“…al. [ 83 ] 2020 NR NR (but data extracted 2018–2019 One medical center Hospital records 8 13 No Average 4.5 Average Total 22 Yes: 10 No: 26 USA United States of America, HCW Health Care Workers, TOPSIS Technique for Order of Preference by Similarity to Ideal Solution, NR Not Reported Fig. 3 PRISMA Flow Diagram …”
Background
The balanced scorecard (BSC) has been implemented to evaluate the performance of health care organizations (HCOs). BSC proved to be effective in improving financial performance and patient satisfaction.
Aim
This systematic review aims to identify all the perspectives, dimensions, and KPIs that are vital and most frequently used by health care managers in BSC implementations.
Methods
This systematic review adheres to PRISMA guidelines. The PubMed, Embase, Cochrane, and Google Scholar databases and Google search engine were inspected to find all implementations of BSC at HCO. The risk of bias was assessed using the nonrandomized intervention studies (ROBINS-I) tool to evaluate the quality of observational and quasi-experimental studies and the Cochrane (RoB 2) tool for randomized controlled trials (RCTs).
Results
There were 33 eligible studies, of which we identified 36 BSC implementations. The categorization and regrouping of the 797 KPIs resulted in 45 subdimensions. The reassembly of these subdimensions resulted in 13 major dimensions: financial, efficiency and effectiveness, availability and quality of supplies and services, managerial tasks, health care workers' (HCWs) scientific development error-free and safety, time, HCW-centeredness, patient-centeredness, technology, and information systems, community care and reputation, HCO building, and communication. On the other hand, this review detected that BSC design modification to include external and managerial perspectives was necessary for many BSC implementations.
Conclusion
This review solves the KPI categorization dilemma. It also guides researchers and health care managers in choosing dimensions for future BSC implementations and performance evaluations in general. Consequently, dimension uniformity will improve the data sharing and comparability among studies. Additionally, despite the pandemic negatively influencing many dimensions, the researchers observed a lack of comprehensive HCO performance evaluations. In the same vein, although some resulting dimensions were assessed separately during the pandemic, other dimensions still lack investigation. Last, BSC dimensions may play an essential role in tackling the COVID-19 pandemic. However, further research is required to investigate the BSC implementation effect in mitigating the pandemic consequences on HCO.
“…al. [ 83 ] 2020 NR NR (but data extracted 2018–2019 One medical center Hospital records 8 13 No Average 4.5 Average Total 22 Yes: 10 No: 26 USA United States of America, HCW Health Care Workers, TOPSIS Technique for Order of Preference by Similarity to Ideal Solution, NR Not Reported Fig. 3 PRISMA Flow Diagram …”
Background
The balanced scorecard (BSC) has been implemented to evaluate the performance of health care organizations (HCOs). BSC proved to be effective in improving financial performance and patient satisfaction.
Aim
This systematic review aims to identify all the perspectives, dimensions, and KPIs that are vital and most frequently used by health care managers in BSC implementations.
Methods
This systematic review adheres to PRISMA guidelines. The PubMed, Embase, Cochrane, and Google Scholar databases and Google search engine were inspected to find all implementations of BSC at HCO. The risk of bias was assessed using the nonrandomized intervention studies (ROBINS-I) tool to evaluate the quality of observational and quasi-experimental studies and the Cochrane (RoB 2) tool for randomized controlled trials (RCTs).
Results
There were 33 eligible studies, of which we identified 36 BSC implementations. The categorization and regrouping of the 797 KPIs resulted in 45 subdimensions. The reassembly of these subdimensions resulted in 13 major dimensions: financial, efficiency and effectiveness, availability and quality of supplies and services, managerial tasks, health care workers' (HCWs) scientific development error-free and safety, time, HCW-centeredness, patient-centeredness, technology, and information systems, community care and reputation, HCO building, and communication. On the other hand, this review detected that BSC design modification to include external and managerial perspectives was necessary for many BSC implementations.
Conclusion
This review solves the KPI categorization dilemma. It also guides researchers and health care managers in choosing dimensions for future BSC implementations and performance evaluations in general. Consequently, dimension uniformity will improve the data sharing and comparability among studies. Additionally, despite the pandemic negatively influencing many dimensions, the researchers observed a lack of comprehensive HCO performance evaluations. In the same vein, although some resulting dimensions were assessed separately during the pandemic, other dimensions still lack investigation. Last, BSC dimensions may play an essential role in tackling the COVID-19 pandemic. However, further research is required to investigate the BSC implementation effect in mitigating the pandemic consequences on HCO.
“…On the other hand, 20 implementations were observational; six implementations in four studies were cross-sectional [56][57][58]70], one implementation was prospective [85], ten implementations were retrospective [53, 62-64, 66-68, 74, 75, 81], and two implementations were prospective and retrospective [72,73]. Finally, one implementation did not have sufficient information or reported the study design [83].…”
Section: Methodsmentioning
confidence: 99%
“…21 of the implementations were performed in hospitals (2ry and 3ry HCOs) [41,[49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67], and 15 in medical centers or health facilities (1ry HCOs) [30][31][32]48,[68][69][70][71][72][73][74][75][76].…”
Section: Settings Differencesmentioning
confidence: 99%
“…From the resulted 36 implementations, 1 was in Spanish, 1 was in Persian, and the rest were in English language. The 36 implementations were done in various countries; 19 [69,72,76], and 1 without location information [73].…”
Section: Language and Locationmentioning
confidence: 99%
“…From the resulting 36 implementations, one was in Spanish [51], one was in Persian [52], and the rest were in English. The 36 implementations were performed in various countries: 19 in Asia [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68], seven in North America [69][70][71][72][73][74][75], six in Europe [51,[76][77][78][79], three in Africa [80][81][82], and one without location information [83].…”
This systematic review aims to identify the Key Performance Indicators (KPIs) which are the most frequently used and important in the Performance Evaluation (PE) of Health Care Organizations (HCOs). Also, it aimed to analyze the resulted Balanced Scorecard (BSC) dimensions during the Coronavirus Disease 2019 (COVID-19) era. This systematic review was prepared according to PRISMA guidelines. PubMed, Embase, Cochrane, and Google Scholar databases, as well as Google search engine, were inspected to find all implementations of BSC at HCOs until 20 September 2020. The Risk of Bias (RoB) was assessed for each included article. The eligible studies were 33, in which 36 BSC implementations were identified. The categorization and re-grouping of the 797 KPIs resulted in 13 major-dimensions: The financial, efficiency and effectiveness, availability and quality of supplies and services, managerial tasks, Health Care Workers (HCWs) scientific development error-free and safety, the time, HCW-centeredness, patient-centeredness, technology and information system, community care and reputation, HCO building, and the communication. Under them, 45 sub-dimension were identified. The high RoB in most implementations was due to the selection bias. None of the 36 BSC implementations was utilized during the COVID-19 pandemic. This review solves the dilemma of categorization differences among BSC implementations, which in turn will improve the data sharing and comparability among studies. A modification for the BSC design to include external and managerial perspectives is required. However, a lack of a comprehensive PE for HCOs during the pandemic was observed, so the resulted dimensions and KPIs are recommended for planning, monitoring, evaluation, and continuous improvement of HCOs. Many dimensions were negatively influenced by the pandemic. However, some dimensions still need further investigation. BSC dimensions have an essential role in tackling the COVID-19 pandemic and will help the health care managers to mitigate its consequences on HCOs.
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