Assessing the Relative Performance of Nurses Using Data Envelopment Analysis Matrix (DEAM)

Ali Vafaee Najar, Alireza Pooya, Ali Alizadeh Zoeram, Ali Emrouznejad

Research output: Contribution to journalArticlepeer-review


Assessing employee performance is one of the most important issue in healthcare management services. Because of their direct relationship with patients, nurses are also the most influential hospital staff who play a vital role in providing healthcare services. In this paper, a novel Data Envelopment Analysis Matrix (DEAM) approach is proposed for assessing the performance of nurses based on relative efficiency. The proposed model consists of five input variables (including type of employment, work experience, training hours, working hours and overtime hours) and eight output variables (the outputs are amount of hours each nurse spend on each of the eight activities including documentation, medical instructions, wound care and patient drainage, laboratory sampling, assessment and control care, follow-up and counseling and para-clinical measures, attendance during visiting and discharge suction) have been tested on 30 nurses from the heart department of a hospital in Iran. After determining the relative efficiency of each nurse based on the DEA model, the nurses’ performance were evaluated in a DEAM format. As results the nurses were divided into four groups; superstars, potential stars, those who are needed to be trained effectively and question marks. Finally, based on the proposed approach, we have drawn some recommendations to policy makers in order to improve and maintain the performance of each of these groups. The proposed approach provides a practical framework for hospital managers so that they can assess the relative efficiency of nurses, plan and take steps to improve the quality of healthcare delivery.
Original languageEnglish
Article number125
JournalJournal of Medical Systems
Issue number7
Early online date31 May 2018
Publication statusPublished - 1 Jul 2018

Bibliographical note

© 2018 Springer Publishing. This is a post-peer-review, pre-copyedited version of an article published in Journal of Medical Systems. The final authenticated version is available online at:


  • Data Envelopment Analysis
  • Data Envelopment Analysis Matrix
  • Healthcare services
  • Performance assessment
  • Relative efficiency of nurses


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