Comparison of Performance Indices of Emergency Departments before and after Implementation of Specialist Residency Program under the Health Sector Evolution Plan in the Hospitals of Bushehr University of Medical Sciences, Iran

Document Type : Original Article

Authors
Seyed Abdolhosein Mousavi-Rigi 1
Mozhdeh Dorahaki 2
Saeed Ebrahimi 3
1 MSc, Health Services Management, Deputy of Treatment, Bushehr University of Medical Sciences, Bushehr, Iran
2 MSc, Health Information Technology, Deputy of Treatment, Bushehr University of Medical Sciences, Bushehr, Iran
3 Lecturer, Health Information Technology, Department of Health Information Technology, School of Paramedicine, Zahedan University of Medical Sciences, Zahedan, Iran
Abstract
Introduction: Due to the importance of the emergency department of hospitals, section three of health sector evolution plan emphasizes on the specialist residency program in governmental hospitals. The purpose of this study was the comparison of performance indices of Emergency Departments before and after implementation of specialist residency program under the health sector evolution plan in the hospitals of Bushehr University of Medical Sciences, Iran.Methods: This was a descriptive-analytic study performed at the Bushehr University of Medical Sciences public hospitals. The researcher collected performance indicators of the emergency ward during 2013 and 2014 period by visiting the university’s deputy of health. Data were analyzed using paired t-test and differences were presented descriptively.Results: The result of comparing performance indicators using paired t-test showed that the difference observed in performance indicators including the percentage of patients who processed in 6 hours, the percentage of patients discharged from the department within 12 hours, patients discharged against medical advice and the average duration of triage in emergency was significant (P < 0.050). While unsuccessful cardiopulmonary resuscitation (CPR) percentage showed no significant changes.Conclusion: Instructions in healthcare evolution plan for specialist residency in public hospitals were successful in improving performance indicators of emergency ward except for the unsuccessful CPR percentage which showed no significant change. In general, this plan has improved the performance indicators of emergency ward and, if continued and continuously improved, can lead to the improvement of other hospital indicators and ultimately the improvement of healthcare as a whole.

Keywords

  1. Emami Razavi SH. Health system reform plan in Iran: Approaching Universal Health Coverage. Hakim Health Sys Res 2016; 18(4): 329-35. [In Persian].
  2. Ministry of Health and Medical Education. Set of instructions healthcare sector evolution plan [Online]. [cited 2015]; Available from: URL: https://mui.ac.ir/sites/default/files/up_file/link/pdf/100.89p1.pdf. [In Persian].
  3. Mayer TA, Cates RJ, Mastorovich MJ, Royalty DL. Emergency department patient satisfaction: customer service training improves patient satisfaction and ratings of physician and nurse skill. J Healthc Manag 1998; 43(5): 427-40.
  4. Yousefzadeh Chabok S, Mohtasham Amiri Z, Haghdoost Z, Mohseni M, Asadi P, Kazemnezhad Leili E. Patients discharged before and after presence of medical emergency specialists. J Holist Nurs Midwifery 2014; 24(1): 64-70. [In Persian].
  5. Nasiri Pour AA, Riyahi L, Gholami Pour M. Effect of the presence of a full-time specialist in gynaecology and obstetrics hospital length of stay in Yazd Social Security. J Med Counc I R Iran 2010; 28(2): 169-75. [In Persian].
  6. Center for Public Relations and Information. The annual report important actions of priority of ministry of health, treatment and medical training in eleventh government [Online]. [cited 2016]; Available from: URL: http://www.behdasht.gov.ir/uploads/kholase%20amalkard.pdf. [In Persian].
  7. Emamirazavi SH, Maasomi G, Jalili M, Siah-Tir M. Emergency department performance index [Online]. [cited 2013]; Available from: URL: https://treatment.sbmu.ac.ir/uploads/0056-shakhes.pdf. [In Persian].
  8. Iranian Students News Agency (ISNA). Increased patient staying in emergency department due to lack of beds [Online]. [cited 2015]; Available from: URL: https://www.isna.ir/news/94021407570. [In Persian].
  9. Horwitz LI, Green J, Bradley EH. US emergency department performance on wait time and length of visit. Ann Emerg Med 2010; 55(2): 133-41.
  10. Trzeciak S, Rivers EP. Emergency department overcrowding in the United States: An emerging threat to patient safety and public health. Emerg Med J 2003; 20(5): 402-5.
  11. Commission of Educational Programs Development in Iran Ministry of Health and Medical Education. Educational program and emergency medicine criteria [Online]. [cited 2008]; Available from: URL:
  12. http://zums.ac.ir/files/education/files/course/264_920_CurriculumTakh_Emergency.pdf. [In Persian].
  13. Tabibi SJ, Najafi B, Shoaie S. Waiting time in the emergency department in selected hospitals of Iran University of Medical Sciences in 2007. Pajouhesh Dar Pezeshki 2009; 33(2): 117-22. [In Persian].
  14. Jafari Sirizi M, Seyedin S, Aghlmand S, Seyed Mahmodi M. Performance indicators of emergency departments following the implementation of specialist residency program under the health sector evolution plan in public hospitals of west Azerbaijan Province. J Health Adm 2017; 20(67): 50-63. [In Persian].
  15. Hashemi B, Baratloo A, Rahmati F, Forouzanfar MM, Motamedi M, Safari S. Emergency department performance indexes before and after establishment of emergency medicine. Emergency 2013; 1(1): 20-3.
  16. Movahednia S, Partovishayan Z, Bastani M. A survey of timing indicators of emergency department at Firoozgar Hospital: 2012. J Health Adm 2013; 16(51): 95-102. [In Persian].
  17. Duno R, Pousa E, Sans J, Tolosa C, Ruiz A. Discharge against medical advice at a general hospital in Catalonia. Gen Hosp Psychiatry 2003; 25(1): 46-50.
  18. Pages KP, Russo JE, Wingerson DK, Ries RK, Roy-Byrne PP, Cowley DS. Predictors and outcome of discharge against medical advice from the psychiatric units of a general hospital. Psychiatr Serv 1998; 49(9): 1187-92.
  19. Razavian F, Khodadadi J, Vafaee K, Ahmadi F. Compare rates and reasons patients discharged against medical advice before and after the implementation of healthcare reform plan in the Kamkar Arabnia Hospital at the Last Quarter of 2013 and First Quarter of 2014 and Second Half of 2014. Proceedings of the National Conference of the 11th Governments Performance Review in the Field of Health; 2015 May 5-6; Tehran, Iran. [In Persian].
  20. Montazar SH, Amooei M, Sheyoei M, Bahari M. Results of CPR and contributing factor in emergency department of Sari Imam Khomeini Hospital, 2011-2013. J Mazandaran Univ Med Sci 2014; 24(111): 53-8. [In Persian].
  21. Bowker L, Stewart K. Predicting unsuccessful cardiopulmonary resuscitation (CPR): A comparison of three morbidity scores. Resuscitation 1999; 40(2): 89-95.
  22. Jafarian A. Evaluation of succesful cardiopulmonary ressuscitation (CPR) rate in haftom teer hospital. Razi J Med Sci 2002; 9(30): 327-31. [In Persian].
Health Information Management
Volume 14, Issue 5 - Serial Number 5
Autumn 2017
Pages 205-210