Introduction
Materials and methods
Eligibility criteria
PICO | Inclusion criteria | Exclusion criteria | Search Strategy (MeSH terms and keywords) for PubMed |
---|---|---|---|
Population | Any type of health care organization | Non- health organization | hospitals[MeSH Terms] hospital department[MeSH Terms] health[MeSH Terms] |
Intervention | Performance assessment of health care organizations through implementing BSC | Studies that used other TQM tools such as MBNQA, ISO, SQA, six-sigma, etc. | “quality indicators, health care”[MeSH Terms] scorecard*[Text Word] “score card*”[Text Word] |
Comparator | -Initiation of BSC implementation (at least one year of implementation) -Or: Comparing 2 measurements after BSC implementation for at least one year -Or: Gross change/ difference after at least one year of implementation | - Initiation of BSC implementation was in less than one year. -Gross change/ difference after less than one year -One-time measurement with no comparability. | No limitation was set in the search strategy, studies that measured BSC impact within less than one year of implementation were excluded after carefully examining the full texts. |
Outcome | -Impact on financial indicators: profitability/loss, change in total revenues, change in total cost, ROI, ROA either in currency or in percentage. -Or: Impact on the patient satisfaction rate -Or: Impact on the HCWs’ satisfaction rate -The impact should be objective and measured/ quantitative. | -Impact on other indicators. -Number of patient complaints -HCWs’ burnout or turnover rate. -Cost/case or revenue/case change -Qualitative or subjective impact, for example: the managers’ opinions in impact | patient satisfaction[MeSH Terms] cost-benefit analysis[MeSH Terms] health care costs[MeSH Terms] Hospital personnel management[MeSH Terms] staff development[MeSH Terms] knowledge management[MeSH Terms] efficiency, organizational[MeSH Terms] |
Study design | All study designs | _ | No limitation regarding study design, type, or time was set in the search strategy |
Data sources, search strategy, and study selection
Data extraction and analysis
Quality assessment
Results
Study selection
Study characteristics
Author/s, year of publication | Country | Design of the study | Duration of data collection | Setting | No. of health facilities | No. of participants | Data collection tool/ data sources |
---|---|---|---|---|---|---|---|
Harber, 1998 [26] | Canada | Experimental uncontrolled pretest-posttest | NR | Peel Memorial Hospital (Hospital in general + Laboratory) | 1 | NR | NR |
Meliones, 2000 [5] | The USA- North Carolina | Experimental uncontrolled Interrupted time series | 1996–2000 | Duke Children Hospital | 1 | NR | NR |
Pink et al., 2001 [27] | Canada | Observational prospective longitudinal | 1997–1998 | Markham Stouffville hospital | 1 | NR | Surveys + hospitals’ reports |
Gumbus et al., 2003 [28] | USA | Case Study/ observational retrospective longitudinal | 1999–2001 | Bridge port hospital | 1 | NR | The patient satisfaction measurement system |
Smith & Kim, 2005 [29] | USA | Observational prospective and retrospective longitudinal | 2001–2004 | Summa’s Food & Nutrition Service Department at Summa Health System (STH & ACH hospitals) | 2 | NR | Press Ganey’s standard inpatient survey + audit checklists |
Devitt et al., 2005 [30] | Canada | Observational prospective and retrospective longitudinal | 2004–2005 | Toronto East General Hospital | 1 | NR | Data extraction from hospital records |
Yang & Tung, 2006 [31] | Taiwan | Retrospective longitudinal/ observational | 2000–2002 | General hospitals & their supervisor agency | 21 | NR | Secondary data from the department of health + primary data structured questionnaire measuring hospitals’ organizational learning and growth perspective |
Lorden et al., 2008 [32] | NR | Multimethod quantitative and qualitative case study/ experimental uncontrolled Interrupted time series | Jan, 1998- June, 2004 | Community hospital | 1 | 300 Inpatient/quarter, 700 outpatient/quarter, 227 employees (1st survey), 191 employees (2nd survey) | Employee satisfaction survey + patient satisfaction survey (via email) |
Josey & Kim, 2008 [33] | USA-Ohio | Observational retrospective longitudinal | 2006 | Barberton Citizens hospital (BCH) | 1 | NR | Patient satisfaction survey |
Chang et al., 2008 [34] | Taiwan | Observational retrospective longitudinal | 2001–2005 | Mackay Memorial Hospital | 1 | NR | NR |
Hansen et al., 2008 [24] | Afghanistan | Observational retrospective longitudinal | July to October of (2004/2005/2006) | Health facilities | > 600 | 1700 HCWs, 5800 patients- provider interaction | NR |
Chu et al., 2009 [35] | Tawian | Case study/ experimental uncontrolled Interrupted time series | 2004–2006 | The nursing department at a public teaching hospital in Taiwan | 1 | 13 reference nurses’ group | Financial data from hospital + questionnaires to executives (the weights of indicators) |
Edward et al., 2011 [36] | Afghanistan | Observational retrospective longitudinal | 2004–2008 | Health facilities in Afghanistan | 700 | 1500 HCWs, 5000 patients | National health services performance Assessment + interviews with patients and HCWs |
Fields & Cohen, 2011 [37] | USA | Experimental uncontrolled Interrupted time series | 2009–2010 | Oregon Health and science university family medicine (Clinics) | 1 | NR | Press Ganey survey for patient satisfaction + medical records. |
Koumpouros, 2013 [38] | Greece | Case study/ experimental uncontrolled Interrupted time series | 18 months but not specified when exactly | General Panarcadian Hospital of Tripolis | 1 | NR | Questionnaires and interviews |
Smith et al., 2014 [39] | Canada/ Alberta | Experimental uncontrolled pretest-posttest | 2010–2011 (12-month trial), March 31, 2013 (results) | Hospitals in Alberta including hip and knee surgeries | 12 | NR | NR |
Abdullah et al., 2014 [40] | Indonesia | Cross-sectional/observational prospective and retrospective longitudinal | April–December, 2013 | Cibto Mangunkusumo Hospital- Digestive endoscopy center | 1 | 76 patients | Endoscopy reports + interviews based on structured questionnaires |
Zambia | Cluster randomized intervention/ experimental RCT | 2011–2013 | Health facilities in Zambia | 12 | 96 HCWs, 429 patient interviews, 410 patient observations | A survey in facilities+ interviews with HCWs and patients + patient observation + survey with households | |
Catuogno et al., 2017 [42] | Italy | Case study/ Experimental uncontrolled pretest-posttest | 2007–2008, & 2014–2015 | Hematology department at a Research hospital in Italy | 1 | 14 | Stakeholder satisfaction; questionnaires + care processes + hospital discharge report + charity report + research process + departmental report + economic and financial; hospital discharge database + departmental report + charity report |
Widyasari & Adi, 2019 [43] | Indonesia | Descriptive Quantitative longitudinal/observational prospective and retrospective | During the year 2018 | Bali Mandara Hospital of Bali (Governmental hospital) | 1 | 30 | Participant observation + structured interviews + semi-structured interviews + documentation. |