Document Type : Original Article

Authors

• . Ahmad Reza Raeisi
• . Mohammad Hossein Yarmohammadian
• . Roghayeh Mohammadi Bakhsh ¹
• . Hamid Gangi ²

¹ Department of Health Services Administration

² Al-Zahra Academic Medical Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Growth and development in any country’s national health system, without an
efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the
system’s goals. The balanced scorecard (BSC) is a technique widely used to measure the
performance of an organization. The basic core of the BSC is guided by the organization’s
vision and strategies, which are the bases for the formation of four perspectives of BSC. The
goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in
Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods:
This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic
Medical Center in Isfahan University of Medical Sciences in 2011. The research populations
were hospital managers at different levels. Sampling method was purposive sampling in which
the key informed personnel participated in determining the performance indicators of hospital
as the BSC team members in focused discussion groups. After determining the conceptual
elements in focused discussion groups, the performance objectives (targets) and indicators
of hospital were determined and sorted in perspectives by the group discussion participants
. Following that, the performance indicators were calculated by the experts according to the
predetermined objectives; then, the score of each indicator and the mean score of each
perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by
the participants in the focus discussion group included five strategies, which were customer
satisfaction, continuous quality improvement, development of human resources, supporting
innovation, expansion of services and improving the productivity. Research participants also
agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community
perspective (customer), two objectives and three indicators were agreed upon, with a mean
score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed  upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives
and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial
perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%.
Conclusion: One way to create demand for hospital services is performance evaluation by
paying close attention to all BSC perspectives, especially the non-financial perspectives such
as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the
hospital managers improve their performance indicators. The learning and growth perspective
obtained the highest score, and the financial perspective obtained the least score. Since the
learning and growth perspective acts as a base for all other perspectives and they depend
on it, hospitals must continuously improve the service processes and the quality of services
by educating staff and updating their policies and procedures. This can increase customer
satisfaction and productivity and finally improve the BSC in financial perspective.

Keywords

• Balanced scorecard
• conceptual elements
• indicators
• performance evaluation