Over recent decades many health care organisations have ‘modernised’ their management accounting systems by using the balanced scorecard (BSC). However, public health care involves multi‐dimensional goals and resolving conflicts of interest. The question is whether a management control system based on measurements is suitable in a health care context. Light can be shed on this question using a study of the application of a BSC over a ten‐year period at Högland Hospital. The study shows that the BSC and measurements of output and behaviour became a way of approaching unanswered questions about processes and quality development. Medical professionals with management responsibility, in co‐operation with medical professionals responsible for different specialities, determined measures and targets and the measurements were integrated into activity processes and affected activities.
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