An integrated approach for evaluating and improving the performance of hospital ICUs based on ergonomic and work-motivational factors

Comput Biol Med. 2024 Jan:168:107773. doi: 10.1016/j.compbiomed.2023.107773. Epub 2023 Dec 4.

Abstract

The intensive care unit (ICU) holds significant importance in hospitals. Primarily concerned with monitoring and providing care to critically ill patients, the ICU has proven effective in reducing mortality rates and minimizing complications of diseases, thanks to the highly complex and specific measures taken within this department. Considering the unique contributions made by the staff in this unit, its performance assessment can help improve patient care and satisfaction. This study presents a framework that utilizes ergonomic and work-motivational factors (WMFs) to assess the performance of various ICUs. Upon the identification of these indicators, a standard questionnaire is developed to collect the required data. The mean efficiency score of the units is then determined using the data envelopment analysis (DEA). The model is validated using the principal component analysis (PCA). Ultimately, the SWOT (strengths, weaknesses, opportunities, and threats) matrix is employed to formulate an appropriate strategy and offer improvement measures to the managerial team to enhance their ICU performance. The proposed framework can be applied to evaluate the performance of other healthcare departments. Among the studied ICU centers, including general ICU, isolation ICU catering to individuals with infectious diseases, cardiac care unit (CCU), and neonatal ICU (NICU). NICU and general ICU have the best and worst performance in terms of macro- and micro-ergonomic and motivational indicators, which are on average 0.826% more elevated and 0.659% lower, respectively. According to the performed sensitivity analysis, the ICUs in question demonstrate the most appropriate and inappropriate performance about the indicators of "knowledge, situation assessment, and situation analysis" and "work stress", respectively.

Keywords: Data envelopment analysis; Intensive care unit; Macro-ergonomics; Micro-ergonomics; Performance evaluation; Work motivational factors.

MeSH terms

  • Critical Care*
  • Delivery of Health Care
  • Ergonomics
  • Hospitals
  • Humans
  • Infant, Newborn
  • Intensive Care Units*