Employee Involvement is the Prime Organizational Culture Trait Influencing Balanced Scorecard Effectiveness in the Hospitals: Evidence from a Correlation Study

Background and Objectives: Balanced Scorecard is an increasingly popular tool for performance evaluation. Healthcare organizations have broadly adopted this method for implementing their strategic plans. There is, however, increasing concerns on barriers to balanced scorecard implementation. Built on the fundamental impacts of organizational culture on hospital performance, this study explored the relationship between balanced scorecard effectiveness and organizational culture.   Methods: A descriptive analytical study of cross-sectional design was conducted within the period of August 2009 to June 2010. One hundred and fifty employees of Hasheminejad Kidney Center were enrolled. The questionnaire comprised two items addressing balanced scorecard effectiveness and 60 items related to four dimensions of organizational culture, including Involvement, Consistency, Adaptability, and Mission. Validity of the questionnaire was examined by seeking expert opinion. A high reliability of the questionnaire was ensured by obtaining a Cronbach’s alpha of 0.94. Survey results were summarized using descriptive statistics. The relationship between organizational culture and balanced scorecard effectiveness was measured using Pearson’s correlation coefficient, and modeled via regression analysis.   Findings: Balanced scorecard effectiveness showed significant correlations with Involvement (r = 0.44, P < 0.01), Consistency (r = 0.27, P < 0.01), Adaptability (r = 0.28, P < 0.01), and Mission (r = 0.35, P < 0.01). Multiple regression analysis identified Involvement as the only predictor of balanced scorecard effectiveness (β = 0.431, P < 0.01).   Conclusions: While all factors of organizational culture can influence balanced scorecard effectiveness, employee involvement holds prime importance. Hence, hospital leadership needs to strongly encourage employee involvement in organizational processes, in order to achieve high effectiveness of balanced scorecard.