Effects of Executing Health Sector Evolution Plan on Emergency Department Performance Indices: A 5-Year Survey

Continuous evaluation, supervision and improvement of the performance of emergency departments (EDs) are done using 5 emergency performance indices (EPI), which are significantly affected by various factors including inward and outward flow of patients, number of ED personnel being in proportion to the number of patients, rapid decision making, the rate of overcrowding in the ED and so on. Since health sector evolution plan (HSEP) can affect the performance of the ED by changing the mentioned factors, we decided to compare these indices in a 5-year period before and after the execution of this program. In this cross-sectional study, all performance indices of ED were calculated and analyzed using parametric and non-parametric tests from one year before to four years after the execution of HSEP. Data were analyzed using SPSS statistical software version 21.0 and all tests were considered significant at 0.05. By continuous execution of HSEP, the total number of ED visits increased in levels 2 and 5 and decreased in level 4. The percentages of patients discharged within 6 hours and discharge against medical advice improved. Mean triage time in all levels, the percentage of patients leaving the ED within 12 hours, unsuccessful cardiopulmonary resuscitation, mean time interval between triage and the first visit in triage levels 3 and 4, and mean time interval between presentation and execution of orders by the nurse in all levels increased. Execution of HSEP can affect performance indices of ED.