Designing a balanced scorecard for an eye clinic : a case study

Abstract

Purpose: Considering the intricate nature of healthcare organisations and the critical impact of performance on patient health, a robust performance measurement system (PMS), such as the Balanced Scorecard (BSC), is imperative. Therefore, the primary aim of this research was to design a BSC, along with a Strategy Map, specifically tailored for a private eye clinic in Malta. In order to establish a solid foundation for the design, it was necessary to clarify the clinic's vision, mission, and strategy. Furthermore, after the BSC was designed, it was analysed in relation to the clinic's existing PMS. Design: To address the research objectives identified, a qualitative case study approach was selected. Data was collected through in-depth semi-structured interviews with various personnel in the clinic. Moreover, this research was also supplemented by validation interviews with the CEO and COO of the clinic. Findings: Initially, the clinic's vision and mission statement were clarified, resulting in the development of a well-defined strategy. These served as the necessary groundwork for the design of the BSC and Strategy Map. Moreover, the design of the BSC followed Rohm’s (1997) ‘Nine-Steps to Success’ framework. Once the BSC was designed and finalised, it was thoroughly analysed against the clinic's existing PMS. Notably, it was observed that the clinic already adheres to ISO 9001, which presented an opportunity for the integration of the two systems. This also provided further rationale for the potential implementation of the BSC within the clinic. Conclusions: Primarily, the BSC will play a crucial role in reinforcing and effectively communicating the formal vision, mission, and overall strategy to employees at all levels within the clinic. Furthermore, the compatibility of the BSC with ISO 9001 was found to be high, leading to the conclusion that the designed BSC is both feasible and advisable for the clinic. These conclusions were further on sustained by the clinic’s CEO and COO, where given that there is no need for the designed BSC to replace their current system, it created more grounds for potential implementation. Value: The value of this research lies in the potential for enhancing the clinic’s PMS and management processes, which are crucial within a health care setting. Furthermore, this study shall not only serve as a guide for other healthcare organisations, but also entice them to adopt a robust PMS, such as the BSC. Lastly, this study shall also add value to the field of management accounting given the lack of local research on the BSC within an eye clinic context.