Emergency department ergonomic design evaluation: A case study using fuzzy DEMATEL-focused two-stage methodology

Objectives: An emergency department (ED) is a unit of a hospital that is designed, staffed, and equipped to treat injured people and those afflicted with sudden and severe illness. Evaluation of ergonomic design of these departments with respect to specific criteria/standards is expected to contribute to the improvement of productivity and service quality since EDs have too much complexity and volume in the patient flow. Therefore, this paper proposes a two-stage methodology for evaluation of ED ergonomic design. Methods: The first stage provides a check-list with 137 items on six main headings to evaluate the ergonomics of ED physical design with the opinions of medical staff. The second stage offers a fuzzy-based cause and effect decision-making model for the decreased items assessed in the first stage. In this stage, a fuzzy decision-making trial and evaluation laboratory (FDEMATEL) is used since the decision-making process involves the vagueness of human judgments. Results: Considering the interdependence among items, proposed FDEMATEL reflects the causal relationships among criteria through a cause-effect relationship diagram. A case study was carried out at a training and research hospital ED in Istanbul, Turkey. Conclusion: In conclusion, several suggestions are offered that the ED needs interventions on accessibility, patient and personnel accommodations, and personnel privacy.