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Purpose

From the data derived from a Vietnamese hospital, this study seeks to discern which organisational culture types, leadership styles, and trust types pave the path for the implementation of the balanced scorecard (BSC) system.

Design/methodology/approach

The study uses a case research approach with a triangulation of data collation methods encompassing access to documents, field observations, and interviews. The in‐depth interviews with 37 hospital members and field observations were conducted during 21 months from March 2009 to November 2010.

Findings

The findings show that features relating to organisational change in terms of organisational culture, leadership style, and trust can impact the success of BSC implementation; nonetheless, the opposite direction can merely be encountered in the relationship between leadership style and BSC implementation.

Originality/value

The study offers insights into a successful model of BSC implementation in the healthcare sector built on such antecedents as organisational culture, leadership, and trust.

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