Theoretical Contribution to Develop the Classical BSC to Health Care Needs

Italian public health care providers are organized in semi-autonomous departments specialized in different areas of care delivery. The governance of local health care services is concerned with translating strategic objectives into operational objectives. These characteristics provide the base to work out approaches for environmental analysis and strategic formulation, in other words what kind of strategy to adopt and how to adopt it. Identifying dynamical relationships in the translation of strategic objectives into operational objectives in consideration of the care delivery system; elaborating a tool to support and transfer objectives in different parts of the system to reach efficacy of health care delivering. We adopt a tool able to develop the strategy in the weak link systems, such as the Italian public administration and, in particular, the Regional Health Service in Campania. This study develops and applies strategic processes by a new dynamic Balanced Scorecard – named Shifting Card – that allows the dynamic shaping and translation of the strategy embedding evolution of the context. Then the paper develops some starting points about health care governance and its translation in government by dialectical methodology.