[Development and evolution of a balanced scorecard in primary health care: Lessons learned].
OBJECTIVE
To describe the design, implementation, and monitoring of eSOAP (Primary Health Care Balanced Scorecard) and its role in the deployment of strategic objectives and clinical management, as well as to show the lessons learned during six years of follow-up.


METHODS
Descriptive study areas: methodology (conceptual framework, strategic matrix, strategic map, and processes map), technology and standardisation.


RESULTS
As of December 2014, 9,046 (78%) professionals are registered in eSOAP. A total of 381 indicators were measured from 16 data sources, of which 36% were of results (EFQM model), 39.1% of clinical management, and 20% were included in the Program Centre Contract. The Balanced Scorecard has enabled to deploy all strategic lines of Primary Health Care, and has enabled the healthcare professionals to evaluate the evolution of results over time, and at patient level (e.g. 16% increase in control of diabetic patients). A total of 295,779 reports were generated and 13,080 professionals were evaluated by goals.


CONCLUSIONS
There was an increased use of the eSOAP application by the professionals. The Balanced Scorecard was the key in deploying Primary Health Care strategies. It has helped clinical management and improved relevant indicators (health, patient experience, and costs), such as the management models that we used as references (EFQM Kaplan and Norton), and new emerging scenarios (Triple aim).
Dirección Técnica de Procesos y Calidad, Gerencia de Adjunta de Planificación y Calidad, Gerencia de AP, Servicio Madrileño de Salud, Madrid, España. Electronic address: Elena.bartolome@salud.madrid.org.
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Bartolomé-Benito
Dirección Técnica de Sistemas de Información, Gerencia de Adjunta de Planificación y Calidad, Gerencia de AP, Servicio Madrileño de Salud, Madrid, España.
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Jiménez-Carramiñana
Dirección Técnica de Sistemas de Información, Gerencia de Adjunta de Planificación y Calidad, Gerencia de AP, Servicio Madrileño de Salud, Madrid, España.
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Sánchez-Perruca
Dirección Técnica de Sistemas de Información, Gerencia de Adjunta de Planificación y Calidad, Gerencia de AP, Servicio Madrileño de Salud, Madrid, España.
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Bartolomé-Casado
Dirección Técnica de Sistemas de Información, Gerencia de Adjunta de Planificación y Calidad, Gerencia de AP, Servicio Madrileño de Salud, Madrid, España.
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Dominguez-Mandueño
Dirección Técnica de Sistemas de Información, Gerencia de Adjunta de Planificación y Calidad, Gerencia de AP, Servicio Madrileño de Salud, Madrid, España.
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Marti-Argandoña
Dirección Técnica de Sistemas de Información, Gerencia de Adjunta de Planificación y Calidad, Gerencia de AP, Servicio Madrileño de Salud, Madrid, España.
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Hernández-Pascual
Gerencia de Adjunta de Planificación y Calidad, Gerencia de AP, Servicio Madrileño de Salud, Madrid, España.
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Miquel-Gómez
D019985:Benchmarking / Q000379:methods*; D019468:Disease Management; D006801:Humans; D009937:Organizational Objectives; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000379:methods; D013030:Spain
Atención Primaria; Balanced scorecard; Cuadro de mando integral; Health; Healthcare; Primary Health Care; Salud; Sanidad