Evaluation of the Performance of a Primary Care Hospital’s Emergency Department in Tunisia

Background: Performance is a complex and multidimensional concept that fundamentally refers to the achievement of continuous improvement in health. Its application to the context of emergency departments allows us to assess how well these services are able to respond effectively to patients’ needs and those they serve. The aim of this study was to evaluate the performance of an emergency department at a primary care hospital in Tunisia. Methods: We conducted our study at the Emergency Department of Kesra District Hospital. We used the EGIPSS model to evaluate the department’s performance. We collected qualitative data through questionnaires and interviews with key actors from the hospital and emergency department, and we extracted quantitative data from annual reports. Results: In terms of adaptation to the environment, several shortcomings were identified, such as centralized resource acquisition systems limiting the ability to meet needs and the absence of feedback mechanisms requiring formal administrative and clinical coordination processes. In regard to values and culture, human resource management is not well developed with a lack of continuous training programs and no clear statement of values for the emergency department and the hospital. As for production, incentives to improve efficiency and quality are lacking, and quality management within the emergency department and the hospital in general do not exist due to the absence of a quality management system. Conclusion: The performance of the emergency department at the primary care hospital level is still deficient and may require setting up systems and processes for improving quality.