Developing Key Performance Indicators for Emergency Department of Teaching Hospitals: A Mixed Fuzzy Delphi and Nominal Group Technique Approach

BACKGROUND: This article demonstrates combination of the fuzzy Delphi method (FDM) and the nominal group technique (NGT) to consolidate consensus agreement within a panel of experts regarding key performance indicators (KPIs) development for emergency department (ED). METHODS: Twenty-four participants for NGT and 10 experts for FDM were randomly chosen from the emergency medicine (EM) department staff list obtained from the human resource department of study centres. A set of item constructs related to KPIs was developed from the NGT session and used for the FDM session in the second phase of the study. RESULTS: We found that 16 out of 22 and 11 out of 15 items satisfied the first prerequisite ‘d’ value ≤ 0.2. Ten items (45%) from the service KPI domain and six items (40%) from the academic KPI domain had expert consensus of more than 75%. A total of 16 out of 22 (73%) and 14 out of 15 (93%) fit the criteria of an average fuzzy number (A value) of more than 0.5. Fifteen items that fulfilled the prerequisites were retained for the final KPI draft. CONCLUSION: The FDM and NGT analyses reached experts’ consensus on the suitability of the pre-selected items in the ED KPIs. The development of the KPI framework is expected to enhance future improvement of EM services and academic activities in all teaching hospitals in the country.