Assessing the Impact of Balanced Scorecard Performance Measurement Impact on Retention and Engagement of Registered Nurses; A Descriptive Study at Armed Forces Hospital in Najran, Kingdom of Saudi Arabia

Abstract

Registered Nurses (RNs) and other health workers may be hard to sustain, recruit and retain in the health sector, which can affect the sustainability of health sector workers, quality of care, and health sector performance. This is a cross-sectional quantitative study which aims at exploring the relationship between the registered nurses measured variables (Satisfaction, work engagement, intention to stay) in the Armed Forces Hospital, Najran, KSA and perceived Balanced Score Card (BSC) performance measurement practices.
A structured questionnaire was used to gather the data from 140 registered nurses and the statistical analysis involved reliability analysis (Cronbach's Alpha), exploratory factor analysis (EFA), correlation analysis, direct-effect regression analysis and mediation analysis. The results demonstrated that BSC perception statistically significantly correlated with nurse satisfaction to the extent of less than 0.5, and less than 0.2 to nurse work engagement and nurse turnover intentions, respectively, and that these two were weak to lack any meaning at all.
The results indicate that BSC as a structured tool for measuring the performance and communicating and aligning the organisation is not a standalone tool to improve the outcomes of the nurse workforce. However, other factors, such as leadership support, culture, workload, compensation, and professional development and work-life balance, might also affect nurse engagement and retention.
The study contributes to the literature on healthcare management by highlighting the importance of examining the performance measurement systems and not only the implementation of the BSC. Future studies could benefit from using a longitudinal design and multi-hospital sample to obtain more evidence of the relationship between BSC practices and nursing workforce outcomes.