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The purpose of this paper is to exemplify the evolving applications of balanced scorecard and strategy map in the healthcare sector. This paper seeks to describe a number of innovative approaches adopted by healthcare organizations and health systems in their implementation of Kaplan and Norton's strategy map and balanced scorecard. Although strategy map and balanced scorecard are useful strategic management tools, policy makers and decision makers should be well‐informed about implementation issues and challenges of their adoption in healthcare organizations and health systems.

The paper is based on a literature review of the applications of strategy map and balanced scorecard in healthcare organizations and health systems. Also publications of the Ministry of Health and Long‐Term Care and its agencies are examined to assess the strategic priorities and plans for Ontario's health system.

From the literature review and case studies cited, an increasing use of strategy map and balanced scorecard was found in the healthcare sector. The implementation is both unique and innovative. Moreover, strategy map and balanced scorecard are effective communication and strategic management tools in aligning and integrating the strategic goals of various levels within the health system.

The paper gives an account of the different implementation approaches of strategy map and balanced scorecard in the healthcare sector; thereby providing policy makers and decision makers with choices on how to implement the strategic management tool in their organizations.

The literature review and case studies described here highlight the value and applications of strategy map and balanced scorecard in the healthcare sector.

Reviews the latest management developments across the globe and pinpoints practical implications from cutting‐edge research and case studies.

This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.

What do you do when, as a large health services provider recently established from a merger of other providers, you need a workable strategy so that everyone knows the vision, mission and how to implement them? A total of 12 years ago Minnesota's brand‐new SMDC Health System faced that challenge and engaged a national consulting firm to develop its first strategic plan.

The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy‐to digest format.

This study looks at board governance in Ontario hospitals.

We conducted a research of the hospitals’ websites and a survey of board directors to study the board structure and examine governance practice in Ontario hospitals.

The findings suggest that the board structure and process in Ontario hospitals are in compliance with Accreditation Canada’s Governance Standards, and such administrative controls are appropriate. Ontario hospital boards, in general, have fulfilled their key functions of governance in terms of working as an effective board; developing a clear direction; supporting the organization to achieve its mandate; maintaining positive relationships with external stakeholders; and being accountable and achieving sustainable results. Building knowledge through information is an area where improvement is needed.

Ontario hospitals have implemented appropriate administrative controls in terms of board composition and committee structure. The results of a survey of 99 board directors from over 25 hospitals suggest that directors, in general, have a good understanding of their governance role and relationship with senior management as well as the government. The findings are also supportive of good governance practice where executives manage and nonexecutive directors monitor the performance of the executives. According to the respondents, Ontario’s hospital boards are actively involved in setting the mission, strategic goals and objectives of their organizations, and they take appropriate steps to ensure that risk management, client safety, and quality improvements are incorporated in their governance and strategic planning process. In order to discharge their fiduciary duty effectively, respondents would like to have more information from different sources. This is an area where management accounting professionals can become involved such that relevant information from a variety of sources, especially external sources, are provided to board directors for decision making.

Ontario’s hospital sector has undertaken initiatives through research and publications to promote good governance practice. Such leadership is critical to ensure that directors have the competence and skills to discharge their duties and responsibilities diligently. Hospital boards should focus on renewal while ensuring that board directors are equipped for the challenging task of governing through professional development and continuing education.

Limitations related to the use of questionnaire applies to this research study. Self-selection bias and low response rate limit the generalizability of the findings. Future research can examine the behavior of directors in the boardroom and the impact of governance variables on hospital performance, such as quality of care and patient safety.

This article looks at the alignment of performance management system with the strategy, structure, and organizational outcome in Canadian health care organizations. In this study, balanced scorecard is the framework adopted for assessing the health care organization's performance management system (PMS) and outcome. CEO and clinical unit managers were surveyed for their perceptions on their organization's strategy, autonomy structure, PMS, and organizational performance. Path analysis was the methodology used in examining the relationship about the above organizational variables. The results indicate that patient satisfaction is the primary and most significant perspective of the depicted balanced scorecard in organizational performance. Patient satisfaction and research criteria, on the other hand, are the significant perspectives of a balanced scorecard in an organization's PMS, which are linked to strategy, autonomy structure, and organizational performance. Moreover, the results show that the strategy/structure links operated as suggested. Surprisingly, strategy on service innovation has a negative impact on the organizational outcome of patient satisfaction. Uncertainty from continuous development and organizational change in pursuing service innovation and cost-cutting measures in response to fiscal constraints are plausible explanations of the adverse impact reported.

To deal with financial constraints and increasing demand on accountability, government administrators have begun implementing modern management tools in their organizations. The balanced scorecard, a performance and strategic management system, has been adopted in for‐profit organizations with success and its application in the government sector is explored in this study. Results of a survey of municipal governments in the USA and Canada show that there is limited use of the balanced scorecard. Most municipal governments, however, have developed measures to assess their organizations' financial, customer satisfaction, operating efficiency, innovation and change, and employee performance. Respondent administrators, in general, have confidence in the quality of the performance measures and about half reported that these measures were used to support various management functions. The respondent administrators also have a good understanding of the balanced scorecard and the implementers are positive about their experience.

This paper aims to examine, the specific literature related to performance measurement in the service sector. In the process, it also aims to classify and examine innovative approaches and models utilized to measure performance in service operational settings. Based on this investigation, the paper seeks to identify relevant benchmarking implications.

A database of 141 peer‐reviewed publications, published between 1981 and early 2008, was utilized for the purpose of this paper. The published works included contributions from both practioners and scholars.

The International Journal of Productivity and Performance Management is found to be the leading journal in terms of contributions to performance measurement in service operational settings. It contributed 25 articles. The bulk of published work appeared in international journals. These contributions were mixed in nature. They included empirical, conceptual, case studies, literatures reviews and interviews. The focus of the articles examined was also mixed. These articles tended to emphasis operational, customer, strategic, supplier, and environmental aspects of service.

Based on the findings of this paper, it is concluded that this area of research is in need of more future efforts aimed at solidifying theoretical constructs and practical applications.

Findings derived from this investigation have relevant benchmarking implications. In this context, understanding the different approaches to performance measurement as utilized in service organizations is critical to the efforts of these organizations' performance improvement efforts.

Understanding the types and scopes of the different approaches and models utilized to measure performance in service operational settings is important in light of the growing significance of the service sector.