Bureaucracy and the balanced scorecard in health care settings.

IF 1 Q4 HEALTH POLICY & SERVICES

INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE Pub Date : 2020-04-08 DOI:10.1108/IJHCQA-07-2019-0121

Helena Costa Oliveira, Lúcia Lima Rodrigues, Russell Craig

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引用次数: 13

Abstract

Purpose: 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/approach: We 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.

Findings: We 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/value: Our 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.

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卫生保健机构中的官僚主义和平衡计分卡。

目的:我们探讨平衡计分卡(BSC)与新官僚主义之间的关系，通过调查平衡计分卡的运作是否包含“新官僚主义”思想，以及在葡萄牙地方卫生单位(LHU)实施的平衡计分卡是否体现了新官僚主义方法。设计/方法/方法:我们与LHU员工进行半结构化访谈，并分析文件，以评估LHU在使用平衡计分卡时官僚组织的特征是否明显。结果:我们在LHU的平衡计分卡中发现了九个明显的官僚主义特征。它们是系统化、合理性、权威、管辖权、专业资格、知识、纪律、透明度和问责制。LHU使用的平衡记分卡展示了一种新官僚主义的方法。原创性/价值:我们的研究有助于揭开官僚主义的神秘面纱，并克服有关其某些原则的普遍偏见。在制定平衡记分卡时，卫生保健管理人员应承认并支持新官僚主义原则。他们应该认识到平衡计分卡涉及一种新官僚主义方法。平衡记分卡是一种有价值的管理工具，医院管理者应该发现它在促进灵活性、协作、创新和适应方面很有用——所有这些都应该有助于改善医疗保健结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE HEALTH POLICY & SERVICES-

CiteScore

4.00

自引率

6.70%

发文量

期刊介绍： ■Successful quality/continuous improvement projects ■The use of quality tools and models in leadership management development such as the EFQM Excellence Model, Balanced Scorecard, Quality Standards, Managed Care ■Issues relating to process control such as Six Sigma, Leadership, Managing Change and Process Mapping ■Improving patient care through quality related programmes and/or research Articles that use quantitative and qualitative methods are encouraged.