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Bureaucracy and the balanced scorecard in health care settings

Bureaucracy and the balanced scorecard in health care settings We explore the relationship between the balanced scorecard (BSC) and neo-bureaucracy by investigating whether the operationalization of the BSC incorporates “neo-bureaucratic” ideas and whether the BSC implemented in a Portuguese Local Health Unit (LHU) demonstrates a neo-bureaucratic approach.Design/methodology/approachWe conduct semi-structured interviews with LHU staff and analyse documents to assess whether features of bureaucratic organization were evident in the use of a BSC by the LHU.FindingsWe found nine bureaucratic features evident in the LHU's BSC. These were systematization, rationality, authority, jurisdiction, professional qualification, knowledge, discipline, transparency and accountability. The BSC used at the LHU demonstrated a neo-bureaucratic approach.Originality/valueOur study helps to demystify bureaucracy and overcome prevailing prejudices regarding some of its principles. Health care managers should recognize and endorse neo-bureaucratic principles in developing a BSC. They should recognize the BSC as involving a neo-bureaucratic approach. The BSC is a valuable management tool that hospital managers should find useful in fostering flexibility, collaboration, innovation and adaptation – all of which should help lead to improved healthcare outcomes. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Health Care Quality Assurance Emerald Publishing

Bureaucracy and the balanced scorecard in health care settings

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References (53)

Publisher
Emerald Publishing
Copyright
© Emerald Publishing Limited
ISSN
0952-6862
DOI
10.1108/ijhcqa-07-2019-0121
Publisher site
See Article on Publisher Site

Abstract

We explore the relationship between the balanced scorecard (BSC) and neo-bureaucracy by investigating whether the operationalization of the BSC incorporates “neo-bureaucratic” ideas and whether the BSC implemented in a Portuguese Local Health Unit (LHU) demonstrates a neo-bureaucratic approach.Design/methodology/approachWe conduct semi-structured interviews with LHU staff and analyse documents to assess whether features of bureaucratic organization were evident in the use of a BSC by the LHU.FindingsWe found nine bureaucratic features evident in the LHU's BSC. These were systematization, rationality, authority, jurisdiction, professional qualification, knowledge, discipline, transparency and accountability. The BSC used at the LHU demonstrated a neo-bureaucratic approach.Originality/valueOur study helps to demystify bureaucracy and overcome prevailing prejudices regarding some of its principles. Health care managers should recognize and endorse neo-bureaucratic principles in developing a BSC. They should recognize the BSC as involving a neo-bureaucratic approach. The BSC is a valuable management tool that hospital managers should find useful in fostering flexibility, collaboration, innovation and adaptation – all of which should help lead to improved healthcare outcomes.

Journal

International Journal of Health Care Quality AssuranceEmerald Publishing

Published: Apr 20, 2020

Keywords: Balanced scorecard; Bureaucracy; Health care management; Management accounting; Organizations; Portugal

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