Factors that affect the adoption of the balanced scorecard and its implementation process in Australian healthcare organisations

Factors that affect the adoption of the balanced scorecard and its implementation process in Australian healthcare organisations

The aim of the research was to further our understanding of the adoption and implementation of the balanced scorecard (BSC) in the Australian Healthcare sector. It looks specifically at four different objectives related to the adoption, implementation and use of a BSC. Firstly, it examined the organisational, technological, and environmental factors that affected both the adoption and the perceived relative advantage of the BSC using a contingency theory approach. Secondly, it examined the characteristics/culture of the healthcare organisations that have impacted on the adoption or implementation of the BSC. Thirdly, it examined the implementation processes the organisations used to try and successfully embed the BSC into their organisations and the barriers to the implementation of the BSC. Fourthly, it outlines a comparative case study analysis, highlighting the differences between the adoption factors and the implementation process leading to different roles and outcomes for the organisations.

This thesis presents two models, that the findings supported. The first model identified factors affecting BSC adoption and implementation chosen from the BSC, the Activity-Based Costing and the Information Systems adoption literatures. The following factors were identified as affecting BSC adoption: top management support, existence of an internal champion, engagement of consultants, organisational size, compatibility of culture, organisational complexity, Information Technology quality, Information Technology compatibility/usability, quality management framework and perceived relative advantage
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The second model examined the critical success factors (CSF) that impacted the implementation of the BSC. The factors were: corporate strategy relationship, measurement vs management, accountability/assigning KPI ownership, quadrant balance & evolution, data quality & information flows, Healthcare performance/regulation, management competences, organisational learning and cultural acceptance. This research identified two additional factors: management of stakeholders (internal & external) and management of barriers as critical, and that best outcomes were achieved when the models are used within a change process project.

A contingency framework was established to show the relationship between the two models and the impact that organisational characteristics/culture has on BSC adoption/Implementation and the outcomes achieved. By clearly identifying the factors that influence the adoption of the BSC and the CSF for implementation, the study can inform practitioners, about what organisational, technological, environmental and cultural factors could impact BSC implementation within their organisations. And how best to manage the whole change process that is necessary for successful implementation and outcomes.

The rigour of this research was maintained by triangulation of the theories and literature. An initial qualitative approach comprising both formal and informal interviews was conducted to test the reliability of the models, followed by case studies to support the findings.