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

Author

Listed:
  • Gaia Bassani
  • Chiara Leardini
  • Bettina Campedelli
  • Sara Moggi

Abstract

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.

Suggested Citation

  • Gaia Bassani & Chiara Leardini & Bettina Campedelli & Sara Moggi, 2022. "The dynamic use of a balanced scorecard in an Italian public hospital," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(3), pages 1781-1798, May.
    • Handle: RePEc:bla:ijhplm:v:37:y:2022:i:3:p:1781-1798
    DOI: 10.1002/hpm.3440
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    References listed on IDEAS

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    1. Deryl Northcott & Necia France, 2005. "The Balanced Scorecard in New Zealand Health Sector Performance Management: Dissemination to Diffusion," Australian Accounting Review, CPA Australia, vol. 15(37), pages 34-46, November.
    2. Henri, Jean-Francois, 2006. "Organizational culture and performance measurement systems," Accounting, Organizations and Society, Elsevier, vol. 31(1), pages 77-103, January.
    3. Simons, Robert, 1990. "The role of management control systems in creating competitive advantage: New perspectives," Accounting, Organizations and Society, Elsevier, vol. 15(1-2), pages 127-143.
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    1. Frida Betto & Alberto Sardi & Patrizia Garengo & Enrico Sorano, 2022. "The Evolution of Balanced Scorecard in Healthcare: A Systematic Review of Its Design, Implementation, Use, and Review," IJERPH, MDPI, vol. 19(16), pages 1-22, August.

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