title: Application of the balanced scorecard to an academic medical center in Taiwan: the effect of warning systems on improvement of hospital performance.
abstract: BACKGROUND
  The balanced scorecard (BSC) is considered to be a useful tool for management in a variety of business environments. The purpose of this article is to utilize the experimental data produced by the incorporation and implementation of the BSC in hospitals and to investigate the effects of the BSC red light tracking warning system on performance improvement.
  
  
  METHODS
  This research was designed to be a retrospective follow-up study. The linear mixed model was applied for correcting the correlated errors. The data used in this study were secondary data collected by repeated measurements taken between 2004 and 2010 by 67 first-line medical departments of a public academic medical center in Taipei, Taiwan. The linear mixed model of analysis was applied for multilevel analysis.
  
  
  RESULTS
  Improvements were observed with various time lags, from the subsequent month to three months after red light warning. During follow-up, the red light warning system more effectively improved controllable costs, infection rates, and the medical records completion rate. This further suggests that follow-up management promotes an enhancing and supportive effect to the red light warning.
  
  
  CONCLUSIONS
  The red light follow-up management of BSC is an effective and efficient tool where improvement depends on ongoing and consistent attention in a continuing effort to better administer medical care and control costs.
authors.affiliation: Department of Medical Affairs & Planning, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Hsueh-Fen
authors.initials: HF
authors.lastname: Chen
authors.forename: Ying-Hui
authors.initials: YH
authors.lastname: Hou
authors.forename: Ray-E
authors.initials: RE
authors.lastname: Chang
mesh_terms: D000046:Academic Medical Centers / Q000592:standards*; D005500:Follow-Up Studies; D006739:Hospital Administration / Q000379:methods; D008330:Management Audit / Q000379:methods; D011787:Quality of Health Care; D012189:Retrospective Studies; D013624:Taiwan