The Prioritization of Lean Techniques in Emergency Departments Using VIKOR and SAW Approaches.

Abstract

Considering various researches were carried out to implement Lean techniques in healthcare centers, this study has tried to investigate how lean principles could be prioritized in the Emergency Department (ED) by comparing physicians and nurses viewpoints. In the first stage, relevant Lean techniques and several criteria to evaluate the ED performance were selected by reviewing the literature. Then, weight factors for each criterion were calculated using the Entropy method, and Lean techniques were compared and ranked via a questionnaire by which the physicians' and nurses' opinions were obtained separately. In the last stage, the final ranking of Lean techniques was done using VIKOR and SAW methods as two powerful means of Multi-Criteria Decision-Making (MCDM). Theory of Constraints (TOC) was selected as the most appropriate principle from the physicians' viewpoints by both decision-making methods. However, according to the nurses' opinions, Jiduka was the best approach by the VIKOR method, while with the SAW method, 5S was chosen as the most practical Lean technique. This study has illustrated that although all Lean techniques are useable for ED, these techniques' prioritization has a key role in choosing the more suitable Lean approach. Moreover, it provides a chance for the emergency wards to keep down different costs and improve staff and patient satisfaction and the quality of treatment simultaneously.