目的：混合方法（mixed methods）係整合質化與量化之結果，進行交互對照與驗證，提升研究的可信度與真實性。藉此瞭解醫院員工於導入平衡計分卡前後，認知程度與推行態度的變化情形，並探討推行期間所面臨的問題、潛在原因與關鍵要素。方法：本研究結合問卷調查法、深度訪談和參與觀察。導入前後各發出調查問卷339份，有效回收率分別為85.84%、86.14%。針對問卷所發現的問題擬製訪談大綱，並參與個案醫院平衡計分卡之委員會議。結果：前測問卷分析結果顯示，在認知程度方面，員工的所屬職別達顯著差異；在推行態度方面，員工的所屬職別、學歷達顯著差異。後測問卷分析結果顯示，在認知程度方面，員工的所屬職別、性別、年齡、學歷達顯著差異；在推行態度方面，員工的學歷達顯著差異。經由教育訓練活動後，員工對平衡計分卡的認知與推行態度均有正向提升。混合方法驗證結果：長官的支持與決心為影響護理人員推行態度的主要原因；過去平衡計分卡之運作經驗、推行內容為日常作業，及透過小組會議和專家與管理師的協助，能夠減少員工在平衡計分卡執行上的困難。結論：多元的研究方法加入，有助於釐清導入平衡計分卡過程中所產生的疑問。管理者的支持與投入為首要的關鍵因素，透過激勵、教育訓練和建立溝通管道等方式，以凝聚組織成員的向心力，讓策略活動成為持續性的循環流程。

Objectives: The aims of this study were to determine the level of understanding and attitude changes of staff in the case hospital before and after implementation of Balanced Scorecard (BSC), as well as to discuss the problems encountered during that implementation. Methods: This study uses Mixed Methods including questionnaire surveys, in-depth interviews, and participant observation to compare and verify the results from both the qualitative and quantitative data in order to increase trustworthiness and credibility. A total of 339 copies of questionnaires were distributed before and after the implementation of BSC, and the effective recovery rates were 85.84% and 86.14% respectively. Results: Findings from the pretest questionnaires show that rank of the staff member made a significant difference in terms of understanding. With regard to attitude, the rank and education level of staff members showed statistically significant. Findings from the posttest questionnaires showed that rank, gender, age, and education level made significant differences in terms of understanding. With regard to attitude, the education level of the staff members showed statistically significant. After training, staff members understood BSC better and had a more positive attitude. On multiple parameters, the determination and support of supervisors were key elements in promoting a positive attitude on the part of nursing staff. Previous experience with BSC, promoting BSC as part of daily activities, group meetings, and the assistance of experts reduced the difficulties in implementing BSC for the staff. Conclusions: With multiple research methods, we were able to clarify the questions which arose during implementation of BSC. Support and participation of supervisors were key factors in promoting BSC. With encouragement, trainings, and open channels of communication, the process of implementation went much more smoothly.