Details

Autor(en) / Beteiligte

• Bassani, Gaia
• Leardini, Chiara
• Campedelli, Bettina
• Moggi, Sara

Titel

The dynamic use of a balanced scorecard in an Italian public hospital

Ist Teil von

• The International journal of health planning and management, 2022-05, Vol.37 (3), p.1781-1798

Ort / Verlag

England: Wiley Subscription Services, Inc

Erscheinungsjahr

2022

Link zum Volltext

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Purpose This paper aims to analyse the dynamic use of the balanced scorecard (BSC) in an Italian public hospital. Design/Methodology/Approach A longitudinal case study was conducted at an Italian public teaching hospital over a period of 5 years. The emergence of dynamic use of BSC was traced over a different combination of social, political, economic and organizational realities. A deeper understanding of these realities requires the adoption of a holistic approach to BSC use. Henri's types of system use (i.e., monitoring, attention focussing, strategic decision‐making and legitimizing) frame this approach in a more concrete manner. Findings This study adds to the debate on whether BSC is used for aspects other than monitoring in public contexts. The case study offers the first example of a legitimizing use of the system and a first longitudinal case study that traces a dynamic use of BSC: the use evolves from monitoring and attention focussing to monitoring and legitimization. Norms, political parties and top managers play a determining role in this process. Originality/Value Through a longitudinal approach, this study presents how BSC can be a dynamic tool steered by legitimacy pressures. The longitudinal study explores how social, political, economic and organizational context shape the implementation and the revision of BSC affecting the use of the tool by top managers. The browse of this dynamism is supported by Henri's type of use along with an in‐depth analysis of the BSC literature evolution in terms of its ‘static, dynamic and expected’ use. Highlights Performance management systems, such as balanced scorecard (BSC), should be understood in a holistic view, namely taking into account the interdependency between the design, the implementation, and the use of the systems and the interdependency between different systems operating at the same time in the same organization. How managers use BSC in hospitals changes over time. At an organizational level, a BSC could provide justification of actions and decisions as well as monitoring results, supporting strategic decision‐making processes and focussing attention on priorities. BSC is a pivotal lever that can be governed by hospital managers as a strategic management tool for facing legitimacy pressures.