Decision Making in an Academic Department of Medicine: The Role of a Management Control System

Abstract

Academic Departments of Medicine have several challenges in managing resources, meeting academic goals and clinical demands. In this paper, we describe a management control system installed in 2014: the Strategic Plan, a Balanced Scorecard reflecting clinical research and educational performance, Annual feedback and review by Departmental and Divisional Chairs, and Improvement Plans.

This system over 8 years resulted in a reduction in 30-day re-admissions of 14%, a decline in length of stay of 0.55 days, and reduced absolute in-hospital mortality of nearly 2%. Clinical revenue increased 42% from 2016 to 2022 largely due to increased ambulatory and procedural volumes. Teaching time and ratings were unaffected by the installation of this system. Return on investment for newly hired researchers and scientists was 67.5% with a 12.7% increase in peer-reviewed funding. We conclude that the Decision Management Control System was feasible to create and allowed capable monitoring of performance and informed decision-making. Major metrics improved after its implementation.