9 Chapter II Literature Review II.1 Introduction This study aims to develop a hospital strategy execution system that prioritizes maximizing daily EBITDA as a Key Performance Indicator (KPI). The hospital business processes can be divided into two distinct systems. The first is general management processes that can be managed by following general management efficiency and productivity. The second are clinical pathways related to business processes that follow strict clinical discipline and healthcare ethics. The author believes this adaptable approach can be easily implemented across various hospitals, including large and small-medium hospitals. This adaptability is a key feature that offers a sense of reassurance in its application, ensuring that the system can be tailored to each organization's unique needs. This system, designed to serve as an effective tool for strategy execution, particularly for hospitals dissatisfied with their operating profit outcomes during the execution process, is adept at addressing specific challenges. Large hospitals may find this system valuable in establishing a discipline for strategy execution before advancing to more complex systems. Non-profit organizations can also benefit from this system, as it enhances operational efficiency and productivity, effectively tackling their unique obstacles. One famous strategy execution system is the Balanced Scorecard (BSC), an intricate and multifaceted framework that integrates Complex Financial, Customer, Business Process, and Learning and Growth perspectives. It provides a powerful tool for revealing an organization's strategic direction, linking its overarching vision and specific objectives to operational execution through various performance indicators (Huang et al., 2011; Kaplan, 2005). However, the BSC does not prioritize the simplification of this complexity. Instead, it champions a detailed and nuanced performance management strategy that can pose significant challenges in terms of comprehension and effective oversight (Kaplan & Norton, 2007; Setyopurnomo et al., 2025a). 10 When applied to operational management, the BSC's reliance on numerous indicators can dilute the focus of operations managers and the physicians responsible for patient care. To address this issue, this research advocates for a more streamlined approach to strategy execution in operational management. It emphasizes the use of a single, straightforward financial metric—EBITDA—as the primary Key Performance Indicator (KPI). This focus not only clarifies operational priorities but also highlights the critical importance of robust financial management in achieving organizational success (Setyopurnomo et al., 2025a). The author critically examines traditional performance management systems, which typically rely on numerous performance indicators that can complicate managerial oversight and impede decision-making (Kaplan & Norton, 2007). It posits that hospitals, particularly within the realm of operations management, would benefit from a streamlined approach centered around a key performance indicator like EBITDA. While recognizing the significance of financial performance and stability, the research advocates for maximizing daily EBITDA as a more manageable and direct method to achieve broader financial objectives at the operational level, thereby instilling confidence in its practicality (Setyopurnomo et al., 2025a).