Department of Management, University of Bergamo, Bergamo, Italy.
Department of Business Administration, University of Verona, Verona, Italy.
Int J Health Plann Manage. 2022 May;37(3):1781-1798. doi: 10.1002/hpm.3440. Epub 2022 Feb 20.
This paper aims to analyse the dynamic use of the balanced scorecard (BSC) in an Italian public hospital.
DESIGN/METHODOLOGY/APPROACH: A longitudinal case study was conducted at an Italian public teaching hospital over a period of 5 years. The emergence of dynamic use of BSC was traced over a different combination of social, political, economic and organizational realities. A deeper understanding of these realities requires the adoption of a holistic approach to BSC use. Henri's types of system use (i.e., monitoring, attention focussing, strategic decision-making and legitimizing) frame this approach in a more concrete manner.
This study adds to the debate on whether BSC is used for aspects other than monitoring in public contexts. The case study offers the first example of a legitimizing use of the system and a first longitudinal case study that traces a dynamic use of BSC: the use evolves from monitoring and attention focussing to monitoring and legitimization. Norms, political parties and top managers play a determining role in this process.
ORIGINALITY/VALUE: Through a longitudinal approach, this study presents how BSC can be a dynamic tool steered by legitimacy pressures. The longitudinal study explores how social, political, economic and organizational context shape the implementation and the revision of BSC affecting the use of the tool by top managers. The browse of this dynamism is supported by Henri's type of use along with an in-depth analysis of the BSC literature evolution in terms of its 'static, dynamic and expected' use.
本文旨在分析意大利公立医院中平衡计分卡（BSC）的动态使用情况。
设计/方法/途径：在意大利一所公立教学医院进行了一项为期 5 年的纵向案例研究。BSC 的动态使用是通过不同的社会、政治、经济和组织现实的组合来追踪的。要更深入地了解这些现实，需要采用整体方法来使用 BSC。亨利的系统使用类型（即监测、关注焦点、战略决策和合法化）以更具体的方式来构建这种方法。
本研究增加了关于 BSC 是否在公共环境中用于除监测之外的其他方面的争论。该案例研究提供了系统合法化使用的第一个示例，以及第一个追踪 BSC 动态使用的纵向案例研究：使用从监测和关注焦点演变为监测和合法化。规范、政党和高层管理人员在这个过程中起着决定性的作用。
原创性/价值：通过纵向方法，本研究展示了 BSC 如何成为一种受合法性压力驱动的动态工具。纵向研究探讨了社会、政治、经济和组织环境如何塑造 BSC 的实施和修订，从而影响高层管理人员对工具的使用。这种动态性的浏览得到了亨利使用类型的支持，并对 BSC 文献在“静态、动态和预期”使用方面的演变进行了深入分析。
