Enhancing Decision-Making in Healthcare Systems: Lean, Agile, Resilient, Green, and Sustainable (LARGS) Paradigm for Performance Evaluation of Hospital Departments under Uncertainty

نوع مقاله : مقاله علمی پژوهشی

نویسندگان

Department of Industrial and Systems Engineering, Fouman Faculty of Engineering, College of Engineering, University of Tehran, Tehran, Iran.

10.22059/imj.2025.386420.1008208

چکیده

Objective: This research aims to propose a multi-criteria decision-making model for ranking hospital departments. The primary purpose of this model is to assist managers in the optimal allocation of limited resources, thereby reducing costs while increasing patient satisfaction. The ranking results help managers in decision-making processes such as equipment development, staff training, and addressing patient complaints.
Methods: This study evaluated the performance of five hospital departments (Emergency, Ophthalmology, Cardiovascular, Infectious, and Neurology) in Shiraz, Iran, using the fuzzy DEMATEL-MARCOS multi-criteria decision-making method. Firstly, criteria were prioritized using the fuzzy DEMATEL method, after which hospital departments were ranked using the fuzzy MARCOS method. A sensitivity analysis was conducted to validate the results.
Results: Performance metrics for the hospital departments were identified based on the Lean, Agile, Resilient, Green, and Sustainable (LARGS) paradigm. The results revealed that patient satisfaction and job satisfaction had the most substantial influence on performance, while reducing excess transportation and over-processing had the least impact. Utilizing the fuzzy MARCOS method, the hospital departments were ranked according to their overall desirability. The sensitivity of these rankings was assessed by adjusting the weights of the criteria. A comparative analysis with four other fuzzy methods (ARAS, COCOSO, EDAS, and WASPAS) confirmed that the fuzzy MARCOS method was the most effective tool for prioritizing hospital departments.
Conclusion: The fuzzy MARCOS results indicated that the “Infectious Department” performed well, while the “Ophthalmology Department” required improvement. Enhancing the “Infectious Department” hinged on better staff training, cost reduction, and safe waste management. This research introduces a novel approach using the fuzzy DEMATEL-MARCOS model, enabling hospitals to assess performance through modern methodologies, such as Lean, Agile, Resilient, Green, and Sustainable, even in uncertain conditions

کلیدواژه‌ها


عنوان مقاله [English]

Enhancing Decision-Making in Healthcare Systems: Lean, Agile, Resilient, Green, and Sustainable (LARGS) Paradigm for Performance Evaluation of Hospital Departments under Uncertainty

نویسندگان [English]

  • Salman Nazari-Shirkouhi
  • Reihane Zarei Babaarabi
Department of Industrial and Systems Engineering, Fouman Faculty of Engineering, College of Engineering, University of Tehran, Tehran, Iran.
چکیده [English]

Objective: This research aims to propose a multi-criteria decision-making model for ranking hospital departments. The primary purpose of this model is to assist managers in the optimal allocation of limited resources, thereby reducing costs while increasing patient satisfaction. The ranking results help managers in decision-making processes such as equipment development, staff training, and addressing patient complaints.
Methods: This study evaluated the performance of five hospital departments (Emergency, Ophthalmology, Cardiovascular, Infectious, and Neurology) in Shiraz, Iran, using the fuzzy DEMATEL-MARCOS multi-criteria decision-making method. Firstly, criteria were prioritized using the fuzzy DEMATEL method, after which hospital departments were ranked using the fuzzy MARCOS method. A sensitivity analysis was conducted to validate the results.
Results: Performance metrics for the hospital departments were identified based on the Lean, Agile, Resilient, Green, and Sustainable (LARGS) paradigm. The results revealed that patient satisfaction and job satisfaction had the most substantial influence on performance, while reducing excess transportation and over-processing had the least impact. Utilizing the fuzzy MARCOS method, the hospital departments were ranked according to their overall desirability. The sensitivity of these rankings was assessed by adjusting the weights of the criteria. A comparative analysis with four other fuzzy methods (ARAS, COCOSO, EDAS, and WASPAS) confirmed that the fuzzy MARCOS method was the most effective tool for prioritizing hospital departments.
Conclusion: The fuzzy MARCOS results indicated that the “Infectious Department” performed well, while the “Ophthalmology Department” required improvement. Enhancing the “Infectious Department” hinged on better staff training, cost reduction, and safe waste management. This research introduces a novel approach using the fuzzy DEMATEL-MARCOS model, enabling hospitals to assess performance through modern methodologies, such as Lean, Agile, Resilient, Green, and Sustainable, even in uncertain conditions

کلیدواژه‌ها [English]

  • Performance Evaluation of Health Care Systems
  • Fuzzy DEMATEL
  • Uncertainty
  • LARGS
  • Fuzzy MARCOS
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