Strategic governance of integrated nuclear medicine, diagnostic radiology, and radiation therapy in comprehensive cancer centres: A balanced scorecard framework.

Healthcare organizations must integrate mission-driven values with financial metrics to govern AI systems. We propose the Total Mission Value (TMV) framework, drawing on insights from Balanced Scorecard, Quintuple Aim, and organizational mission priorities. TMV integrates five ethically grounded domains that define TMV in healthcare: Patient Care, Staff Experience, Operations, Economic, and Education and Research. TMV supports aligning AI implementations with healthcare's core purpose while maintaining economic sustainability.

This study aims to examine how integrating regenerative principles into a digitalised balanced scorecard (BSC) can support hospital resilience, sustainability and governance in contexts characterised by systemic complexity, recurrent crises and accelerated digital transformation. While sustainability initiatives in healthcare have traditionally emphasised harm reduction and operational efficiency, a regenerative perspective extends beyond mitigation by fostering net-positive environmental, social and organisational (ESG) outcomes. In this study, regenerative governance refers to practices that reinforce ecosystem stewardship, workforce well-being, organisational learning and adaptive capacity, thereby supporting long-term resilience and more integrated strategic decision-making. A comparative multiple-case study was conducted across three Portuguese public hospitals. Data collection combined semi-structured interviews conducted between April 2024 and January 2025 with senior executives and key functional managers, documentary analysis of strategic and sustainability reports and longitudinal performance indicators covering the period 2018-2023. This comparative and longitudinal design enabled identification of patterns in digitalisation practices, governance approaches and resilience-related capabilities, supporting interpretation of the BSC as a governance framework rather than solely a static performance measurement tool. Hospitals incorporating regenerative principles within digitalised BSC architectures appeared to exhibit comparatively stronger adaptive capacity, more structured ESG reporting practices and more consistent continuity of care during periods of disruption. Implementation challenges remain evident, including cultural resistance to change, fragmented information systems, resource constraints and uneven levels of digital maturity. Overall, findings indicate that hospital resilience is influenced not only by structural efficiency but also by governance capabilities that integrate sustainability principles, organisational learning and data-informed decision-making processes. The integration of digital data infrastructures with sustainability-oriented governance practices appears to be associated with stronger cross-departmental coordination, enhanced organisational learning and more structured crisis-response mechanisms. The study focuses on three hospitals operating within the same national healthcare system, which may limit transferability to institutional environments characterised by different regulatory structures, governance arrangements or funding conditions. Although the comparative design provides analytically rich insights, findings should be interpreted as theoretically informative rather than statistically generalisable. Future research may extend the empirical base through cross-country comparative studies, expanded longitudinal datasets and complementary quantitative modelling approaches to further examine the proposed regenerative digital BSC framework. Aligning BSC architectures with ESG-oriented metrics and digital performance monitoring systems may strengthen transparency, interdepartmental coordination and anticipatory decision-making. In practice, this integration may support earlier identification of operational vulnerabilities, more coherent allocation of resources and closer alignment between sustainability objectives and performance management systems. A digitalised BSC may facilitate continuous organisational monitoring, more timely responses to disruptions and stronger accountability structures. Embedding regenerative principles within governance systems may support a gradual transition from reactive crisis management towards more adaptive and learning-oriented organisational practices. The study highlights the potential social value of performance management systems that integrate digital intelligence and regenerative governance in healthcare. By embedding ESG indicators and workforce well-being into strategic decision-making, hospitals can enhance transparency, trust and social accountability. The proposed framework supports more inclusive and ethically grounded governance practices, contributing to improved quality of care and institutional legitimacy. However, broader social impacts depend on sustained policy alignment, organisational commitment and meaningful stakeholder participation beyond managerial levels. As patient and community voices were not directly included in the empirical data, the social implications identified here should be interpreted as enabling conditions rather than fully realised outcomes. Nonetheless, the findings suggest that digitally enabled and regenerative performance systems can strengthen the social role of hospitals within their communities over time. The study develops a governance-oriented perspective integrating regenerative principles with digital performance management within the BSC framework. Moving beyond conventional applications focused primarily on performance measurement, the study conceptualises the BSC as a dynamic governance mechanism linking sustainability, digital intelligence and adaptive organisational capabilities. This integrative perspective contributes to emerging debates on resilient healthcare governance and provides a theoretically grounded basis for future empirical research on sustainable health system transformation.

Circular supply chain partnership performance indicators in the paint and coating industry using a sustainable balanced scorecard framework

Institutional drivers and sustainability priorities in blockchain adoption for an emerging economy

A SBSC framework for wet roundwood storage logistics

This study presents a systematic literature review aimed at identifying and analyzing Key Performance Indicator (KPI) determination methods in the context of sustainability performance measurement. A total of 56 peer-reviewed articles published between 2011 and 2025 were examined across various sectors including manufacturing, supply chains, organizations, and urban areas. This study employed a Systematic Literature Review approach. This review categorized the literature based on three main dimensions: first, the Triple Bottom Line (TBL) domains of economic, social, and environmental; second, the object level of individual, organization, process, and sector; and fourth, the tools or methods used for KPI determination, including the Balanced Scorecard, Analytical Hierarchy Process (AHP), Performance Prism, and literature-based approaches. The findings indicate that most studies focus on the organizational and supply chain levels, using various approaches for KPI selection and weighting. Although some studies integrate all TBL domains, there is still a gap in comprehensive measurement of social and environmental aspects. This review provides an overview of methodological trends in KPI determination for sustainability and identifies opportunities for developing more contextual and integrated models in future research.

The article examines theoretical and methodological foundations of integrating cost management into the enterprise Balanced Scorecard system. The subject of the research is the development of a strategically oriented cost management system based on the use of financial statements and management reporting indicators. The study addresses the need to improve the effectiveness of cost management under conditions of limited information support, instability of the external environment, and the increasing role of strategic management tools in ensuring enterprise performance. The purpose of the study is to develop a methodological approach to integrating cost management into the Balanced Scorecard of an enterprise. The methodology includes a systemic approach, methods of economic analysis, comparison, generalization, and logical modeling. The analysis is based on financial statements and management reports of JSC “Ukrainian Energy Machines”. The study proposes a methodological approach to integrating cost management into the Balanced Scorecard system. This approach involves structuring cost indicators according to four perspectives: financial, customer, internal business processes, and learning and growth. A model of integrating cost management into the system of strategic performance indicators of the enterprise has been developed, which makes it possible to establish cause-and-effect relationships between resource use, costs and performance outcomes. The findings can be applied in the practical activities of enterprises in forming a strategically oriented cost management system based on financial and managerial data. The study shows that the proposed approach allows transforming financial reporting data into a system of strategic cost management indicators and improving decision-making quality. The results contribute to aligning the enterprise cost policy with its strategic development objectives and improving the efficiency of resource utilization.

ABSTRACT Universities face increasing pressure to demonstrate sustainability commitments while remaining competitive in global rankings and cultivating strong reputations. This study develops a sustainability-aligned governance performance framework for private higher education groups that integrates governance, reputation management, and stakeholder communication. Built on Balanced Scorecard theory, the framework was developed through focus group discussions and refined through two rounds of Delphi consultation involving fifteen experts (eight higher education scholars and seven institutional leaders). The resulting system spans 5 dimensions – finance, stakeholder satisfaction, internal processes, learning and growth, and organizational governance – and comprises 16 secondary and 50 tertiary indicators, which were finalized after expert evaluation and refinement through the Delphi consultation process. The Delphi results highlight governance transparency, stakeholder-oriented performance indicators, and sustainability-related metrics as core components of effective governance. A subset of indicators reflects sustainability across governance, finance, and social domains. This multi-stage design, which includes literature review, expert input, Delphi consensus, and indicator weighting, ensures methodological rigor and provides a structured basis for aligning sustainability practices with institutional performance and reputational positioning.

The need for robust performance evaluation frameworks in research laboratories has become increasingly critical. This study aimed to develop a comprehensive system for key biomedical research laboratories. To construct a scientifically validated and comprehensive performance evaluation indicator system for research management in key biomedical research laboratories based on the balanced scorecard framework. A mixed-methods approach was employed, integrating literature review, Delphi expert consultation (n = 17), and analytic hierarchy process (AHP). The initial indicator framework was developed through systematic literature analysis and refined through 2 rounds of Delphi consultation. The AHP method was used to determine indicator weights. Consistency was assessed using Kendall coefficient of concordance (W) and consistency ratio. The final evaluation system comprises 4 primary indicators (financial, customer/service, internal process, learning and growth), 12 secondary indicators, and 28 tertiary indicators. Expert consensus was achieved with W = 0.812 (P < .001) after 2 Delphi rounds. The AHP analysis yielded weights of 0.245 for internal process, 0.232 for learning and growth, 0.278 for financial, and 0.245 for customer/service perspectives. The consistency ratio (= 0.089) indicated acceptable consistency. The developed balanced scorecard-based performance evaluation system provides a comprehensive and balanced framework for assessing research management in key medical laboratories, emphasizing strategic orientation and sustainable development.

The intense competition among higher education institutions (HEIs) in Indonesia requires them to have a robust performance management system. This study aims to identify general performance management practices at HEIs in Indonesia, specifically at Widyatama University (UTama). This study is a qualitative study. Data credibility was tested using method triangulation. Data analysis employed content analysis and direct interpretation. The research data sources were scientific articles, secondary data, and primary data. The scientific articles were sourced from national and international journals. Secondary data consisted of strategic planning documents, quality manuals, and other related documents from several top universities in Indonesia. Primary data were collected through interviews with leaders and experts at UTama. The results of the study indicate that HEI in Indonesia and UTama already have a structured performance management system. Leaders and experts at HEI in general, and at UTama in particular, tend to choose or use the TWOS Matrix and the Balanced Scorecard (BSC) as part of their performance management system. The research results suggest that HEIs in Indonesia and UTama can create a combined performance management system using TWOS, BSC, Performance Prism, and Key Performance Indicators (KPIs) that meet both national and international criteria.

In the current conditions of increasing environmental awareness of society and stricter requirements for sustainable development, there was a need to transform the marketing strategies of agricultural enterprises. The aim of the study was to develop a comprehensive criteria scale for evaluating the effectiveness of green marketing strategies in the agricultural sector. The methodological basis of the study was formed by methods of system analysis, generalisation and classification. As a result of the study, an expanded multi-level criteria system was formed, combining economic, environmental and social parameters into a single integrated assessment model. A detailed list of indicators was proposed, covering resource efficiency, energy consumption, pollution levels, waste management, impact on soil and water quality, enterprise participation in social initiatives, interaction with communities and the level of environmental transparency. Traditional assessment systems, including Return on Investment, Triple Bottom Line and Balanced Scorecard, have been adapted to the context of sustainable agricultural production, making it possible to integrate quantitative and qualitative parameters into a common methodological platform. A step-by-step algorithm for the practical application of the criteria scale has been developed: identification of relevant indicators, their normalisation, determination of weighting coefficients, construction of an integral index and further interpretation of the results. The proposed scale makes it possible to identify structural imbalances between economic performance indicators and environmental or social impacts, form predictive assessments, and determine directions for optimising green marketing strategies. The practical significance lies in the possibility of using the developed scale to improve management decisions and increase the effectiveness of green marketing approaches of agricultural enterprises

This study proposes an AI-based model to predict corporate management performance by combining financial data with strategic information extracted from CEO messages in sustainability reports. Using a dataset of 1,271 listed companies on Korea's KOSPI and KOSDAQ markets (2016-2023), we applied eight machine learning and deep learning classifiers: KNN, SVM, GBM, CatBoost, GAN, RNN, LSTM, and Transformer. Financial variables were selected based on prior accounting research, while strategic variables were derived via text mining of CEO messages and categorized using the Sustainable Balanced Scorecard (SBSC) framework. Results show that models incorporating both financial and strategy-based variables outperformed those using financial data alone. Notably, the Transformer model achieved the highest predictive accuracy, followed by LSTM and RNN. These findings provide actionable insights for investors and corporate stakeholders while advancing interdisciplinary research between accounting and AI. Under 5-fold cross-validation, the best-performing hybrid model (Transformer with SBSC features) achieved Accuracy = 0.8467, AUC = 0.8481, and F1 = 0.8572, and adding SBSC strategy indicators improved mean performance across models (ΔAccuracy=+0.0121; ΔAUC=+0.0092; ΔF1=+0.0119).

Modern businesses achieve their objectives through non-physical assets which have become more important than their traditional financial resources. The chapter investigates Emotional Intelligence (EI) because organizations treat it as hidden organizational asset which generates both human capital and financial benefits. The study shows that EI builds organizational and personal capabilities through its main elements which include self-awareness, self-regulation, motivation, empathy, and social skills. The study uses theoretical and conceptual methods by uniting main management theories which include Human Capital Theory, Resource-Based View (RBV), Behavioral Theory of the Firm, and Social Exchange Theory to demonstrate how EI provides strategic value to organizations. The chapter investigates how EI affects financial performance through three pathways which include better decision-making, strong leadership capabilities, and higher employee satisfaction which leads to better customer relationships. EI enables better human value accomplishments because it helps people build better connections with others and facilitates group work while minimizing disputes and advancing staff mental health. The chapter recommends organizations to use multi-method assessments and HR analytics and balanced scorecards as strategies to measure Emotional Intelligence despite its difficulties in assessment because it exists as an intangible attribute.

This study aims to analyze the role of strategic management in improving the quality of Qur'an memorization in tahfidz programs at Islamic junior high schools (Madrasah Tsanawiyah) in Purbalingga from the perspective of the sociology of educational institutions. The research employs a qualitative approach with a multiple case study design at MTs Muhammadiyah 01 Purbalingga and MTs Ma’arif NU 05 Majasari. Data were collected through interviews, observations, documentation, and archival records, and analyzed using pattern matching, explanation building, and cross-case synthesis techniques. The findings reveal that the implementation of strategic management—covering strategy formulation, implementation, and evaluation—plays a significant role in enhancing the effectiveness of tahfidz programs. Strategy formulation through SWOT and PESTLE analysis helps schools comprehensively understand internal and external conditions. Strategy implementation supported by resource management and supervision using the Balanced Scorecard improves program execution. Meanwhile, periodic evaluation through monitoring systems and feedback loops enables continuous improvement in students’ memorization achievements. Overall, comprehensive strategic management enhances the quality of Qur'an memorization and fosters competitive advantage in Islamic education institutions.

Over the past four years, return on equity has declined and reached a low point in 2018 in the Kenyan Insurance Sector compared to the last five years. Additionally, during the same period, the expenditure ratio in the sector has grown from Kenya shillings 158 billion in 2016 to Kenya shillings 188 billion in 2020, indicating a rise in underwriting costs for general insurance without a corresponding increase in the premiums charged for these risks. This study analyzes the way in which strategic management processes impact the performance of organizations in 10 different insurance companies in Nairobi, Kenya. The types of strategic management processes that were assessed in this study included; environmental scanning, strategic planning, strategy implementation, and monitoring &amp; evaluation. The theoretical framework for this study included; Balanced Scorecard model/theory, Structural Contingency theory, and Institutional theory. Description research methodology was used. The research population was 10 insurance companies that were still operational in Nairobi City County as of 2024, with a total sample population of 2094 respondents from each of the 10 insurance companies. Stratified sampling method was used to sample the study the population. The sample size consisted of 209 respondents. The tool employed in collecting data was semi-structured questionnaire. Data analysis was done by employing descriptive statistical values like mean and standard deviation. Moreover, determination of relationship was achieved by using inferential statistics like regression and correlation analyses methods. Tables and figures helped in presenting findings. The study’s findings were that environmental scanning (β=0.0152, p=0.003), strategic planning (β=0.0264, p=0.003), strategy implementation (β=0.0331, p=0.004) and monitoring and evaluation (β=0.0412, p=0.003) had led significant improvement on the insurance companies’ performances. The conclusion was that environmental scanning of these companies had assisted in identifying the market and customer behaviors and these companies could tailor their products to respond to these changes appropriately. The companies had a good strategic planning which had enabled them to achieve clear and proper directions for improved coordination across departments and making the employees to focus towards achieving the same goals. Proper implementation of strategies had made these companies in effectively streamlining their processes, minimize redundancy and expenses. Continuous monitoring allowed these companies to monitor effectively their operations resulting to better decision making process and delivery of services. The proposed recommendation were that the insurance companies should look for more enhanced integration of technology for improved collection and procession of data. They should use data analytics to understand client behavior and market trends, enabling tailored products and services. Leadership must set clear, measurable goals to align teams and resources effectively. The companies should adopt tech platforms for real-time customer insights to improve decision-making.

The development of information systems and information technology (IS/IT) has significantly transformed higher education; however, inadequate strategic planning often leads to inefficiencies and environmental impacts, such as high energy consumption and electronic waste. Despite the growing importance of sustainability, existing IS/IT strategic planning approaches generally do not explicitly integrate environmental considerations, thus creating a gap between digital transformation and sustainability objectives. This study aims to develop an IS/IT strategic planning framework that integrates green IT principles within the Ward and Peppard methodology. A qualitative case study approach was applied at Akademi Farmasi Yarsi Pontianak using data collected through interviews, observations, and questionnaires. The analysis incorporated multiple frameworks, including the Balanced Scorecard, PEST, Porter’s Five Forces, SWOT, and Critical Success Factors. The results produced integrated IS/IT strategies that align organizational goals with sustainability principles, including the development of information systems, environmentally oriented IT infrastructure, and governance mechanisms that support green IT implementation. The findings indicate that integrating green IT into IS/IT strategic planning can enhance operational effectiveness while contributing to environmental sustainability. This study contributes by extending the Ward and Peppard framework through the explicit incorporation of environmental sustainability as a strategic dimension, providing a practical and replicable model for higher education institutions pursuing sustainable digital transformation.

This study examines the relationships between digital marketing, service quality, business strategy, and SME performance in the coffee industry in Lampung, Indonesia. This study employed a quantitative explanatory design, collecting data from 243 coffee SME owners through structured questionnaires and analyzing them using SEM-PLS. The results show that digital marketing and service quality significantly enhance SME performance, both directly and through business strategy. Digital marketing was found to have the strongest influence on business strategy, highlighting its role as a critical source of market intelligence and competitive advantage. Service quality also significantly contributes to shaping customer-oriented strategies. Furthermore, business strategy acts as a partial mediator, strengthening the impact of internal capabilities on performance outcomes. The model demonstrates strong explanatory power and good fit, confirming its robustness. The findings support the integration of Resource-Based View (RBV) and Balanced Scorecard (BSC) perspectives in explaining SME performance. Practically, the study emphasizes the importance of integrating digital capabilities and service quality into strategic planning to enhance competitiveness and sustainability in SMEs

Purpose: This empirical study examines the relationship between strategic entrepreneurship and institutional performance within the Saudi Public Investment Fund (PIF), with a particular focus on the mediating role of strategic leadership. The study addresses a gap in the literature by explaining how entrepreneurial orientations are translated into measurable performance outcomes in sovereign wealth funds. Design/methodology/approach: A quantitative cross-sectional research design was employed. Data were collected from a stratified random sample of 337 professional employees at different organizational levels within PIF. Strategic entrepreneurship was modeled as a second-order construct comprising entrepreneurial mindset, entrepreneurial leadership, entrepreneurial culture, strategic resource management, and creativity and innovation application. Institutional performance was measured using the Balanced Scorecard dimensions, while strategic leadership was conceptualized as a reflective construct. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS 4, supported by bootstrapping procedures. Findings: The results indicate a significant positive effect of strategic entrepreneurship on institutional performance. Strategic leadership was found to partially mediate this relationship, confirming its role as a key mechanism through which entrepreneurial capabilities enhance performance. The measurement and structural models demonstrated strong reliability, validity, and explanatory power. Originality/value: This study extends strategic entrepreneurship and leadership theories to the context of sovereign wealth funds and provides empirical evidence on the mediating role of strategic leadership in enhancing institutional performance. Practical implications: The findings offer actionable insights for policymakers and executives in sovereign investment institutions, emphasizing the importance of developing strategic leadership capabilities and fostering entrepreneurial practices to improve institutional performance.

ABSTRACT We examine how startups leverage open government data (OGD) to overcome resource constraints and enhance R&D. Using a case study of a South Korean startup, we investigate the development of BIC PM (Big Data Insight Customization Product Manager) – a data-driven platform integrating OGD with AI. This system enables the firm to streamline R&D, improve product validation, and accelerate market readiness despite its limited resources. We apply the Balanced Scorecard framework to assess the system’s multidimensional impact on R&D efficiency. Our findings show that BIC PM facilitates innovation, reduces development time and costs, and supports the launch of competitive products in South Korea. We demonstrate how startups can utilise OGD to build data-driven capabilities that enhance compliance, quality, and competitiveness. This study contributes to the literature by illustrating how public data infrastructure supports startup innovation, offering insights for policymakers to strengthen digital entrepreneurial ecosystems.