Danish Municipality Århus Kommune

Less bureaucracy and better target follow-up using SAS®

In the future at Århus Kommune – the Municipality of the city of Århus, Denmark – managers at all levels of elderly care centers will be able to create an overview of key performance indicators (KPIs) and fulfill management objectives with less manual work involved. Using this approach, it is possible to adapt and target efforts continually because all members of the staff have adopted a much better management method using a balanced scorecard.

"Without doubt, the focus among local authorities nowadays is being placed upon target management and the ability to follow up the targets. In the health and care sector in the Municipality of Århus, the Town Council has established a range of objectives that we must strive toward," states Carsten Nykjær, the departmental manager of the city government's third department of the Municipality of Århus.

Over a number of years, the municipality has built up a large data warehouse that supplies its contents to the municipality's management information system. In order to follow development within areas of political aims, environmental and energy-related aims, financial aims and personnel aims, the municipality chose in the autumn of 2000 to introduce a balanced scorecard in the health and care sector. The system is a result of support from the Ministry of Social Affairs, which, in connection with a project to improve quality in home care, allocated funds for this endeavor, among others.

"The reality of a modern municipality means that we are moving away from simply measuring performance against hard financial key objectives," says Nykjær. "Particularly in regard to the care for the elderly (included in our balanced scorecard), we only obtain a realistic picture of the situation if we give consideration to soft values such as satisfaction among the elderly with our services and the staff's satisfaction with their work."

"The aim behind our balanced scorecard is quite clear – for the members of the staff at the local centers to spend less time on bureaucratic work and more time on their actual work tasks, namely caring for the elderly. A range of important conditions can, in fact, be made clear and be documented without a large manual input, enabling the work to be more targeted," adds Nykjær.

Increased Focus
When the municipality's balanced scorecard has been fully implemented, about 300 people will have access to the extensive information it contains – all the way from the councilor with responsibility for the care of the elderly sector through the departmental managers in the city government's third department, to the area manager and other leaders of the municipality's 36 local centers that are engaged in the care of the elderly.

"The balanced scorecard affords us an entirely new and comprehensive picture of our daily work in the local centers. In contrast with the previous situation, we are now able to focus upon potential problem areas. Also significant is our ability to compare ourselves with other local centers," says Hanne Juul-Madsen, the manager of the Hørgaarden local center.

Within the four focus areas, the municipality has defined a range of objectives and sub-objectives, all of which are to be met. In order for users of the balanced scorecard to be able to identify potential problems quickly, each objective is marked with green, yellow or red, depending upon whether the objective has been achieved or whether there are grounds for immediate reaction.

"In addition to our becoming aware of possible problem areas, we also have the opportunity to examine what is causing the problem or anomaly. For example, it is conceivable that increased financial outlay is due to a larger number of elderly people requiring care, which can then be compensated for," says Juul-Madsen.

Considerable Preparation
"The establishment of a balanced scorecard is not a simple process. For the very reason that many municipalities are focusing upon decentralization and targeted management, we are often contacted by others who would very much like to adopt our solution. But they forget one important thing. The construction of a balanced scorecard requires thorough preparation. One must bear in mind that, long before the actual establishment of our balanced scorecard, we had already begun to discuss how the various strategies and objectives were to be formulated and measured in practice, in purely concrete terms," says Nykjær.

"And we are still not finished," emphasizes Nykjær. "It is a major mistake to believe that because one has obtained a balanced scorecard that represents the end of the process. A balanced scorecard is an ongoing and dynamic management method, rather than a one-time solution."

Because the Municipality of Århus built up its management information system using SAS Balanced Scorecard and had, in that connection, defined how the strategies of the health and care sector were to be measured, it took only a few weeks to develop the actual solution.

"Together with consultants from SAS, we held a weeklong workshop in the autumn of 2000, during which we defined our balanced scorecard. We subsequently designed the completed solution. The fact that it all proceeded so quickly is due to our data foundation in the data warehouse being in order and also to the process involving target definition having already been carried out," says Henning Pedersen, the office manager of the city government's third department.

He explains that the next step is to afford the users the means of analyzing the data. The idea is for the users, when they see a figure that is marked in red, to be able to click on to it and jump directly into the management information system, which is able to provide a more exhaustive explanation.

Some Growing Pains, Then Benefits
"To begin with, it was painful to be exposed in this manner. One must bear in mind that we were not used to being able to compare the local centers at lightning speed and see who was reaching their objectives. Sometimes one may possess knowledge that makes it appear unfair for an objective to be suddenly marked in red", says Juul-Madsen.

She explains that in connection with the financial objectives, the system makes a forecast that is based upon previous consumption, but that does not take into consideration the decisions that may already have been taken for the future of the local center. "We have established a forum in which all the local centers and representatives of the municipality regularly meet and where we also discuss these circumstances. In this way, we have the opportunity to talk about the causes of the development of the various effort areas and, together, arrive at a sensible conclusion," says Juul-Madsen.

"Our balanced scorecard has helped us in a wide range of areas. In particular, it affords us the means of gaining a better overview and to make comparisons across the length and breadth of the local centers. One major advantage is that we have the means of differentiating between the local centers so that not everybody is tarred with the same brush. One may say that we have obtained a tool that affords us a more carefully shaded picture of our working day – an efficient management tool that, in the years to come, will become even better," adds Nykjær.

"With our balanced scorecard, we are far better able to follow up with regard to whether or not we achieve our aims in the health and care sector," concludes Nykjær:

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