The design and use of OKRs in healthcare organizations

Abstract

Purpose: This paper explores how Objectives and Key Results (OKRs) - a goal-setting and performance management framework widely used in technology firms - can be adapted and applied to healthcare organizations. It aims to investigate their potential to enhance strategic alignment, patient-centered outcomes, and organizational agility while addressing the unique complexities of European healthcare systems. Design/Methodology/Approach: The study adopts a conceptual research design, integrating insights from performance management, healthcare management, and organizational behavior literatures. A multi-stage process of literature review, comparative analysis, contextual adaptation, and synthesis is employed to develop a framework tailored to the healthcare sector, highlighting principles for the design, implementation, and use of OKRs in clinical and organizational settings. Findings: The paper demonstrates that OKRs can bridge the gap between strategic aspirations and operational realities in healthcare. When properly designed, objectives capture mission-driven goals, while key results provide measurable and patient-centered indicators of progress. OKRs foster alignment across multidisciplinary teams, improve accountability, and introduce agility through iterative review cycles. However, risks such as staff resistance, over-quantification, and misalignment with existing performance systems must be addressed through participatory approaches, integration, and cultural sensitivity. Originality/Value: This paper is among the first to conceptualize OKRs as a hybrid governance and performance management mechanism in healthcare. By positioning OKRs as both technical tools and cultural levers, this approach contributes to the management control literature and provides actionable insights for practitioners. The proposed framework highlights the potential of OKRs to transform European healthcare organizations from compliance-driven to commitment-driven systems, focusing on measurable, patient-centric outcomes. Research Implications: The paper makes important theoretical contributions to performance management research by conceptualizing OKRs as hybrid control mechanisms that bridge diagnostic and interactive systems, advancing understanding of strategic alignment in professional service organizations, and developing prescriptive theory that connects management control scholarship with organizational behavior insights.