Author/Authors :
Sadegh Tabrizi, Jafar Health Services Management Research Center - School of Management and Medical Informatics - Tabriz University of Medical Sciences , Pour-Aghayi, Mahboub Department of Emergency Medicine - School of Medicine - Tabriz University of Medical Sciences , Abdollahi, Leila Students Research Committee - Tabriz University of Medical Sciences , Daemi, Amin Health Management and Economics Research Center - Iran University of Medical Sciences, Tehran , Sherkati, Soheila Emergency Department - Shahid Madani Specialty Hospital of Heart, Tabriz , Yaghoubi, Rouhollah Department of Health Services Management - School of Management and Medical Informatics - Tabriz University of Medical Sciences
Abstract :
Background and Objectives: The Iranian Ministry of Health and Medical Education (MOHME) has obligated
health settings to follow the reference guidelines developed by the ministry in implementing the emergency department
triage system. The present study aimed at auditing the compliance of the emergency department triage
system in Shahid Madani Hospital in terms of compliance with MOHME guidelines, and to explore the impact of
appropriate interventions in enhancing this compliance.
Methods: A check list developed based on the ministry’s guidelines was used as the study instrument. Two areas
including inputs and processes were surveyed. After auditing the initial state of the triage system, interventional
strategies such as keeping the triage active in the afternoon and night shifts, allocation of welcoming patient
carrier, and training the staff on the standards of triage system were implemented, and the triage system was
re-audited. Descriptive statistics and graphs were used to describe the results. T-test was used to compare the
degree of compliance pre- and post-intervention.
Findings: Before introducing the intervention, a compliance degree of 80, 62 and 88% (the standards of physical
space, staffing, facilities and equipment, respectively) and 80%, 14% and 67% (to service process, logistic process
and management process, respectively) was identified, respectively. After implementation of the intervention, the
degree of compliance was found to be 80, 87, 92% for the three former areas, and 90%, 14% and 100% for the
three latter areas, respectively. The overall degree of compliance showed a significant increase from 75% to 82%
post-intervention (P = 0.028).
Conclusions: Adherence of the emergency department triage system to the reference standards can be improved
by implementing relevant interventional strategies. The gap between degree of compliance after intervention
and the ideal situation, however, shows the need for more comprehensive identification of the shortcoming
and devising appropriate strategies.
Keywords :
Clinical audit , Triage , Emergency Department , Hospital management
