Abstract

Emergency department of each hospital is active 24 hours a day and usually has the highest number of daily visitors in the health center. The visitors present with a variety of problems and expectations in various times and the physicians and staff should be present in this unit at all times during day and night, on weekdays and weekends. Patients with any financial and social position and race are visited in this department and only the severity and type of their disease determines the order of their treatment. Currently, one of the concerns of the authorities of health care in different countries is developing an efficient emergency department with high capacity for responding to the vast number of visitors, which obviously correlates with adhering to the standards and principles in this regard. Therefore, improving its efficiency has gained importance more than ever. Periodical evaluation of the emergency department can reveal the existing problems and show them to the responsible authorities, which can help relieve them. In a descriptive cross-sectional study in 2005 and 2008, the condition of emergency department was evaluated in 6 hospitals supervised by Shahid Beheshti University of Medical Sciences including Mofid, Loghmane Hakim, Taleghani, Shahid Modarres, Shohadaye Tajrish, and Imam Hossein using 340 indices extracted from Iranian accreditation standards and American Academy Of Emergency Medicine standards. The findings of the study showed that in 2005, Loghmane Hakim Hospital with a total score of 129, Imam Hossein with 128, and Mofid with 125 points were adhering to the evaluated standards the most. In 2008, the accreditation score of all the hospitals had raised. The changes in total score of Loghmen Hakim, Taleghani, Modarres, Shohadaye Tajrish, Mofid, and Imam Hossein hospitals were 3, 52, 19, 22, 13, and 84, respectively. The highest improvement in score belonged to Imam Hossein, Taleghani, and Shohadaye Tajrish hospitals. Maybe improvement of emergency services and their management in Tehran, especially in teaching hospitals, has helped moving towards the standards. Many factors including the rise in the number of certified emergency medicine specialists in Iran, the raise in the budget considered for improving emergency departments, and better education of emergency department staff have led to this. The important point in this study is improvement of data registration systems as well as information management systems that have increased the speed of information access and have led to better cooperation between different hospital units, including emergency physicians, and the patients. This has resulted in the improvement of services provided on one hand and increased patient satisfaction on the other. It seems that repeating these kinds of evaluation and increasing reinforcement mechanisms can help in keeping or even accelerating this trend.

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