The number of perspectives was likely reduced to further refine the focus of the scorecard and the performance measurement system. Too many perspectives and critical success factors could reduce the desired emphasis on key measures. The two perspectives, quality and process improvement, were combined in 2010, for this reason. Both of these perspectives were related to performance in meeting patients’ expectations through improved operations, and the combination of the two provide greater focus on operational improvement. The remaining four perspectives could be related to the conventional balanced scorecard in the following way: