Journal of Medical Systems

, Volume 35, Issue 5, pp 1039–1062 | Cite as

Data Envelopment Analysis Model for the Appraisal and Relative Performance Evaluation of Nurses at an Intensive Care Unit

  • Ibrahim H. Osman
  • Lynn N. Berbary
  • Yusuf Sidani
  • Baydaa Al-Ayoubi
  • Ali Emrouznejad


The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.


Data envelopment analysis Health care services Nursing appraisal Performance evaluation Ratio pitfalls of units to measures Talent management 



The authors would like to thank the director of nursing services at Hospital G for cooperation and allowing access to their confidential data without such the project would not have been achieved.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Ibrahim H. Osman
    • 1
  • Lynn N. Berbary
    • 1
  • Yusuf Sidani
    • 1
  • Baydaa Al-Ayoubi
    • 2
  • Ali Emrouznejad
    • 3
  1. 1.Olayan School of BusinessAmerican University of BeirutBeirutLebanon
  2. 2.Faculty of Science ILebanese UniversityBeirutLebanon
  3. 3.Aston Business SchoolAston UniversityBirminghamUK

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