Background: Kaplan and Norton developed the Balanced Scorecard in 1992. This framework has given the management the opportunity to better understand how the organization is functioning. Communication is the vital factor for success with the Balanced Scorecard and the organization. Nowadays, in a world of rapid change and competition the organizations face an untold quantity of leadership challenges, and by applying the Balanced Scorecard the management will get the chance to achieve results by putting their strategies into action. The Jönköping County Council is responsible for the healthcare within its area, and is one of numerous organizations that have implemented the Balanced Scorecard.

Purpose: The purpose of this study is to investigate the reasons the healthcare department within Jönköping County Council applied the Balanced Scorecard, how they use it, and to understand from their perspective how it benefits them. In addition to this we will present advice from employees to the management that is considering implementing the tool.

Method: This is a qualitative study with an abductive approach, where we used both primary and secondary data in this research paper. The primary data was gathered through interviews with different departments at Jönköping County Council, which contributed to different views on the use of the Balanced Scorecard. Theories about the Balanced Scorecard were gathered through secondary data.

Results/conclusions: Overall the management at Jönköping County Council are pleased and satisfied with the Balanced Scorecard. In addition to this they are all motivated and engaged in using the framework. However, they believe that the main drawbacks with the Balanced Scorecard are to make employees understand and connect the daily work to the framework, as well as finding the “correct” numerical values that reflects the organization. The benefits according to the management are the multidimensional view of the organization through the four perspectives in the Balanced Scorecard, and also the fact that they now have a framework which encourage the staff to strive to achieve a unison vision through action plans. The nursing staff was not aware of the term ‘Balanced Scorecard’ or the four perspectives, and therefore wanted to get more information about it from their executives, since they are expected to work in accordance with the framework. Through interviews with the upper- and middle management and the nursing staff we can draw the conclusion that the Jönköping County Council implemented the Balanced Scorecard since they wanted to have a system that could be used at all levels within the organization, this to get an overview and a better control of what is happening within the business.