en Nursing Orginal research <span style="line-height:2;"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="unicode-bidi:embed"><span calibri=""><span style="color:#2980b9;"><b><i><span new="" roman="" times="">Background:</span></i></b></span><span style="color:#000066;"> </span><span new="" roman="" times="">Emergency medical services (EMSs) organize care provided to patients in out-of-hospital settings, playing a crucial role in minimizing physical and psychological harm resulting from diseases and emergencies. Consequently, pre-hospital emergency is an integral component of healthcare systems, requiring performance standards to improve outcomes for injuries and other illnesses. Thus, the effective utilization of modern management methodologies is essential in this context. </span></span></span><br> <span style="unicode-bidi:embed"><span calibri=""><span style="color:#2980b9;"><b><i><span new="" roman="" times="">Objectives:</span></i></b></span><b> </b><span new="" roman="" times="">The current study aimed to determine the impact of the Lean Six Sigma (LSS) program on performance standards of pre-hospital emergency.</span></span></span><br> <span new="" roman="" times=""><span style="color:#2980b9;"><b><i>Methods:</i></b> </span><span style="color:black">This single-group quasi-experimental study with a pretest-posttest design was conducted on 50 pre-hospital emergency personnel in Koohdasht County in 2023 using a census method. The research tool included a performance standard measurement checklist, completed through observation before and after implementing the LSS method. Data were analyzed using the paired t-test in SPSS v.18 software.</span></span><br> <span style="unicode-bidi:embed"><span calibri=""><span style="color:#2980b9;"><b><i><span new="" roman="" times="">Results:</span></i></b></span><span new="" roman="" times=""> The findings revealed that the majority of participants held bachelor&rsquo;s degrees (54%), were contractual employees (56%), and were all male. There was a statistically significant difference in the mean score of the performance standards in the personnel (p=0.001), equipment (p<0.001), and overall (p<0.001) dimensions before and after the intervention.</span></span></span><br> <span style="unicode-bidi:embed"><span calibri=""><span style="color:#2980b9;"><b><i><span new="" roman="" times="">Conclusion:</span></i></b></span><span new="" roman="" times=""> Based on the findings, the implementation of the LSS program was able to enhance the performance standards of pre-hospital emergency in the personnel and equipment dimensions, and overall. Hence, the use of this method is recommended in other centers and other dimensions affecting the performance standards of pre-hospital emergency.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><span style="font-size:8.0pt"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span></span> Total Quality Management, Emergency Medical Services, Institutional Practice 51 58 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-287-2&slc_lang=en&sid=1 Ehsan Koshki koshkiehsan0849@gmail.com 100319475328460013734 0009-0000-3740-8876 No Department of Nursing, Nursing and Midwifery Care Research Center, Non-Communicable Diseases Research Institute, Shahid Sadougi University of Medical Sciences, Yazd, Iran Mohammad Zarezadeh momehdi@yahoo.com 100319475328460013735 100319475328460013735 No Department of Health Management and ecomomics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Khadijeh Nasiriani nasiriani@gmail.com 100319475328460013736 100319475328460013736 Yes Department of Nursing, Nursing and Midwifery Care Research Center, Non-Communicable Diseases Research Institute, Shahid Sadougi University of Medical Sciences, Yazd, Iran