Challenges of the Balanced Score Card Implementation at Kenyatta National Hospital, Kenya

Abstract

In the current 21st business arena, companies compete in a complex and challenging context that is being transformed by many factors from globalisation, rapid change in technology, aggressive competitors and political interference. It means that for companies to gain and maintain a competitive edge they must develop and execute strategic plans with precision. Thus the main purpose of the study was to determine the challenges of balanced score card implementation in the health sector and specifically at Kenyatta National Hospital which is a national referral hospital. The findings from this study may particularly be useful in providing additional knowledge to the Hospital and other organizations especially in the health sector on implementation of the balanced score as a strategy implementation tool. The research design that was used in this study was case study. Primary data was collected using interview guide while secondary data was obtained from the Hospitals record. The researcher thus interviewed eight (8) managers in the Executive Management Committee of the Hospital. The researcher used content analysis to analyse the data through describing phenomena, classifying it and seeing how the concepts interconnect. It is established that Kenyatta National Hospital has a well-founded strategic planning system. The hospital has had three strategic plans since 2005. The first two strategic plans were based on log frame framework but the third strategic plan (2013-2018) was based on balance score card approach. The use of the Balanced score card was to align the day to day activities of the Hospital to the vision and mission. The Balanced score card has three additional perspectives over and above the traditional financial perspective. The other perspectives that is, learning and growth, internal business process and customer perspectives are the drivers of the future financial performance. The implementation of the balanced score card has challenges which included but not limited to rigid organizational structure, lack of resources, complaisant organization culture, lack of functional equipment, leadership, lack of effective communication, negative stakeholder influence and cascading. The findings of the study should be understood and valuated in light of the limitations of the study. The study is especially useful to Kenyatta National Hospital. The study has also highlighted institutional policy and practice recommendations to overcome the challenges of strategy implementation using balanced scorecard. Also provide are suggestions for further studies.