The Successes in Long-Term Implementation of Balanced Scorecard: A Healthcare Organization Study

53 Pages Posted: 6 Aug 2009 Last revised: 13 Jan 2010

See all articles by Wen-Cheng Chang

Wen-Cheng Chang

Taiwan Buddhist Tzu Chi Foundation

Tsuilin Kuo

Fu-Jen Catholic University

Anne Wu

National Chengchi University (Taipei)

Date Written: August 6, 2009


Measuring organizational success is a continuous challenge for both academics and practitioners. Even though studies seem to support that the Balanced Scorecard (BSC) is widely used in many different organizations, few reports identify critical success factors that can maximize the benefits, and overcome certain serious predicaments faced by different BSC implementation phases in the long run. This study is dedicated to the question of how to reflect the successive phases in the evolution of the BSC implementation for the largest Presbyterian hospital system in Taiwan. We discuss four phases in implementing BSC from 2001 to 2008, and examine the proposed phases and the activities performed in each phase. Four stages can be distinguished: (1) the planning and designing; (2) weighting and evaluating the strategic performance measures; (3) aligning the strategic business units and strategic support units; and (4) achieving longitudinal performances and cultural changes. Our study also elaborates the experience and results of monitoring and guiding organizational performance toward a long-term dynamic realization of an overall goal from the perspective of healthcare executives, while exploring managerial guidance for similar implementations. These findings can be generalized for other organizations to adopt or consider adopting the BSC.

Keywords: Balanced scorecard, healthcare organization, strategic management, performance measurement, longitudinal study

JEL Classification: M40, M46

Suggested Citation

Chang, Wen-Cheng and Kuo, Tsuilin and Wu, Anne, The Successes in Long-Term Implementation of Balanced Scorecard: A Healthcare Organization Study (August 6, 2009). AAA 2010 Management Accounting Section (MAS) Meeting Paper, Available at SSRN: or

Wen-Cheng Chang

Taiwan Buddhist Tzu Chi Foundation ( email )

No.289, Jianguo Rd., Sindian City, Taipei County 2
Taipei, Taiwn

Tsuilin Kuo

Fu-Jen Catholic University ( email )

No. 510, Zhongzheng Rd., Xinzhuang Dist.
New Taipei City, 24205
886-2-2905-3999 (Phone)
886-2-2904-7925 (Fax)

Anne Wu (Contact Author)

National Chengchi University (Taipei) ( email )

No. 64, Chih-Nan Road
Section 2
Wenshan, Taipei 11623

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