Authors

1 Associate Professor, Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran

2 Assistant Professor, Industrial Management, Tehran Markaz Branch, Islamic Azad University, Tehran, Iran

3 PhD Student, Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran

Abstract

Introduction: Balanced scorecard is one of the most successful and widely used models of performance 
assessment in healthcare organizations, especially in hospitals. The model is a framework for designing a 
set of performance measures for organization strategies. The study was conducted aiming to yield a 
performance assessment model for Iranian social security hospitals with balanced scorecard approach. 
Methods: In this adaptive and descriptive research, 11 theory and practical models of balanced scorecard 
with successful experiences were studied. A model for Iranian social security hospitals was designed. A 
questionnaire was designed as a data collection tool. It was validated using expert's survey in Delphi
method. Reliability coefficient for this questionnaire was relatively high (Cronbach's alpha = 0.94). 
Independent t-test was used to identify significance of expert responses. 
Results: The mean score of experts opinion about the proposed model was 4.02 (out of 5) for mission 
statement and 4.5 for continuous improvement in healthcare quality and safety policy, 4.66 for 
optimization of current resources and facilities utilization, 4.66 for team working for satisfying our
patients/clients policy, and 4.32 for responsible for environment and employee health and safety policy. 
The mean score was 11.66 for clinical perspective, and 11.5 for patient perspective, 11.66 for internal 
processes perspective, 10.78 for financial perspective and 11.46 for employee growth perspective. Totally, 
27 measures were designed for these perspectives one of which was excluded. 
Conclusion: The model can be implemented in one or all the social security hospitals and also can be used 
for comparing the performance of the hospitals. Because of the dynamic nature of the balanced scorecard, 
the model is a flexible framework that could be adjusted by local situations based on differences in targets. 

Keywords