The Effect of Specialist Residency program on the Performance Indicators of Emergency Department of Hospitals in Tehran: An Interrupted Time Series Study

The performance of the emergency department as one of the most dangerous treatment areas has a great impact on the performance of other hospital departments. This study investigated the effect of specialist residency program in the health system reform plan on the performance indicators of the emergency departments in hospitals affiliated to Tehran University of Medical Sciences.

The present study was a descriptive-analytical cross-sectional one that was performed in 2019 in the emergency departments of all hospitals affiliated to Tehran University of Medical Sciences. Six emergency performance indicators were collected on an average monthly basis in two time periods, 26 months before and 46 months after the implementation of the program, by referring to the hospital units. The data were analyzed using interrupted time series model with Eviews 10 and SPSS 24.

The implementation of the program did not have a significant effect on the level and trend of the percentage of some indicators including patients decided upon within 6 hours, patients discharged from the emergency department within 12 hours, unsuccessful cardiopulmonary resuscitation, and mean triage time (level 2). However, it had a significant effect on the level and trend of the percentage of discharge against medical advice. Implementation of the program did not have a significant effect on the trend of the mean triage time (level one), but had a significant effect on the level of the said indicator.

Although some of the performance indicators of the emergency departments improved after the implementation of the program, still certain infrastructure such as human resources supply and holding well-organized and efficient training courses are needed for the proper implementation of this program.