HSD31 Analysis of the Balanced Scorecard's Managerial Subdimensions in Health Care Organizations During the COVID-19 Pandemic

Abstract

We intended to review all the managerial subdimensions used in balanced scorecard (BSC) implementations and then to assess the impact of the pandemic on the managerial subdimensions of health care organizations (HCOs). We performed a systematic review in accordance with PRISMA guidelines to find all internal key performance indicators (KPIs) used in BSC implementations from the time of inception until October 2020 in PubMed, Embase, Cochrane, Google Scholar databases, and Google's search engine. Second, we searched for independent studies using the resulting managerial subdimensions with the COVID-19 keyword in Google engine and Google Scholar until June 2021. Out of 4031 studies, 36 implementations remained. From these, 72 managerial KPIs were extracted. Categorizing KPIs resulted in 4 subdimensions: planning and targets, standards and regulations, internal assessment, and external assessment. Hospitals utilized some of these subdimensions’ KPIs to perform planning and internal assessment of their performance. The CDC developed a checklist to help hospitals assess and improve their preparedness for responding to COVID-19. However, insufficient standardization of quality measurement approaches in the COVID-19 era was perceived, which disrupted the comparison and understanding of health systems’ optimal performance. The lack of standardization and conflicting or irrational managerial decisions were deemed dissatisfactory factors for health care workers in the pandemic. Moreover, few studies have examined centralized governance's impact on HCOs during the pandemic, which positively affected reactive strategies. Learning from past pandemics was suggested to may positively influences proactive and reactive strategies. However, the role of internal assessment, such as BSC and total quality management tools, or external assessments, such as Joint Commission International accreditations, certification, auditing, or peer review on HCOs during the pandemic, still requires more investigation. Future research to improve the performance of the managerial subdimensions during the pandemic, as well as a comprehensive assessment for HCOs is still needed.