The Balanced Scorecard (BSC) was originally developed by Kaplan and Norton as a performance measurement tool for managers to obtain a quick, yet comprehensive view of how their businesses were operating (Kaplan and Norton 1992). Since 1992, the BSC has been adopted by a wide range of industries, including hospitals, universities, long-term care facilities, psychiatric centres, insurance companies, pharmaceutical companies, national healthcare organizations and federal and local governments (Zelman et al. 2003). However, there has been limited research and progress in the use of the BSC as a performance measurement tool in public health.