A new approach for emergency department performance positioning: The quality-efficiency matrix

Area of Science:

• Healthcare Management
• Health Services Research
• Operations Research

Background:

• Emergency department (ED) crowding is a significant factor affecting patient care quality.
• Measuring ED performance is crucial for enhancing healthcare system efficiency and quality.
• Developing effective performance measurement tools is essential for EDs.

Purpose of the Study:

• To develop a tool for evaluating ED performance, analyzing quality and efficiency.
• To assess performance changes resulting from a new organizational model.
• To implement and validate the tool in two Italian EDs.

Main Methods:

• Conducted a literature review to identify key ED performance metrics.
• Developed a matrix to visualize the relationship between quality and efficiency.
• Utilized a method to translate annual ED performance data into a benchmarking graph.
• Compared 'as-is' (current) and 'to-be' (post-change) scenarios.

Main Results:

• The developed tool effectively depicts ED performance, illustrating changes between 'as-is' and 'to-be' states.
• The tool facilitates benchmarking between healthcare organizations.
• It aids in identifying strategic areas and optimizing resource allocation.
• Results clearly indicate performance improvements or declines post-organizational change.

Conclusions:

• The graphical tool summarizes performance changes, aiding decision-making for EDs and hospitals.
• It provides a clear analysis of service quality (triage appropriateness, patient satisfaction) and efficiency.
• The tool simplifies the evaluation of organizational changes in ED settings.