Performance Management and Determination of Asset Maintenance Indicators Based on the Balanced Scorecard Method

This research aims to develop a comprehensive framework for managing performance and determining  asset maintenance indicators in Shahid Beheshti affiliated hospitals using the balanced scorecard method. Employing a mixed-methods approach, the study integrates qualitative and quantitative data collection. Initially, an inductive approach was utilized to gather data from relevant literature, hospital documents, and indicators established by the Ministry of Health and Treatment. Subsequently, individual interviews with experts were conducted, and the Delphi method was employed to refine and localize the identified   indicators. The qualitative sample consisted of senior managers from the hospital and professors from the Department of Management and Health Economics at Shahid Beheshti University of Medical Sciences. A total of 12 participants were selected through non-probability judgmental sampling to form the balanced scorecard team. For the quantitative aspect, the target population included all high, middle, and basic  managers of Shahid Beheshti Hospital, comprising the president, assistants, internal managers, nursing staff, human resources, finance, quality improvement, health information technology, medical equipment, and clinical department supervisors. A random-cluster sampling method was employed, resulting in a   sample size of 384 individuals. The findings reveal that through a thorough review of the literature, hospital documentation, and both individual and group discussions, 20 key performance indicators were identified. These indicators were categorized within the balanced scorecard framework for asset maintenance         performance management. The financial perspective indicators included the number of critical equipment, failure time, net operational cost per equipment price, and the percentage of equipment obsolescence.   Customer perspective indicators focused on equipment availability and health status probability. Internal process indicators comprised the percentage of discovered failures, waiting time for service, and the      percentage of equipment registered in the management software. Finally, growth and learning perspective indicators included the number of training courses completed by personnel annually and the number of completed reports. Through confirmatory factor analysis, a robust framework for managing the         maintenance performance of hospital assets was established, providing a structured approach to enhance operational efficiency and service quality. performance management and asset maintenance are critical components of effective supply chain operations in healthcare settings. By implementing the balanced scorecard method, hospitals can ensure that their asset management strategies align with broader          organizational goals, ultimately leading to improved service delivery, reduced operational costs, and     enhanced patient satisfaction. This framework not only supports the strategic alignment of resources but also fosters a culture of continuous improvement within the healthcare supply chain, contributing to better health outcomes and operational resilience.