近年來急診的服務量日漸增多，為了使病患能得到妥善的治療，急診醫療團隊皆積極地開發出理想的檢傷分類系統以因應時勢。然而案例急診室內科輕症病患仍舊約有四成五的比例超出建議的候診時間，能夠縮減病患等候時間、病患滯留時間進而降低超出建議的候診時間之比例即為本研究所關切的議題。
以南部醫學中心急診部為實例，為期五個月的實際觀察，詳細了解急診室實際運作流程。首先針對急診流程繪製價值流圖（Value Stream Mapping，VSM）檢視現況並找出浪費之所在，作為改善之契機，本研究利用單元工程的概念應用於案例急診部，產生出適合且實務可行的四個設施佈置方案，四個改善方案相對於現況均有改善成效，其中滯留時間改善幅度20%至22%之間、等待時間為11%至15%之間及服務水準為17%至24%之間，改善方案同時也改變看診地點，提升病患的隱私性以及護理人員效率。
而設施規劃考量為了考慮周全性，除了考慮以上之定量指標，本研究與使用者討論出四個代表性的定性指標，透過各層級評選人為改善方案評分，其中評選人包含精實專家、急診室主任、資深醫師和護理長等等七位成員與先前模擬實驗結果產生的定量指標以模糊多屬性決策分析程序進行方案評選，找出評選最佳佈置方案為方案4。
方案4在綜合評比中得到最評價且於定量五項評比中皆是最高分，但在定性的改善難易度的指標中被認定為最難，雖目前無法達成，供使用者可作為未來改善目標。

First, the study applies the Value Stream Mapping (VSM) to find out wastes among the process. From VSM, we can discover potential improvement opportunities in this emergency department system. Second, based on lean principles, we design four cell layouts to shorten the distance of movement for medical staffs. In order to increase the possibility of changing the layout, we discuss with users in the design layouts process for several times.
Third, for the purpose of evaluating layout well, we adopt multiple performance indexes, including quantitative indexes and qualitative indexes. The use of a discrete-event simulation method can collect a variety of quantitative performance measures, such as moving distance and total waiting time. On the other hand, fuzzy multiple attribute decision making method (FMADM) can collect a variety of qualitative performance measures, such as difficulty of changing layout and flow efficiency. Finally, we follow the proposed FMADM methodology to solve the case-study ED and put appropriate alternatives to user in different situations. These suggestions can provide facility designers with some findings and results.

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