Reducing crowd volumes at Emergency Departments (EDs) has been of a significant concern for healthcare providers worldwide. While some consider Urgent Care at Home (UCH) as a means to ease ED volumes, the combination of lean assessment tools (LAT) and UCH is thought to be a more effective approach to address this complicated problem. A comprehensive framework has been developed to explore the key critical factors of lean assessment tools by integrating these lean effective tools with UCH. That for this study the key step to enhance the operational performance to the framework is the comparative impact of LAT and UCH between two countries, Kingdom of Saudi Arabia (KSA) and the United States of America (USA) in terms of lean assessment tools, urgent care at home, and their related variables. This important benchmarking study compares thirty responses to survey questions from KSA and USA. The sixty qualified professionals have a vast amount of experience in the field of lean concepts and lean six sigma in both industry and academia. The primary analytical tool for this study is the use of ordinal regression to determine which of the countries have a statistically significant effect on the lean assessment tools, Urgent Care at Home, and their related variables. The results indicate that there is a significant difference in the application of lean assessment tools, Urgent Care at Home, and their related variables. It was found that the increase in the likelihood of better performance in some of variables in the USA Emergency Departments as compared to KSA Emergency Departments. This study provides the framework for future collaborative improvement projects and studies in healthcare for increased performance of EDS.


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Graduation Date





Elshennawy, Ahmad


Doctor of Philosophy (Ph.D.)


College of Engineering and Computer Science


Industrial Engineering and Management Systems

Degree Program

Industrial Engineering




CFE0008118; DP0023454





Release Date

August 2025

Length of Campus-only Access

5 years

Access Status

Doctoral Dissertation (Campus-only Access)

Restricted to the UCF community until August 2025; it will then be open access.