Professional Documents
Culture Documents
Corresponding author:
Acknowledgements:
This paper has benefited from comments from Margaret Abernethy and from
workshop participants at the University of Amsterdam, RSM Erasmus
University, the 5th Conference on New Directions in Management Accounting
(Brussels, December 2006), the 2007 AAA Annual Meeting and the 4th
Conference on Performance Measurement and Management Control (Nice,
September 2007).
Abstract
(MAS) and others do not, is still underdeveloped. This paper contributes to the
innovative MAS for organizations with different types of CFO’s. We test our
hypotheses using a combination of archival and survey data from the public
hypotheses.
systems had lost their relevance (Johnson and Kaplan, 1987), organizations
have become interested in new techniques that are allegedly better able to
today’s more complex and dynamic business environments (Foster and Ward,
1994; Ittner and Larcker, 1998), evidence shows that the adoption of
and sectors (e.g. Krumweide, 1998; Baines and Langfield-Smith, 2003) and
that many organizations do not use advanced MAS despite their apparent
processes (e.g. Gosselin, 1997; Baines and Langfield-Smith, 2003, Baird et al.
innovate reflects a rational trade-off between the expected costs and benefits
3
organizations’ adoption and use of new MAS and point to institutional and
managerial factors that go beyond the rational trade-off of expected costs and
benefits of innovation (e.g. Abernethy and Chua, 1996; Burns and Scapens,
control systems design (cf. Emsley et al., 2006). In this paper, we develop and
test the general thesis that CFO’s differ in their support for MAS innovations,
innovation, and how these characteristics affect the impact of strategy and
the potential benefits from innovation, and CFO characteristics that determine
administrative change.
4
We test our hypotheses using both survey data from the public hospital
sector in Spain and archival data. The survey data is collected as part of a
larger research project that aims at increasing our understanding of how top
Previous papers from this project have addressed how top management team
2007a, 2007b). In this paper, we focus on how a specific board member (the
these different types of factors. Second, this study contributes to the growing
2005; Indjejikian and Matejka, 2006). Our finding that MAS innovation
depends on the age, tenure and educational background of the CFO adds
significance to the limited existing evidence that the individual acting as CFO
(Emsley, 2005; Emsley et al. 2006) and suggest that management accounting
research may profit from a further focus on the individual differences between
5
CFO’s. Third, our focus on strategy as an antecedent of MAS innovation
Smith, 2003). Our paper is the first in the management accounting literature to
years affects their inclination to innovate. While this issue has been discussed
design (e.g. Reid and Smith, 2000). Finally, our study’s focus on the
beyond manufacturing settings (cf. Cavalluzzo and Ittner, 2003; Lapsley and
which MAS innovation has primarily been studied (e.g. Reid and Smith, 2000;
for industry effects which may have played a role in earlier studies (e.g.
MAS. Section 3 describes the research method used. Section 4 presents the
6
results of the empirical analysis. Finally, Section 5 discusses the conclusions
and limitations of this study and points towards directions for future research.
2. Hypothesis development
adopting organization (cf. Daft, 1978; Demanpour, 1991). In this study, we are
organizations with similar goals. This is the typical definition used in the
set of tools and techniques that have been developed over the past two decades
this study focuses on three such innovations: the Balanced Scorecard (BSC,
Kaplan and Norton, 1996; Ax and Bjornenak, 2005), Activity Based Costing
(ABC, e.g. Shields, 1995) and Benchmarking (Elnathan, et al., 1996). Not
only have these three innovations received most attention in the innovation
also underlined in interviews with managers from the target population made
during the planning stage of this study. Thus, this study aims to identify
7
Because these techniques have been described in some detail in the extant
insight into the organization’s strategic success (Kaplan and Norton, 1996). As
performance (e.g. Banker, et al., 2004), they are deemed to be of practical use
industry.
the variety and complexity of products, not just to the physical volumes
produced. Accordingly, ABC defines not only products, but also product
different levels: unit level activities, batch level activities, product sustaining
‘best practices’ and setting goals to achieve ‘best practice’ performance levels
8
performance toward desired objectives, and achieving them through
large producer of performance data, but embedding data from other hospitals
Extant research indicates that adoption levels of the BSC, ABC and
(Ter Bogt and Van Helden, 2000; Cavalluzzo and Ittner, 2003; Lapsley and
Wright, 2004). Overall, however, the literature also suggests that adoption
innovation and change (Reid and Smith, 2000; Baines and Langfield-Smith,
2003; Chenhall, 2003). Our study focuses on two such contingency variables
of which prior literature suggests that they might affect MAS innovation:
9
The second category of factors concerns the extent to which
organizations are in better “fit” with their environment than others (Chenhall,
Thus, evidence shows that adoption and use of new management systems
requires that responsible managers recognize the need for innovation and
initiate the necessary change (Bantel and Jackson, 1989; Elenkov, et al.,
2005). In the case of MAS innovation, the key individual responsible for the
Emsley, 2005). Based on Upper Echelon theory (Hambrick and Mason, 1984;
and willingness to recognize and act upon these needs. We develop hypotheses
10
In line with most management accounting research, we adopt Miles and
opportunities and their urge and capability to develop new products and to find
organizations, on the other hand, are more reactive than proactive market
explanation of the relation between strategy and MAS we will, however, refer
generally suggests that more complex and proactive strategies (i.e. prospector
organizations) require more advanced MAS. The reason for this is that
of issues and therefore need timelier, less aggregated and broader scope
11
performance need to be integrated into the organization’s MAS (Baines and
Langfield-Smith, 2003)
illustrate, Simons (1987) found that prospectors are more likely to adapt their
cost systems to the needs of their users than defenders are. Similarly, Gosselin
(1997) argued and found that prospectors were more likely to adopt activity-
based management techniques, not only because they had a higher need for
these techniques, but also because their focus on flexibility and product
innovation made it easier for them to adopt and implement new administrative
and indeed found that these effects were generally higher for organizations
and Abernethy (2000) showed that firms making more highly customized
products were more likely to have adopted broad scoped MAS. In summary,
influence the need to adopt innovative MAS (cf. Mone et al. 1998). Poor
12
performance creates a gap between an organization’s actual results and those
and processes fail to increase results, firms will need to look for alternatives.
Thus, organizations which have performed relatively badly over the previous
period will experience a relatively high, and perhaps urgent, need to change
literature (Lant, et al., 1992; Mone, et al., 1998). Empirical evidence supports
the notion that firms which experience performance downturns are more likely
to take risks and to adopt innovations. For example, Hundley et al. (1996) and
and Kaplan, 1987). Indeed, Reid and Smith (2000) provide evidence that cash
13
techniques. It should be recognized, however, that the effect of low
It should be noted here that the majority of existing studies (e.g., Abernethy
and Guthrie, 1994; Naranjo-Gil and Hartmann, 2006, 2007a, 2007b) model
and use. Thus, MAS has been found to affect strategy implementation
the relationship between MAS and strategy is most likely dynamic and
recursive over time and, therefore, more complex than any of these individual
Chenhall 2003).
14
The role of the CFO
which needs to make the actual adoption decision and which will determine
2006, 2007). This paper focuses on CFO characteristics, since within the
operating the organization’s MAS (cf. Anthony, 1988; Siegel and Sorensen,
1999; Emsley, 2005). Consequently, our general expectation is that the use of
et al., 2002; Burns and Baldvinsdottir, 2005; Emsley, 2005). Studies that
and prefer to see their own role as that of a relatively independent ‘watchdog’.
For example, Hopper (1980) found that there was a considerable difference
between the services general managers demanded from their finance staff and
the services that they actually delivered, which in part may be explained by
15
financial managers’ ‘conservative and bureaucratic orientations fostered
during early training and work experiences’ (Hopper, 1980, p. 402). Pierce
and O’Dea (2003) confirmed the existence of such an expectation gap, and
their empirical results suggested that this gap was largely due to the fact that
study. Also, Johnston et al. (2002) found that management accountants were
happening’ (Johnston, et al., 2002, p. 1331). Joseph et al. (1996) found that
most value.
16
In summary, the literature suggests that financial managers’ propensity
variance is not entirely clear. We therefore need to identify variables that are
that demographic variables provide good proxies for underlying cognitive and
Finkelstein and Hambrick, 1996). There are a vast number of studies which
2004) and a number of studies has also found associations between board
(e.g. Bantel and Jackson, 1989; Young, et al., 2001; Camelo-Ordaz, et al.,
2004; Auh and Menguc, 2005; Elenkov, et al., 2005). In addition, Naranjo-Gil
and Hartmann (2006, 2007) show that top management team characteristics
are related to the design and use of MAS. In particular, we believe that age,
innovativeness.
negative association between age and dynamic lifestyle, and age’s declining
Hambrick, 1996). Older managers are less able to evaluate new ideas quickly
17
flexibility decreases and rigidity and resistance to change increase (Wiersema
and Bantel, 1992). Older managers thus prefer security and generally support
the present status quo, while younger managers like to take risks and to initiate
new projects that might advance their careers (Finkelstein and Hambrick,
1996; Tihanyi, et al., 2000; Young, et al., 2001). Concerning MAS, older
CFO’s will have had more traditional accounting education, and will have
1980; Granlund and Lukka, 1998; Järvenpää, 2007). Younger CFO’s on the
other hand, will have entered the profession more recently, and therefore have
The arguments that support the expectation that younger CFO’s will be
more likely to adopt innovative MAS systems than older CFO’s, transfer to
found a negative effect of manager age on firm innovation and change have
Wiersema and Bantel, 1992; Boeker, 1997; Young, et al., 2001). Thus,
managers who have spent a substantial part of their career in organizations are
likely to have developed a power basis, social networks and work routines that
they do not want to put at risk, even if they believed that innovation and
18
Concerning educational background, we distinguish between CFO’s
will have received at least some education in the fields of accounting and
finance, they will differ with regard to the extent to which their educational
career has prepared them for operational work. This is particularly true in
healthcare and have later made a career switch, while others are graduates
from business schools who lack clinical knowledge (Hunter 1992, Buchanan
be more familiar with MAS techniques and more open to changing existing
substantial evidence from the Upper Echelon literature, which suggests that
(Wiersema and Bantel, 1992; Finkelstein and Hambrick, 1996) and with the
accounting innovations.
examination of these effects is needed. Not only is the existing evidence with
19
limited (c.f. Naranjo-Gil and Hartmann 2006), the finding that the
would also shed new light on existing theories that view MAS innovation as
recognized that while our theory points to a specific direction in which age,
H3a: Organizations that have a relatively young CFO will make more
H3b: Organizations that have a relatively short tenured CFO will make
MAS.
Interaction effects
We also predict that CFO characteristics will moderate the effects of strategy
arguments specified above lead us to expect that CFO’s who are older, more
tenured and have a non-business background are not only less innovative per
20
se, but are also less likely to recognize and act upon the need for innovative
and Hegarty (1993) found that the effect of top manager characteristics on
environment. Similarly, the results of, for example, Thomas and Rhamaswamy
(1997), Keck (1997) and Carpenter (2002) suggest that demographic top
reinforces the need for innovative MAS, younger, less tenured and relatively
business-oriented CFO’s are more likely to see this need and to translate a
21
Older and more tenured CFO’s are less likely to see administrative
Instead, they will look for ways to support their organizational strategy in
ways that fit their personal knowledge and do not require much effort to learn
and implement (Bantel and Jackson, 1989; Young et al. 2001). Like CFO’s
perceive systems such as ABC and BSC as fads and fashions (cf. Abrahamson,
strategic needs (Boeker, 1997; Finkelstein and Hambrick 1996; Lapsley, 2001;
Jacobs, 2005).
Second, CFO age, tenure and educational background are also likely to
the actual adoption and use of innovative MAS will be less in organizations
with older, more tenured and less business-oriented CFO’s. Higher age and
longer tenure lead managers to look for performance increasing action plans
that do not affect the present status quo and organizational routines (Bantel
and Jackson, 1989; Boeker, 1997). Additionally, older and relatively tenured
management techniques and innovative MAS and are less likely to believe that
such innovations are useful (Young et al. 2001). Concerning their own role in
increasing the performance of the organization, older and more tenured CFO’s
22
independent scorecard keepers whose task is merely to keep track of the
results of other managers’ actions (Hopper, 1980; Pierce and O’Dea, 2003).
Finally, CFO’s with a strong background in the medical profession will focus
battle performance downturn and will also be more skeptical about the
their knowledge of these systems will make the apparent solutions that they
offer more salient. These arguments lead to the following two hypotheses:
23
3. Research method
Our hypotheses are tested using data from the public hospital sector in Spain.
European countries (Hyvönen and Järvinen 2006, Desombre et al., 2006), the
measurement systems (Del Llano et al., 2000; Meneu et al., 2005). This
actually adopt and implement innovative MAS was ultimately left to the
MAS over the Spanish hospital sector was still in its initial phase (cf. Malmi,
However, as a result of the campaign the diffusion process took off and the
start of the campaign the use of innovative MAS was considerable. However,
there was also much variation in the extent of use of these systems by the
24
hospitals. Thus, while some hospitals responded to the institutional pressure
The dataset that we use contains both survey and archival data. We
the Spanish health care authorities (cf. Insalud, 2004). The questionnaire was
(2000) Tailored Design Method and was sent to the board members of all 218
public hospitals in Spain. The questionnaire was sent in 2002, three years after
the start of the government health care reform campaign. To test our
by CFO’s with tenure of less than three years, indicating that they had not
been in their position at the start of the government campaign. We also chose
to disregard these questionnaires for further analysis, to ensure that the CFO’s
in our study are the same ones who have decided about the adoption of new
MAS in their hospitals. Accordingly, we test our hypotheses using data from a
25
final sample of 98 CFO’s (44.95 percent) with at least three years of tenure.
the original mailing list and compared the answers provided by early and late
industry. The interviews showed that all managers had at least a basic
understanding of the three innovative MAS techniques that our study focused
on. In addition, the interviews were also used to discuss hospital performance
as follows3.
Scale from 1 (not at all) to 5 (to a very great extent) to what extent the
following techniques were used in their hospital: the BSC, ABC, and
Malmi, 1999; Kennedy and Affleck-Graves, 2001; Ittner et al. 2003). One of
26
the reasons is uncertainty about whether adoption should be considered
question throughout the hospitals in our sample and to avoid many of the
some previous studies. Also, in support of the validity of our instrument, the
hospital managers had a common basic understanding of ABC, the BSC and
benchmarking.
prospector hospital and a defender hospital. They were asked to indicate their
perception of the hospital’s strategic position three years ago (that is: at the
time the government’s campaign was launched) and at the moment of the
and ‘complete prospector’ (5). The two items were modelled as reflective
data. We acquired operational performance data for the three years before the
survey administration from the Spanish Regional Health Care Services (e.g.
27
Insalud, 2004). To be able to select those performance measures that provide
managers that preceded the actual data collection. Both the literature and the
Watkins, 2003; Griffith and Alexander 2002). This is especially the case for
the hospitals in our sample, which rely on public funding and for whom
within the financial boundaries set by the local governments. The choice to
mortality rate and waiting time. These six measures were selected because
they are important performance indicators for all hospitals regardless of their
the world to compare hospitals’ performance (Jacobs et al., 2005; Roos et. al.
28
1999; Griffith and Alexander 2002; see Van Peursem et al., 1995 for a review
indicator over the three years, and then modeled the average scores to be
Echelons tradition (Hambrick and Mason, 1984). Age and tenure refer to the
education years.
Hospital size was measured as the number of beds (Abernethy and Brownell,
1999). Care complexity was measured using objective data on the hospitals’
Case-Mix Index (Covaleski et al. 1993; Jonge et al. 2001). The Case-Mix
29
Index is an indicator of care complexity according to the average diagnosis-
related group weight5. A score higher than 1 indicates a hospital’s case mix is
4. Results
Bouwens, 2005; Chenhall, 2005) the hypotheses were analyzed using Partial
Least Squares (PLS Graph 3.0). The assessment of the measurement model in
the variables in the model and Table 3 shows the correlations between these
characteristics are generally low. Only the correlation between strategy and
case-mix index, which is consistent with prior research (Nath and Sudharshan
1994).
30
Table 4 shows the frequencies of the answers on our three items
measuring the use of innovative MAS. The figures in this table confirm that at
the moment of the survey the majority of the organizations in our sample had
they were using the innovative systems to a (very) great extent was still
limited though, as can be expected three years after the start of the government
addition, internal reliability for the three constructs in our model (use of
all three cases6. In addition, the Average Variance Extracted (AVE) was
higher than 0.5 in all cases, also indicating appropriate internal reliability (cf.
1998; Hulland, 1999). Results showed that discriminant validity was also
satisfactory, as in all cases the AVE was higher than the squared correlation.
Table 5 reports the loadings of items on their respective constructs and the
31
Figure 2 displays the PLS model tested. To calculate the interaction terms we
standardized the item scores and then calculated the interaction terms as the
product of the standardized item scores. Table 6 contains the detailed output
statistics of the analysis of the structural model and reports on the significance
bootstrapping procedure that used 500 samples with replacement. This table
also reports the R-squared statistic for the dependent variable7. In analyzing
ran the model with main effects only (panel A) after which we analyzed the
The results in panel A of Table 6 support H1, since the path coefficient from
innovative MAS use is negative and significant at the 10 percent level (-0.188,
H3b and H3c. The results show that CFO age (-0.232; p = 0.031) and tenure (-
32
MAS, while educational background has a significantly positive effect (0.226;
p = 0.034), as expected.
clear from panel B of Table 6, our results do support H4. Age and tenure
0.208; p = 0.026 for age and -0.226; p = 0.07 for tenure). In addition,
In summary, the findings indicate that strategy affects the adoption and
use of innovative MAS and that this effect is moderated by the characteristics
to use innovative MAS, this effect of strategy is more salient for hospitals with
younger, less tenured CFO’s and hospitals with a CFO with a business
MAS innovation. Not much evidence exists with regard to CFO characteristics
moderating this effect. Finally, the CFO characteristics age, tenure and
33
To see how much predictive value the interaction terms add to the
model, we compared the R2 from the model with interactions with the R2 from
the main effects model. The path coefficients, their significance and the R2 for
this model are presented in panel b of table 5. The additive explanatory power
measure (Cohen, 1988; Chin, et al., 2003, p.211)8. Results show that the
interaction constructs have a total effect size f of 0.200, which indicates that
This paper set out to increase our understanding of why some organizations
techniques than others. We predicted that the use of innovative MAS would be
accounting systems and the willingness and ability of the CFO to recognize
found evidence that two factors we believed reflect the need for innovative
these systems. Furthermore, we found that our hypotheses that younger, less
34
CFO characteristics. Evidence for the hypothesized interaction between
and the general management literature (e.g. the Upper Echelon perspective) as
process and institutional pressures (cf. Malmi, 1999; Reid and Smith, 2000)
Pierce and O’Dea, 2003; Burns and Baldvinsdottir, 2005; Järvenpää, 2007;
Byrne and Pierce, 2007). We show that some CFO’s are more likely to change
their organizations’ accounting systems than others and that demographic data
over time. Finally, this study answers calls in the literature to focus on
35
Our paper contributes to the Upper Echelon literature by confirming
(Wiersema and Bantel, 1992; Young et al., 2001). Furthermore, our results
should not only look for direct effects but should also investigate how
into account. Some of these limitations are inherent to the survey method, such
as the use of perceptual measures and the potential for common-method bias.
data where such data was available. One specific limitation is that we were
Likert scale type questions. Although we believe that our measure of the use
still a perceptual measure and objective data might have provided a more
36
A final limitation of our study is that we only investigated a small
innovation adoption. In sum, despite our belief that this study provides some
settings and using different methods and to examine other antecedent variables
1
We further elaborate on how this study fits within existing research on MAS and strategy in
the hypothesis development section.
2
Spanish hospitals are required to report several financial and non-financial indicators that
cover the use of resources, productivity and health care performance. These indicators are
integrated in a system, known as INIHOS (‘INformation Inter HOSpitales’), which provides
indicators used for measuring, comparing and evaluating health care performance among
hospitals.
3
A more detailed description of the survey items is found in the appendix
4
Note that asking respondents about their organization’s strategy in the period in advance of
the survey allows us to express with more certainty that strategy is indeed an antecedent of
MAS rather than the consequence. In this sense, it allows us to address the recursive
relationship between strategy and MAS design (Langfield-Smith, 1997).
5
The Diagnosis-Related Group (DRG) refers to a system to classify hospital activities into
one of approximately 500 groups expected to have similar hospital resource use. DRG
categories, which reflect the nature and intensity of the hospital services, can essentially be
thought of as the hospitals ‘‘products.’’ (Preston, 1992; Pizzini, 2006, p. 183).
6
This composite reliability measure is interpretable as Cronbach’s alpha (see Fornell and
Larcker, 1981).
7
The control variable size did not have a significant effect on the use of innovative MAS.
Care complexity is significantly associated with the use of innovative MAS (ß = 0.218; p =
0.017).
8 2
f = (R2 interaction model – R2 main model)/(1- R2 main model). Interaction effect sizes are
small if 0.02, medium if 0.15, and large if 0.35 (Chin et al., 2003).
37
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Tables and Figures
Occupancy rate (use of Daily census / Number of Number of inpatients receiving care
beds) hospital beds each day at hospitals’ beds as a
fraction of total capacity.
Use of surgery rooms Hours used at surgery room Use of surgery facilities (equipment)
/ Hours available at surgery at hospitals as a fraction of capacity.
room
Mortality ratea Total Patients Deaths / Total Proportion of the patients at a hospital
Patients Admission that died within 60 days of hospital
admission.
Waiting timea Total number of days waited The time which elapses between the
/ Outpatient activity request by a general practitioner for an
appointment and the attendance of the
patient at the outpatients’ department
a
Reverse coded
Table 2. Descriptive statistics for variables (n=98)
Variable Mean SD Theoretical Range Actual Range
1. Strategy 3.08 0.42 1.00-5.00 1.00-5.00
2. Historical performance 0.57 0.06 0.00-1.00 0.52-0.74
3. Age 43.3 3.4 --- 34-48
4. Tenure 4.1 1.8 --- 3-12
5. Educational background 0.67 0.05 0.00-1.00 0.54-0.93
6. Innovative MAS 2.93 0.35 1.00-5.00 1.00-4.00
7. Care Complexity (CMI) 1.57 0.16 --- 0.93-1.61
8. Size 336.18 109.27 --- 190-1230
47
Table 3. Correlations from PLS model (n=98)
Variable 1 2 3 4 5 6 7
1. Strategy 1.000
2. Historical performance 0.161 1.000
3. Age 0.164 0.076 1.000
4. Tenure 0.129 0.069 0.107 1.000
c
5. Education 0.190 0.157 0.152 0.168 1.000
a c a b
6. Innovative MAS 0.228 -0.187 -0.246 -0.214 0.197b 1.000
c
7. Care Complexity (Case-mix) 0.193 0.142 0.082 0.103 0.159 0.201b 1.000
8. Size 0.154 0.116 0.056 0.127 0.088 0.162 0.149
a b c
Significant at 0.01 level (two-tailed) Significant at 0.05 level (two-tailed) Significant at 0.1 level (two-tailed)
48
Table 4. Actual percentages for MAS innovation response scale (n=98)
Use Technique
To a great extent 9% 1% 6%
49
Table 5. Reliability and validity analysis of multi-item constructs (n=98)
50
Table 6. Results from PLS analysis (path coefficients, n=98)
B. Full model
To: Innovative MAS use
From: Path coefficient P value
Strategy 0.228 0.004
Historical performance -0.191 0.072
Age -0.251 0.001
Tenure -0.216 0.021
Education 0.232 0.003
Strategy x age -0.208 0.026
Strategy x tenure -0.226 0.007
Strategy x education 0.204 0.029
Historical performance x age 0.147 0.131
Historical performance x tenure 0.156 0.122
Historical performance x education 0.182 0.081
Care Complexity (Case-Mix) 0.218 0.017
Size 0.124 0.139
2
R = 0.309
51
Figure 1: Research model
Strategy
Historical performance
52
Figure 2. Results PLS structural analysis full model
Historical
performance x tenure
Care Complexity
0.156
0.218b 0.182c
Historical 0.147
performance
- 0.191c
Strategy 0.228a
Innovative MAS use
R2=0.309
-0.251a
Age
-0.216b
Tenure
0.232a
0.204b
0.124 -0.208b
Education
-0.226b
Strategy x
Strategy x education
Size age
Strategy x
tenure
53
APPENDIX– Questionnaire items
1. Organizational strategy
The following two descriptions of hospitals were given to respondents. They were
asked to circle on five-point Likert-type scales where they would place their hospital
three years ago and where they would place it currently.
‘Hospital B makes relatively frequent changes in, and additions to, its set of services
and tends to offer a wider range of medical services compared to other hospitals of
the same categories. Hospital B responds rapidly to early signals of market needs or
opportunities and it consistently attempts to be at the forefront of new service
developments. Other hospitals often follow Hospital B in the development of these
services. This type of hospital may not maintain its strength in all of the areas it
enters.’
• Balanced Scorecard
• Activity Based Costing
• Benchmarking
54
3. CFO characteristics
• Age
• Tenure in organization
• University degree and title
• Years of health care postgraduate education (e.g. seminars, special courses on
clinical issues)
• Years of business administration postgraduate education (e.g. seminars, special
courses, MBA)
55