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Bureaucracy and the balanced scorecard in health care settings

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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) evidences 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 evidenced 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 fostering flexibility, collaboration, innovation and adaptation – all of which should help lead to improved health care outcomes.

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Balanced scorecard Bureaucracy Health care management Management accounting Organizations Portugal

Citation

Craig, R. and Oliveira, H. and Rodrigues, L. L. (2020) 'Bureaucracy and the balanced scorecard in health care settings.', International journal of health care quality assurance., 33 (3). pp. 247-259.

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Emerald Publishing Limited

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