 100.0 100.0 3.44 (0.71)
Managing ward through efficient decision making 83.3 66.6 3.16 (0.80)
Improving outcome through participation in policy making on critical patient’s treatment 100.0 100.0 3.44 (0.51)
Customer Observation of ethic code/ethical nursing 100.0 6.6 3.40 (0.65)
Technical and smooth communication 100.0 6.6 3.56 (0.51)
Nursing with critical patient’s family 83.3 100.0 3.36 (0.64)
Creation of healing environment - 100.0 3.52 (0.51)
Internal business process Nursing provision using a nursing process 83.3 66.6 3.48 (0.51)
Improvement and accomplishment of evidence based nursing through the research/QI 100.0 100.0 3.48 (0.59)
Standardization and accomplishment of critical nursing principle/practice 100.0 66.6 3.68 (0.48)
Learning & Growth Development of nurse’s ability and career 100.0 100.0 3.64 (0.49)
Standardization of nurse’s skillful process and evaluation of practice ability 83.3 100.0 3.76 (0.44)
Completion of special nursing program/continuous education 83.3 100.0 3.44 (0.51)

* Rate of agreement for content validity of nursing practical strategies to achieve nursing visions of ICUs;

† Rate of agreement for classification validity of nursing practical strategies according to 4 perspectives of BSC.

Table 3.
Nursing KPIs of ICUs based on BSC
Perspective Key performance indicators Agreement rate (%)* Validity score M (SD)
Finance Application rate of an article, instrument and equipment 83.3 3.24 (0.52)
Maintenance rate of an adequate stock quantity 66.7 3.24 (0.52)
Reduction rate of prescription omission 83.3 3.25 (0.61)
Turn over rate of career nurse 66.7 3.08 (0.64)
Customer Performance rate of patient’s right 66.7 3.20 (0.65)
Patient/family’s satisfaction 100.0 3.56 (0.71)
Rate of hospital infection 66.7 3.42 (0.78)
Rate of medication error 83.3 3.44 (0.71)
Length of stay 66.7 3.20 (0.65)
N/A, not applicable Internal business process Number of problem solving using a nursing process 83.3 3.17 (0.64)
Number of nursing accident occurrence 83.3 3.42 (0.50)
Hours of direct nursing care 66.7 3.54 (0.59)
Number of standard development of nursing process 83.3 3.42 (0.65)
Number of patient accident occurrence 66.7 3.38 (0.58)
Rate of bed circulation 66.7 2.75 (0.79)
Error rate of malfunction of medical devices 83.3 2.87 (0.87)
Number of error and omission on nursing record 100.0 3.39 (0.58)
Learning & Growth Rate of in-service education participation 100.0 3.44 (0.64)
Rate of research participation 83.3 3.21 (0.59)
Nurse’s educational satisfaction 66.7 3.33 (0.82)
Hours of continuing education 66.7 3.00 (0.76)

* Rate of Agreement for classification validity of nursing KPIs according to 4 perspectives of BSC; KPIs=key performance indicators.

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