Hashemi Behrooz, Baratloo Alireza, Rahmati Farhad, Forouzanfar Mohammad Mehdi, Motamedi Maryam, Safari Saeed
Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Emerg (Tehran). 2013 Fall;1(1):20-3.
Emergency department performance index (EPI) greatly influences the function of other hospital's units and patient satisfaction. Recently, the Iranian Ministry of Health has defined specific national EPI containing five indexes. In the present study the performance indexes of emergency department (ED) in one educational hospital has been assessed before and after establishment of emergency medicine.
In the present cross-sectional study the ED of Shohadaye Tajrish Hospital, Tehran, Iran was assessed during one-year period from March 2012 to February 2013. The study was divided into two six-month periods of before and after establishment of emergency medicine. Five performance indexes including: the percentage of patients were disposed during 6-hour, leaved the ED in a 12-hour, had unsuccessful cardiopulmonary resuscitations (CPR), discharged against medical advice, and the mean time of triage were calculated using data of department of medical records on daily patients' files. Then, Mann-Whitney U test was used to make comparisons at P<0.05.
The average triage time decreased from 6.04 minutes in the first six months to 1.5 minutes in the second six months (P=0.06). The percentage of patients leaving the ED in a 12-hour decreased from 97.3% to 90.4% (P=0.004). However, the percentage of disposed patients during 6-hour (P=0.2), unsuccessful CPR (P=0.34) and discharged against medical advice (P=0.42) did not differ between the two periods.
It seems that establishment of emergency medicine could be able to improve ED performances indexes such as time to triage and leave in a 12-hour period.
急诊科绩效指标(EPI)对医院其他科室的功能及患者满意度有很大影响。最近,伊朗卫生部制定了包含五项指标的特定国家EPI。在本研究中,一所教学医院急诊科在急诊医学设立前后的绩效指标得到了评估。
在本横断面研究中,对伊朗德黑兰塔吉里什烈士医院的急诊科在2012年3月至2013年2月的一年期间进行了评估。该研究分为急诊医学设立前后的两个六个月时间段。使用病历部门日常患者档案中的数据计算了五项绩效指标,包括:6小时内处理的患者百分比、12小时内离开急诊科的患者百分比、心肺复苏(CPR)未成功的患者百分比、违反医嘱出院的患者百分比以及平均分诊时间。然后,采用曼-惠特尼U检验进行比较,P<0.05。
平均分诊时间从前六个月的6.04分钟降至后六个月的1.5分钟(P=0.06)。12小时内离开急诊科的患者百分比从97.3%降至90.4%(P=0.004)。然而,两个时间段内6小时内处理的患者百分比(P=0.2)、CPR未成功的患者百分比(P=0.34)以及违反医嘱出院的患者百分比(P=0.42)没有差异。
急诊医学的设立似乎能够改善急诊科的绩效指标,如分诊时间和12小时内离开的时间。