Implementation effect of specialist residency program: A case study on performance indicators of emergency departments

ABSTRACT

Background

The aim of the study is to evaluate the performance of emergency departments in hospitals affiliated to Urmia University of Medical Sciences following the implementation of Specialist Residency Program as a part of the Health Transformation Plan.

Methods

This is an applied type and descriptive-analytic study. The data related to performance indicators of publics in Iran were collected through forms for 2six-month periods before and after implementation of Specialist Residency Program analyzed with Repeated Measure ANOVA test using SPSS 18. The interview data were analyzed using MAXQDA 10 and framework analysis technique.

Results

The execution of Specialist Residency resulted in relative improvement of performance indicators such as ‘mean time of triage (level 1)’ (0.17 min decrease) and ‘the percentage of patients released in 6hours’ (1.36% increase, p-value > 0.05). Results of the interviews showed that the factors that affect the overall improvement of ED performance include the permanent presence of emergency’s, management method in emergency department, patient triage and counseling methods, providing necessary facilities and physical spaces, training classes for staff members, availability of diagnostic facilities and personnel motivation.

Conclusions

Appropriate implementation of the Specialist Residency Program results in improvement of performance indicators in Emergency Departments. Meanwhile, physicians’ motivation is a requirement for successful implementation of this program.

KEYWORDS:

• Specialist residency program
• performance indicator
• emergency departments
• Iran

Acknowledgements

We would like to thank all healthcare professionals and managers who took the time to participate in this research.

Disclosure statement

No potential conflict of interest was reported by the authors.

Availability of data and materials: Data generated or analyzed during this study are available from the corresponding author on reasonable request.

Authors contributions: MJ, MM and HS, participated in designing the study. MM and SA supervised data collection. MM and AN performed the statistical analyses with support from MJ. AN wrote the first draft of the manuscript. All the authors edited the manuscript versions. All the authors were involved in the interpretation of the results, and read, commented and approved the final version of the manuscript.

Ethics approval and consent to participate: This project is approved by Ethical Review Committee in school of health service management (IR.IUMS.REC.1394.921564204).

Consent for publication: Not applicable.

Notes on contributors

Mehdi Jafari is an associate professor in the Department of Health Economic and Management Services at the School of Management and Information Sciences, Iran University of Medical Sciences. Jafari’s research fields include (1) Governance in Health System, (2) Health System Reform and (3) Health System Financing. He is also the Head of the Health Management Development Institute. Most of his work is focused on Designing Organizational Reform Model for health system.

Ali Nemati is a PhD candidate in Health Service Management affiliated to Iran University of Medical Sciences, Tehran, Iran. Nemati’s research fields include (1) Patient-centred Care; (2) Palliative Care; and (3) Cost Control in Health System. He is also one of the members of the Health Management Development Institute of the Ministry of Health and Medical Education.

Mohsen Seyed Mahmoudi is a PhD candidate in health service management affiliated to Tehran University of Medical Sciences, Tehran, Iran. Mahmoudi’s research fields include (1) Performance Indicators; (2) Hospital Performance Evaluation; and (3) Organizational Culture.

Hesam Seyedin PhD in health care management is an assistant professor in the Department of health in disaster and emergencies at the School of Health, Iran University of medical sciences. Seyedin’s research fields include (1) health policy; (2) health disaster management; (3) Service Quality. He is also one of the member of the National Committee for Disaster Health Research.

Seyede-Elahe Hosseini is a PhD candidate in healthcare management affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Hosseini’s research fields include (1) Quality of Health Care; (2) Medication Errors; and (3) Hospital Performance Evaluation. She is also one of the members of the Health Management Development Institute of the Ministry of Health and Medical Education.

Amir Rakhshan holds PhD in Teaching English as a Foreign Language (TEFL). Rakhshan’s research interests include (1) Medical Education; (2) English for Specific Purposes; and (3) EAP English for Academic Purposes. He has also worked in Iran’s Ministry of Health and Medical Education and its universities for nearly 16 years.

Siamak Aghlmand is an associate professor in the Urmia University of Medical Sciences. Aghlmand’s research fields include (1) Primary Health Care, (2) Quality Improvement and (3) Medical Errors.

Payam Mahmoudian is a PhD candidate in healthcare management affiliated to Iran University of Medical Sciences, Tehran, Iran. Mahmoudian’s research fields include (1) Pre-hospital Emergency; (2) Medication Errors; and (3) Education Quality. He is also one of the members of the Health Management Development Institute of the Ministry of Health and Medical Education.