Rapid Assessment of Hospital Emergency Department Performance from the Perspectives of Sustainability, Resilience, and Lean Management

Abstract

The hospital emergency department, as one of the most critical units within the healthcare system, plays a vital role in saving patients' lives, improving the quality of medical services, and increasing public trust. However, challenges such as patient congestion, limited resources, high workloads, and exposure to unforeseen crises have made evaluating and enhancing the department's performance a significant challenge. Therefore, this study aimed to comprehensively and rapidly assess the hospital emergency department's performance based on the Goodson model, utilizing three complementary approaches: lean management, resilience, and sustainability. This applied, descriptive-analytical study was conducted cross-sectionally at a healthcare center in Iran. Data were collected through standardized questionnaires on lean management, resilience engineering, and organizational sustainability, and analyzed using the Goodson rapid assessment model. Experts confirmed the validity of the instruments, and their reliability was verified using Cronbach's alpha. The findings revealed that the emergency department's performance in the sustainability dimension was at an excellent level, surpassing the criteria of the assessment model, indicating a strong focus on social, economic, and environmental factors. The resilience dimension was rated as demonstrating relative readiness to handle critical situations. However, the lean management dimension showed incomplete implementation of lean principles and the presence of waste in some operational processes. These results highlight the importance of improving lean management practices while maintaining and strengthening resilience and sustainability to enhance the overall performance of the hospital emergency department.