Effect of establishing a clinical governance system on the timely discharge index of the emergency department of Ayatollah Kashani Academic Medical Center in Shahrekord (2011)

Abstract

Introduction: The nature of work in the emergency department is such that for saving the lives of patients, high quality care must be provided in the shortest possible time. Clinical service governance is a concept that encompasses all activities related to the promotion, review, evaluation and monitoring of the quality of services provided to patients. The aim of this research was to determine the effect of establishing a clinical governance system on the timely discharge index of emergency department of Ayatollah Kashani Academic Medical Center in Shahrekord.

Methods: This research was a cross-sectional, applied, descriptive and correlational study, which was conducted in 2011 on 300 cases of emergency patients of Ayatollah Kashani Hospital in Shahrekord. The population under study was the patients of that center, sampling was done randomly. The collected data were analyzed in two stages before and after the intervention through paired t-test and descriptive statistics in Excel and Spss software.

Results: The frequency of timely hospital assignments before the establishment of the clinical governance system in the emergency department increased to 254 and after the establishment of the system to 284. It showed an increase in the rate of timely discharge from 84.6% to 94.7% of emergency patients. The number of timely assignments according to the standard definition before the establishment of the clinical governance system increased from 174 cases and after that to 200 cases, which showed the growth of the index from 58% to 67%. The average triage time before assignment was 365 minutes before the establishment of the clinical governance and 295 minutes after that.

Discussion and Conclusion: Improvement and growth of timely discharge frequency showed the effect of establishing clinical governance on timely discharge or assignment of emergency patients. By strengthening and supporting clinical governance programs, it is possible to maintain a positive trend in the timely discharge index.