1. Thomas Jefferson
University Hospitals
Industry: Healthcare & Education
Website: www.jeffersonhospital.org
CUSTOMER OVERVIEW
Established in 1825, Thomas Jefferson University
Hospitals (TJUH) are an integral part of the Jefferson Health
System providing services at five locations with 957 licensed
acute care beds across the Philadelphia region. TJUH has
been ranked by U.S. News & World Report among the
nation’s top medical centers in eight specialties and has
achieved MAGNET designation for superior nursing care.
Customer PROFILE
Philadelphia, PA
“We were looking for a partner who
had the software and experience to go
beyond automating what we had in Excel
and PowerPoint and could help us connect
metrics with accountability and action.”
- Ronald P. Burd
Executive Vice President for Strategy
and Organizational Development
In 2006, as a way to position the hospitals to successfully
address a rapidly changing healthcare industry, new
economic factors and impending health reforms, TJUH
held an internal review of its overall strategy and
performance programs. This review resulted in the
creation of a new culture-driven performance model that was
designed to focus the organization on core strategic value
areas, tie operations, budgets, and people to the strategy,
and help the system navigate a journey toward performance
excellence.
The organization chose to implement a Balanced Scorecard
performance management framework as a way to support
the new model and to help integrate various aspects of the
model into the organization. As a first step, a small team
of senior leaders created a top-level Scorecard using the
organization’s five strategic value areas (Quality and Safety,
Service, People, Finance and Operations, and Growth) as
the Scorecard perspectives and then defined key high-level
strategic objectives and metrics within each perspective.
This initial Scorecard was presented to 50 vice presidents
and senior directors who suggested more than 90 projects
that they felt would address various under-performing
metrics on the Scorecard.
Plymouth Meeting, PA | San Francisco, CA | info@activestrategy.com
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BACKGROUND
While these high-level projects were now more clearly
defined and better aligned than ever before, it was
obvious from the sheer volume of proposed work that
some different approaches would be required to close
the gaps and achieve organizational goals.
TAKING THE NEXT STEP
Though the team that had developed the first Scorecard
at TJUH recognized that performance management tools
alone would not guarantee favorable results for the
long term, there was a strongly held belief that these
tools and processes, when placed in the context of an
overall performance model, deployed effectively, and
supported by strong leadership at all levels, would drive
significant benefit. So they set out to find external
resources that could support their efforts.
Late in 2008, the TJUH team learned of ActiveStrategy,
an organization that provides performance excellence
consulting and performance management software
called ActiveStrategy Enterprise® (ASE). TJUH found
that ActiveStrategy offered the solution they were
seeking to align efforts supporting their strategic values,
develop a common view of key metrics and initiatives,
and drive accountability across the organization.

2. Customer PROFILE
Plymouth Meeting, PA | San Francisco, CA | info@activestrategy.com
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ActiveStrategy began working closely with the hospitals’
executive leadership and the hospitals’ designated Strategic
Value Champions to build and automate Performance
Dashboards and Scorecards. In parallel, hospital
performance improvement teams were trained in Six Sigma,
Lean, Work-Out, and CAP performance excellence
methodologies.
The initial top-level Scorecard that had been developed by
the small core team has now been expanded into an
increasingly solid network of linked, cascaded Scorecards
that are automated in ASE. This framework has been
developed with feedback from 85 senior leaders,
performance improvement leaders, and change agents,
as well as substantial contributions from nearly 300
different staff members. All TJUH employees are
encouraged to view the Scorecards in real time, using
links to ASE posted on the hospitals’ intranet. This wider
participation in the process is an important part of ingraining
the culture-driven performance model.
A project scoping process has also been implemented to
develop projects that support positive results in measures
that are most critical to achieving the hospitals’ goals. The
TJUH staff leverage the project management capabilities
within ASE to help standardize the improvement processes,
monitor progress, and communicate results. For example,
several projects were put in place to improve the hospitals’
“Length of Stay” measure. These were tracked in ASE so
that any impact on the outcome measure could be
monitored. Over the course of two fiscal years, this key
operational indicator improved by 8% and the hospitals
continue to set more aggressive targets in this and other
strategically-aligned areas. In fact, the hospitals recently
added a benchmark comparator to some of the key
measures it tracks in ASE, allowing TJUH to see how
performance matches up to best-in-industry results.
ASE Stoplight Charts, Program Groups, and Measure Detail
pages are being used in conjunction with existing resources
to produce visually compelling, accurate reports on their five
key service line areas. A “Results and Outcomes” report is
also in the works to serve as a repository for tracking key
operating indicators related directly to the pursuit of TJUH’s
goal of achieving excellence in organizational performance.
Another dashboard they created in ASE helps leaders
monitor overall readiness for accreditation in specific
programs, helping the hospitals address any issues much
more proactively than before.
Example of a Stoplight Chart in ASE
*Data for illustration only*
RESULTS
In addition to the progress noted in the hospitals’ Length of
Stay measure, dozens of other key measures from MRSA
infection rates to HCAHPS metrics have shown significant
improvement. The hospitals have also seen over $7 million
in reduced expenses as a result of the overall model and
performance improvement efforts. Organizational alignment
has also improved dramatically. In 2009, for the first time
ever, TJUH was able to tie goals for over 250 leaders and
managers specifically to the organizational Scorecard goals.
In 2010, TJUH was recognized for its level of proficiency by
the Keystone Alliance for Performance Excellence (KAPE),
which is Pennsylvania’s state-level performance excellence
organization. The feedback report from KAPE cited the
hospitals’ use of ASE software as one of the organization’s
most significant strengths. The report praised the fact that
“data for Balanced Scorecard metrics are collected from
various sources utilizing an integrated software suite that is
also used to report Balanced Scorecard metrics to all
management levels.” This was the first time TJUH had
applied for the award and to be recognized at this level was
a significant step on its continuing journey toward
excellence.