Author/Authors :
Amini, Afshin shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Dindoost, Payam tehran university of medical sciences tums - Faculty of Medical Services and Information Management - Health Service Management, تهران, ايران , Moghimi, Mehrdad shahid beheshti university of medical sciences - Faculty of Medicine, تهران, ايران , Kariman, Hamid shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Shahrami, Ali shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Arhami Dolatabadi, Ali shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Ali-Mohammadi, Hossein shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Alavai-Moghaddam, Mostafa shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Derakhshanfar, Hojjat shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Hatam Abadi, Hamid Reza shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Heidari, Kamran shahid beheshti university of medical sciences - Faculty of Medicine, Taleghani Hospital, تهران, ايران , Alamdari, Shahram shahid beheshti university of medical sciences - Faculty of Medicine, Taleghani Hospital, تهران, ايران , Kalantar Meibodi, Mohammad shiraz university of medical sciences - Faculty of Medicine, Namazi Hospital, ايران , Shojaee, Majid shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Foroozanfar, Mohammad Mehdi shahid beheshti university of medical sciences - Faculty of Medicine, Shohada Hospital, تهران, ايران , Hashemi, Behrooz shahid beheshti university of medical sciences - Faculty of Medicine, Shohada Hospital, تهران, ايران , Sabzeghaba, Anita shahid beheshti university of medical sciences - Faculty of Medicine, Imam Hossein Hospital, تهران, ايران , Kabir, Ali shahid beheshti university of medical sciences - Department of Epidemiology, تهران, ايران , Kabir, Ali tehran university of medical sciences tums - Center for Educational Research in Medical Sciences, تهران, ايران
Abstract :
Objective: To assess the deficiencies and potential areas through a medical audit of the emergencydepartments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. Methods: A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) andafter (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Results: Education and CPD (p= 0.042), design and facility (p= 0.027), equipment (p= 0.028), and disaster (p=0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research.Conclusion: Security, disaster planning, research, design and facility had improved in hospitals that wavestudied, while equipment, records, ancillary services, administration and bench-marking had the lowestimprovement even after the establishment of emergency department, and, hence, needed specific attention.
