<![CDATA[Introduction: Head ward nurses (HWNs) play a critical role in healthcare organizations by coordinating ward activities, managing staff, and ensuring quality care delivery. Identifying and structuring their core competencies is essential for improving performance and supporting strategic workforce development. This study aimed to identify, map, and grade HWNs’ core competencies using the Balanced Scorecard (BSC) framework. Methods: A mixed-method study with an exploratory sequential design was conducted in the surgical department of the Azienda Unità Sanitaria Locale (AUSL) of Piacenza, Italy. The qualitative phase informed the development of a survey administered to a convenience sample of healthcare professionals, including physicians, nurses, assistants, and therapists, representing 39% of the eligible population. Additionally, all nurse ward managers in the department were included in the quantitative phase (100% of the target population). Results: The BSC framework enabled the identification, organization, and measurement of HWNs’ competencies across key performance domains. It facilitated alignment with strategic priorities, supported the development of a balanced competency profile, and enabled the grading and evaluation of skills within professional practice. Conclusions: Mapping and grading HWNs’ core competencies using the BSC model provides a structured approach to clarify professional roles, enhance performance, and support competency-based evaluation. This framework offers a valuable tool for leadership development and workforce planning. Future research should validate this model in diverse healthcare settings and examine its impact on organizational outcomes, staff performance, and patient care quality.]]>
