The impact of senior early assessment model of care on the emergency department’s improvement index in a general teaching hospital in Southern Iran

Abstract

Background: Emergency departments (EDs) play a crucial role in healthcare systems that are currently inflicted by countless problems. A high level of mismatch between supply and demand in EDs entail crowding and weak performance. Objectives: To compare the senior early assessment model of care in the ED of main referral medical center in southern Iran. Methods: The present study evaluated ED performance measures over a six month period prior to (Sep. 2013 - Feb. 2014) and following (Sep. 2014 - Feb. 2015) the development of the senior early assessment model of care, through the use of retrospective data. All admission records were collected and calculated via Iranian national ED performance measures and further analyzed (α = 0.05). Results: Atotal of 48 194 patients were visited over a sixmonthperiod prior to the senior early assessment model of care; in addition, 49,133 patients were analyzed during a six month period after. The percentage of patients disposed within six hours was different before and after the intervention (79.48% vs. 88.05%, P = 0.025). Although the percentage of discharge with personal responsibility and the mean ± SD of duration of triage time were reduced, no statistical significant changes were observed before and after the intervention (P = 0.127, P = 0.132). Moreover, the percentage of unsuccessful CPR was increased, however, it was not significant (P = 0.347). Conclusions: It seems that applying new models of care, such as senior early assessment, can solve ED overcrowding. In the present research, the patients’ disposition within six hours was reduced. On the other hand, no recognizable difference was found as far as reducing unsuccessful CPR, duration of triage time, and discharge with personal responsibility. It is recommended that future studies assess the efficacy of models of care.