Developing an Integrated Scorecard
Developing an integrated scorecard combining health status and functional level model with the balance scorecard involved identifying the key processes in the organization wherein there will be a logical fit between two models which are traditionally considered as separate entities.
From the review of current literature on balance scorecards, the researcher had isolated the more significant models reflective of the current thinking in business organisations and from the findings from the three cases, the health indicators which have proven significant in the experiments conducted was integrated in coming up with a version of a combined effective workforce and human productivity equation. The method of evaluation used in this part of the paper make use of four broad categories of indicators: potential, constraints, gaps and value of the particular model with respect to the task at hand.
5. 2. The Choice of Model to Evaluate The choice of model to evaluate was based on the criteria of significance, completeness and compatibility of the model with the basic premises of health status and functional level models. Of all the models reviewed, the Third Generation Balance Scorecard Model (Kaplan) was the most expansive taking into consideration all the business and personnel factors including financial, customer
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One potential of the model to accommodate health and functional factors is its recognition of the importance of the feedback loops or its being systematic and integrative in approach. This means that change and innovation is inherent in its construction. To any organisation adhering to this model, it would not be difficult to stress the need for expansion of the model to integrate health and performance consideration. The model represented the complexity involved in a business organisation, the dynamics between the workforce and the demands of operation.
More important, the model recognises the need for a motivated and prepared workforce, making it a fundamental premise. It is in this fundamental premise wherein we can anchor the health and performance models analysed in the previous survey and three cases. 5. 4 . Integrating conceptual models It would not be difficult to appreciate that a business organisation though it has division of labor and responsibilities is still made up of interacting people wherein basic psychosocial dynamics are operative.
At the conceptual level, health and fitness could be interpreted as parallel to the business organisation. The psychosocial factors could be best represented by two models – the Fitness Integrated Therapy Model and Transtheoretical Model of Change while the performance in a context of a business organisation could be represented by the Third Generation Balance Scorecard Generic Strategy Map (Figure 15). Psychosocial factors are operative at all levels and at all concerns of the organisation, though often times it is not tacitly illustrated or is missing from most models.
But it we treat health and functionality as a program or even a strategy or a perspective, it becomes easier to situate it with the scorecard model, as part of the model and not only a parallel or supplementary concept. Parallel Models : Priority Reasoning Figure 14: Parallel models, ecological, psychosocial and organisational 5. 4. 1. Psychosocial Factors The psychosocial models combined looked at a human being from physiological to the realms of motivation and values. The Fitness Integrated Therapy model ( Burke, 2001), see Figure 12.
The second model is the Transtheoretical Model of Change ( Prochaska, Norcross and Diclemente, 1994), see Figure 13. Fitness Integrated Therapy Model EXERCISE LIFESTYLE ADJUSTMENT POSITIVE PHYSICAL CHANGE IN THINKING CHANGE PATTERNS & EMOTIONS IMPROVED QUALITY OF LIFE POSITIVE BEHAVIOURAL CHANGES
Figure 12 : Illustrates the fitness integrated therapy, highlighting the importance of both physiological and psychosocial factors in behavioral changes. (Burke, 2000) In fact, research claims that in each organisation, only ten percent of employees will be consistently in the active, and maintenance stage of exercise ( O’Donnell, 2000) . So it is essential to consider the other ninety percent. This means that if you are offering an intervention of just an exercise program, then you are only meeting the needs of ten percent of the employees.
Therefore, based on this model the program consists of coaching and mentoring, wellness clinic, as well awareness and motivational lectures, educational materials, self development and effective communication lectures, to meet the needs of the ninety percent. The program also included the other action orientated strategies for the ten percent , i. e. : time and stress management, as well as onsite stair climbing, walking meetings, yoga, tai chi, pilates, circuit classes, stretching and exercise fitness classes, etc. Based on the fitness integrated model , the measurements for the study included both physiological and psychosocial factors.
Transtheoretical Model of Change Pre contemplation Ignorance is bliss Relapse Lost the plot Contemplation Sitting on the fence Maintenance Walking the talk Preparation Testing the waters Action Taking the plunge Figure 13: Illustrates the Transtheoretical Model of Change – reflecting the behavioral factors of change. (Prochaska , Norcross, and DiClemente, 1994) The physiological measurements used in the study included body weight ( body mass index), bioelectrical analysis measurements of intracellular water, extracellular water, fat percentage, lean body mass percentage and basal metabolic rate.
For more details on bioelectrical impedance analysis see Appendix 1. The Quality of Life and Lifestyle Factors are measured using the SF36 questionnaire. The reliability and validity of this questionnaire has been well assessed and normative data exists (NIH, 1994; Jenkinson et al, 1993). 5. 5.. Validating the Measures used in the Integrated Model From the current research findings the hypothesis of each case study can now be accepted. It is evident that onsite workplace wellness programs do provide significant (p= <0. 05) improvements in both the physiological and psychosocial aspects of employee health, contributing to productivity.
Also, that high risk and high demand occupational groups do require a high level of work fitness and health status so as to maximize the firefighting skill set (p= <0. 05) . These hypotheses now form the statistically significant foundations from which the health productivity balance scorecard can be developed from. Revisiting the two main questions that were developed from the literature review and addressed in the research chapter of this thesis involved: the limitation in many scorecards is that many of the measures and indicators selected at an operational level are not the correct ones.
If they are incorrect they will not align with the strategy of the organisation . Therefore the question being what physiological and psychosocial indicators should be included in the health productivity management scorecard. As researched in case study one . The second question involved : investigating theoretical evidence to strengthen and support the causal relationship in organisations that healthy and functional employees , improve productivity , the final outcome being improved organisational profitability.
Therefore the question being does workforce fitness and health status maximise both skill set and work knowledge the effective workforce equation. EWF = f ( OS+OL) (BS+BL) x f ( WHS+WFL). As researched in case study two and three. 5. 6. The Particularity of Health & Productivity Programs The Particularity of Health & Productivity Programs in relations to accepted measures, needs to be addressed. As seen in figure 15, the summary of the results from the current research , that is of interest to business leaders when developing and implementing a productivity strategy includes : workplace wellness programs do provide significant (p= <0.
05) improvements in both the physiological and psychosocial aspects of employee health. There are statistically significant decreases in cholesterol, and improved cardiac function .. There are statistically significant findings in the interventional group of improvement in productivity, showing a decrease in the productivity of the control group. There is a cost saving in healthcare due to the reduction of upper limb injuries( P=0. 000) . There is improved self efficacy in the participation of job injury prevention practices (P= 0. 003).
In high demand and risk occupations, such as firefighting , health status and functional level of employees has the highest impact in performance on the job, compared with knowledge and skill set ( p=<0. 05). When employees have a health risk of either increasing age, smoking history, or overweight there are statistically significant reductions in performance ( especially in high risk, high demand occupations) ( p=<0. 05). Employees, from the high demand, high strain group, that have high health risks such as hypertension or obesity also have a decreased performance ( p=<0. 05).
Employees from the high demand, high strain group , that have diseases such as diabetes and hypertension also have a decreased performance ( p=<0. 05). Each case study supports the cause and effect relationship between workforce functional level, and workforce health status and productivity. These results assist in the control and application of the health productivity management scorecard, as seen in figure 15 . There is also a challenge about the sufficient and necessary causation between the skill set and the motivation to work, compared with workforce fitness level and workforce health status and productivity.