title: The association of physical access with the interval between attending the hospital and receiving service in emergency department.
abstract: BACKGROUND
  The relation between physical access in emergency department ‎(ED) and the time patients have to wait before being served is unknown.
  
  
  OBJECTIVE
  Our objective was to discover the associations between the physical access in ED and the time patients had to wait before receiving services.
  
  
  METHODS
  In this cross-sectional study, statistical society comprised two portions, namely, public hospitals' EDs and referred patients to the ward. Data on waiting time for 240 patients in six public and private hospitals were gathered. In addition, physical condition of EDs was inspected by visiting these hospitals. A designed checklist, based on the introduced physical space, was filled for each hospital. Results of the checklist were scored using Likert's five-points scale and Spearman and Pearson's correlation coefficient were applied to determine the relationship between physical access and waiting time.
  
  
  RESULTS
  The correlation between the waiting time beginning from the very moment of stepping into the ward until first examination and physical condition at the triage wards in private (P < 0.001) and public hospitals (P > 0.05) was not significant. The waiting interval, beginning from the very moment of stepping into the ward until first examination and access to physical space of ED, was significant for private hospitals (P < 0.001) and insignificant for public hospitals (P > 0.05).
  
  
  CONCLUSIONS
  According to the results, there was a direct correlation between access to physical space in ED and waiting time. In addition, improving the physical access did not necessarily result in shorter waiting time. Therefore, to improve triage process, improvement of waiting time indices, and modifying forms of work process in ED are recommended.
authors.affiliation: Department of Health Care Management, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: MohammadReza
authors.initials: M
authors.lastname: Maleki
authors.affiliation: Department of Economics and Management, Islamic Azad University, Tehran Science and Research Branch, Tehran, IR Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Haji Nabi
authors.affiliation: Hospital Management Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ayoubian
authors.affiliation: Eye Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Hashemi Dehaghi
keywords: Emergency Medical Services; Emergency Services; Hospital; Triage