OBJECTIVES: Customers in health include patients and health care workers (HCWs). We intended to review all the customer subdimensions used in balanced scorecard (BSC) implementations and then to assess the impact of the pandemic on the customer subdimensions at health care organizations (HCOs).

METHODS: First, we performed a systematic review in accordance with PRISMA guidelines to find all customer key performance indicators (KPIs) used in BSC implementations from the time of inception until October 2020 in PubMed, Embase, Cochrane, Google Scholar databases, and Google's search engine. Second, we performed a search for independent studies using the resulting customer subdimensions with the COVID-19 keyword in Google engine and Google Scholar until June 2021.

RESULTS: 161 customer KPIs were extracted from 36 implementations. Categorizing KPIs resulted into 3 major-dimensions and 12 subdimensions. In the next step, the patient centeredness major-dimension, patient satisfaction was not affected or was found to remain positive. Few studies have focused on assessing the psychological effects on patients. Patient complaints, loyalty assessment, and the psychological impact on non-COVID-19 patients still need more investigation. In the response to patients and communication major-dimension, physician–patient communication positively affected the patient's psychological status. However, using protective equipment during the pandemic could have imposed a barrier to effective communication. More research is still needed to improve and evaluate patient education programs, patient guidelines, counseling and consultation services, and communication between HCWs and patients during the pandemic. In HCWs’ centeredness major-dimension, HCWs’ satisfaction, burnout, stress, psychological support and motivation were found to be improved. Studies have suggested strategies to facilitate recruitment. Nevertheless, the HCW vaccination, engagement, motivation, teamwork, and loyalty subdimensions and their impact are still not well investigated during the pandemic.

CONCLUSIONS: Researchers are encouraged to analyze the pandemic impact on customer subdimensions, and to better focus on them in the future performance evaluations of HCOs.