Transformation in the Iran health-care system: Has the performance of hospital emergency department been improved?

BACKGROUND: To respond to the growing expectations of the public and to meet the needs of the society, health systems have always tried to improve their performance. This study investigated the changes in the performance and quality of emergency department (ED) after implementation of the health transformation plan (HTP) in Iran. METHODS: This was a before–after study that was conducted in Tehran's Lolagar General Hospital in 2016. The data related to the performance indices and patients’ satisfaction indices were collected in the two periods of 6 months before and 6 months after the implementation of the HTP. The data were gathered by a checklist designed by the researchers. RESULTS: Among performance indices, the maximum positive change was related to the failure in cardiopulmonary resuscitation, which had a reduction of 18.27%. Discharge against medical advice had a reduction of 1.11%, which is considered to be significant. Among the factors related to patients’ satisfaction, the maximum changes belonged to the out-of-pocket payment, access to medicines, and giving information to the patients, which were 0.87%, 72%, and 61%, respectively. CONCLUSIONS: HTP and its supporting packages have led to positive changes in the performance of the ED of the hospital. Therefore, based on the results of this study, the continuation of this plan is recommended.