title: [The Balanced Scorecard as a management tool in a public health organization].
abstract: OBJECTIVE
  The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives.
  
  
  METHODS
  Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard.
  
  
  CONCLUSIONS
  The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board.
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, España. jrvillal@aspb.es
authors.forename: Joan R
authors.initials: JR
authors.lastname: Villalbí
authors.forename: Joan
authors.initials: J
authors.lastname: Villalbí
authors.forename: Joan
authors.initials: J
authors.lastname: Guix
authors.forename: Conrad
authors.initials: C
authors.lastname: Casas
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
authors.forename: Júlia
authors.initials: J
authors.lastname: Duran
authors.forename: Lucía
authors.initials: L
authors.lastname: Artazcoz
authors.forename: Esteve
authors.initials: E
authors.lastname: Camprubí
authors.forename: Meritxell
authors.initials: M
authors.lastname: Cusí
authors.forename: Pau
authors.initials: P
authors.lastname: Rodríguez-Montuquín
authors.forename: Josep M
authors.initials: JM
authors.lastname: Armengol
authors.forename: Guy
authors.initials: G
authors.lastname: Jiménez
mesh_terms: D005568:Forms and Records Control; D006801:Humans; D007324:Institutional Management Teams; D008330:Management Audit / Q000379:methods*; D008331:Management Information Systems; D008962:Models, Theoretical; D010934:Planning Techniques; D015397:Program Evaluation; D011635:Public Health Administration / Q000379:methods*; D013030:Spain