Abstract
BackgroundThe paper aims to review, design and implement a multidimensional performance measurement system for a public research hospital in order to address the complexity of its multifaceted stakeholder requirements and its double institutional aim of care and research.MethodThe methodology relies on a participative case study performed by external researchers in close collaboration with the staff of an Italian research hospital.ResultsThe paper develops and applies a customized version of balanced scorecard based on a new set of performance measures. Our findings suggest that it can be considered an effective framework for measuring the research hospital performance, thanks to a combination of generalizable and context-specific factors.ConclusionsBy showing how the balanced scorecard framework can be customized to research hospitals, the paper is especially of interest for complex healthcare organizations that are implementing management accounting practices. The paper contributes to the body of literature on the application of the balanced scorecard in healthcare through an examination of the challenges in designing and implementing this multidimensional performance tool. This is one of the first papers that show how the balanced scorecard model can be adapted to fit the specific requirements of public research hospitals.
Highlights
The paper aims to review, design and implement a multidimensional performance measurement system for a public research hospital in order to address the complexity of its multifaceted stakeholder requirements and its double institutional aim of care and research
The analysis of the existing Performance measurement system (PMS) of the research hospital The interviewees and the data collection highlighted that the Research hospital (RH) relied on a simplified PMS based on the following tools: strategic plan, annual report, budget plan, performance plan based on past and expected performance data
We present the results of the design and implementation of a multidimensional PMS in a public RH based on a case study conducted through a participatory approach
Summary
Each domain operates on different and contrasting principles, success measures, structural arrangements, and work modes, and can be seen as conflicting with each other [3]. This complexity is further enhanced by the wide range of clinicians It raises the need of measuring multiple performance dimensions to satisfy the interests of different stakeholders [5, 6] In this sense, the design of an effective performance measurement system that fosters information sharing and accountability, and that includes the selection of multiple measures for analysing results, is central. Performance measurement is especially useful for benchmarking, rewarding quality and efficiency [7] and helping professionals in evaluating clinical practice [8]
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