| Although efforts to measure Emergency Department (ED) performance have contributed to our understanding of many of the processes and outcomes associated with ED care, limited attempts have been made to place this work within a broader theoretical framework. This study contributes to the health care performance measurement literature by contributing an ED performance framework and set of indicators that balances stakeholder interests as well as multiple dimensions of performance. The study draws on the Competing Values Framework of organizational effectiveness to describe and analyze ED stakeholders' perspectives (physicians, nurses, managers, community care access center personnel, and pre-hospital care personnel) on the dimensions and indicators necessary to evaluate ED performance. Feedback on the importance of ED performance indicators indicates that, while ED stakeholders are primarily interested in indicators that focus on their role and capacity to provide care, there is a higher degree of consistency in stakeholder interests than might be anticipated, that key differences exist between hospital and non-hospital stakeholders, and that physicians place lower importance on ED performance measures than other provider stakeholders in the study. The results suggest that small hospital stakeholders may have different ED performance information needs than their teaching and community hospital counterparts. An ED performance framework and set of indicators that integrates the interests of provider stakeholders is proposed, the contribution of the framework and managerial implications are discussed, and future research opportunities are explored. |
