title: Clinical audit of emergency unit before and after establishment of the emergency medicine department.
abstract: OBJECTIVE
  To assess the deficiencies and potential areas through a medical audit of the emergency departments, 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) and after (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.
  
  
  CONCLUSIONS
  Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.
authors: Imam Hossein Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Afshin
authors: A
authors: Amini
authors: Payam
authors: P
authors: Dindoost
authors: Mehrdad
authors: M
authors: Moghimi
authors: Hamid
authors: H
authors: Kariman
authors: Ali
authors: A
authors: Shahrami
authors: Ali Arhami
authors: AA
authors: Dolatabadi
authors: Hossein
authors: H
authors: Ali-Mohammadi
authors: Mostafa
authors: M
authors: Alavai-Moghaddam
authors: Hojjat
authors: H
authors: Derakhshanfar
authors: HamidReza
authors: H
authors: Hatamabadi
authors: Kamran
authors: K
authors: Heidari
authors: Shahram
authors: S
authors: Alamdari
authors: Mohammad Kalantar
authors: MK
authors: Meibodi
authors: Majid
authors: M
authors: Shojaee
authors: Mohammad Mehdi
authors: MM
authors: Foroozanfar
authors: Behrooz
authors: B
authors: Hashemi
authors: Anita
authors: A
authors: Sabzeghaba
authors: Ali
authors: A
authors: Kabir
mesh_terms: D054869:Clinical Audit; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006749:Hospital Design and Construction; D006769:Hospitals, General / Q000458:organization & administration*; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D007492:Iran; D010559:Personnel Management