Scoping review of balanced scorecards for use in healthcare settings: development and implementation

Diane V. Lacaille · Claire E.H. Barber

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Accounting and Organizational Management Healthcare Quality and Management Patient Satisfaction in Healthcare

Abstract

OBJECTIVE: Balanced scorecards (BSCs) were developed in the early 1990s in corporate settings as a strategic performance management tool that emphasised measurement from multiple perspectives. Since their introduction, BSCs have been adapted for a variety of industries, including to healthcare settings. The aim of this scoping review was to describe the application of BSCs in healthcare. METHODS: Medline, Embase and CINHAL databases were searched using keywords and medical subject headings for 'balanced scorecard' and related terms from 1992 to 17/04/2020. Title and abstract screening and full text review were conducted in duplicate by two reviewers. Studies describing the development and/or implementation of a BSC in a healthcare setting were included. Data were abstracted using pilot-tested forms and reviewed for key themes and findings. RESULTS: 8129 records were identified and 841 underwent a full text review. 87 articles were included. Over 26 countries were represented and the majority of BSCs were applied at a local level (54%) in hospital settings (41%). While almost all discussed Kaplan and Norton's original BSC (97%), only 69% described alignment with a strategic plan. Patients/family members were rarely involved in development teams (3%) which typically were comprised of senior healthcare leaders/administrators. Only 21% of BSCs included perspectives using identical formatting to the original BSC description. Lessons learnt during development addressed three main themes: scorecard design, stakeholder engagement and feasibility. CONCLUSIONS: BSC frameworks have been used in various healthcare settings but frequently undergo adaptation from the original description in order to suit a specific healthcare context. Future BSCs should aim to include patients/families to promote patient-centred healthcare systems. Considering the heterogeneity evident in development approaches, methodological guidance in this area is warranted.

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2006Using thematic analysis in psychology 2018PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation 1992The balanced scorecard : measures that drive performance 1997The balanced scorecard: Translating strategy into action 1992The balanced scorecard--measures that drive performance.2020Chapter 11: Scoping reviews 2019Chapter 11: Scoping reviews 2002Applying the Balanced Scorecard in Healthcare Provider Organizations

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