A large group linguistic Z-DEMATEL approach for identifying key performance indicators in hospital performance management

In hospital management, performance measurement is of vital importance for improving healthcare service quality. The performance of a healthcare organization is often influenced by numerous indicators, and it is unrealistic to manage them all due to the restriction of resources. In addition, the performance measurement for improvement relates to the benefits of many departments, and it is necessary for large number of experts with different backgrounds to participate in the evaluation process of healthcare indicators. In response, this study develops a large group evaluation approach using linguistic Z-numbers and decision-making trial and evaluation laboratory (DEMATEL) to determine key performance indicators (KPIs) for hospital management. For this approach, the complex and uncertain interrelation evaluations among indicators are given by experts using linguistic Z-numbers. An extended DEMATEL method is proposed to determine KPIs based on the cause and effect relationships of performance indicators. Finally, a case study in a rehabilitation hospital is presented to illustrate the effectiveness and usefulness of the proposed large group linguistic Z-DEMATEL approach. The results indicate that incidents/errors, accidents/adverse events, nosocomial infection, nursing technology pass rate, and length of stay are KPIs for the given application. (C) 2019 Elsevier B.V. All rights reserved.