Without having an active emergency and trauma center, no hospital can serve effectively because the effectiveness of other hospital services depends on the function of this part. The current study has been done to compare the management of the emergency ward in Qazvin teaching hospitals. Methods & Materials: This comparative study has pursued the staff 's viewpoints of emergency ward managements. All staff that work in emergency ward were included in this study. The information was collected through a questionnaire based on general hospital assessment checklists of ministry of health. The questionnaire included four parts: Planning and organizing, personnel training, activity and operation of emergency ward, and available space and equipment. The results of this study showed that the staff 's viewpoints of emergency ward management in the mentioned four parts, in comparison with existing standards, in hospital number 4, 1, 2 and 3 were respectively 61.04%, 57.38%, 57.15%, 50.93%. The findings show that there are some deficiencies in emergency ward management in comparison with standards of ministry of health, so there is need to a special and continuous attention in order to improve as much as possible.

Emergency ward is of special importance in medical education, as students have the opportunity of getting experienced and skilled in crisis management. Hence, this study was performed to investigate interns’ viewpoints toward the present situation of education at the end of emergency ward. In this descriptive cross-sectional study performed during the academic year of 2007-2008, 120 interns of emergency ward were selected using census sampling method in educational hospital of Emam Reza affiliated to Tabriz University of Medical Sciences. Data was collected using a questionnaire consisting of 4 parts (how interns’ time is spent, their satisfaction with learning patient management in special situations, clinical skills, and quality of emergency ward). Data was analyzed by SPSS software version 5 using descriptive statistics and t-test. Satisfaction of the majority of students with the manner of clinical skills education in the management of special urgent situation was in average to high level (except for the management of allergic emergencies which was reported to be low). Interns’ satisfaction with procedural skills education was reported to be mainly within the range of average to very high. Agreement of 64.2% of participants about extending the duration of emergency ward course was high or very high. The mean ranking score of the emergency ward rotation compared to other passed rotations by interns was almost 2 (1: the best situation, 10: the worst situation). Although students’ satisfaction with educational status showed an improvement compared to previous studies, but the current one is still far from ideal condition.

One of the main preferences of Ministry of Health and Treatment is organizing emergency department as one of the busiest wards in hospitals. To gain goals, hospital management is of most importance. This study aimed to assess the relation of demographic and professional characteristics of emergency ward managers and structure, process and practice in these wards. In this cross-sectional study, data were gathered by a checklist and a researcher-made questionnaire. The validity and reliability of questionnaire were proved. The demographic and professional characteristic of emergency ward managers and structure, process and practice in these wards of 12 teaching hospitals associated with Tehran University of Medical Sciences, Iran were assessed. The checklists and questionnaires were completed by observation, interview and use of dossiers and instruments. Finally, the data were analyzed using SPSS soft ware. There was not any significant relation between the manager's sex and work experience in emergency ward with management, human resources, space, equipment and materiel, teaching process, and recipes and practice aspects in these wards. Only, the relation between work experience and human resources was significant (P = 0.040). According to our study, male and female managers are similar in direction of emergency ward. Job history is no different in management manner, too. Only, the managers with less job history have tendency for presence in emergency ward, cooperation with other specialists, and nursing training.

Triage is the most important measures in the emergency ward. Accurate triage decision has a significant impact on patients’ outcomes. The aim of the present study was to investigate the factors influencing triage decision making in the emergency wards. All physicians (N=22) and nurses (N= 135) in 18 emergency wards of Tabriz hospitals participated in this descriptive study. For data collection a questionnaire was used that assessed staff and non-staff related factors (including patients and emergency ward related factors) that influencing triage decision making. Social- Demographic and professional information of staff was assessed by a checklist. Data analysis was performed by SPSS statistical software and descriptive statistics. The most important factors in staff related factors were experience and skill in non-staff factors related to patient vital signs and type of injury; and in non-staff factors related to ward were overcrowding and probability of injury to the patient. Also، it was found that the basis of decision-taking regarding staff and non- staff factors related to patient was correct، but this basis regarding none-staff factors related to the ward was incorrect. The results showed that the quality of triage decision-making among staff working in emergency wards can be improved by enhancing the quality of clinical wards’ structure.

Standardization of hospital emergency units is a major goal in developed countries to decrease the duration of patients stay in these units. The present study was undertaken to evaluate the prevalence of long-term staying in an emergency ward. In the present 2-month cross-sectional study, patients referring to the emergency ward of Imam Hossein hospital were assessed. The patients’ demographic data, including age, the presenting symptoms and signs, reasons for delays, and the final outcome in relation to the location of hospitalization and discharge information were recorded. Data were reported as frequencies and percentages. The results were reported as means and standard deviations using SPSS version 20. Of 10087 patients admitted into the emergency ward during a 2-month period, 75 patients (0.7%) needed to stay and wait for more than 24 hours. The mean ± standard deviation of the patients’ ages was 62.5 ± 20.2 years, with 60% of the patients being over 60 years of age. The most common reason for overcrowding in the emergency ward was a lack of empty beds, with the need for ICU beds as the most important reason for bed deficiency in 59% of the cases. Nervous system problems were the most common reasons for referring to the emergency unit (41%) in patients under study. Finally, 81% of the patients were hospitalized, 10% died, 7% were discharged based on personal request and 1.3% were transferred to another hospital. The prevalence of patients staying and waiting in the emergency ward for more than 24 hours was 0.7%. Lack of empty ICU beds was the most important reason for such delays; however, paraclinical problems had no role in these delays which were associated with the death of 10% of patients.

Members of the health care team in medical emergencies have little information about admitted patients and rely on several information resources in order to manage these patients. The aim of this study was to determine the information resources for medical students in emergency ward. This descriptive study was performed on 146 last year medical students attended in emergency ward of educational hospitals. Data gathering methods included observation and questionnaire. Data was analyzed using descriptive statistics and Pearson Correlation coefficient. Most of medical students (50 %) used patient and his/her file as information source. Medical students mostly used print sources for obtaining the needed information for patient's treatment. The results of this study underscore the importance of access to variety of information resources in emergency ward. It is recommended to plan educational programs for promoting student's awareness about Personal Digital Assistant (PDA) and using it for evidence-based decision-making.

Emergency wards today are facing with an increasing numbers of older patients. Therefore, it seems important and essential to develop a short screening tool with an acceptable predictive power to identify the seniors being discharged from hospital and mean while are at risk of a decline in physical and mental performance, and thus, facing re-admission emergency wards in hospitals.
 
This prospective study was performed on 190 randomly selected elderly people being discharged from emergency centers in Sabzevar city. Data were collected using Identification of Seniors at Risk (ISAR), GHQ-12 and Barthel questionnaires. Descriptive and inferential statistical methods including Pearson correlation coefficient and area under the ROC curve were used for data analysis.
 
Within the six months period of follow up,  the accuracy of ISAR tool for predicting functional and mental performance decline was at a moderate level (AUC = 0.74 , AUC = 0.77 ) but at desirable level for both physical and mental performances, as a whole condition (AUC = 0.84).

ISAR has moderate accuracy to predict the risk of physical or mental decline in elderly people six months after discharge from hospital emergency wards.

Considering the effects of crisis on society, emergency medicine and crisis management by scientifically and systematically observing crises and analyzing them, seeks to prevent and prepare for crisis and in case of its occurrence reduce the destructive effects and react quickly and appropriately. The purpose of this research study, capacity building in the rate of hospitalization of patients in times of crisis in Razi hospital, Ahvaz. This study was performed in Razi hospital, Ahvaz. In this study the amount of capacity at first emergency ward to providing medical services during before the crisis. Data was collected by crisis questionnaire Razi hospital and analyzed by descriptive statistics using EXCELL and SPSS. The results of this study showed that capacity to accept were 14 injured in time of disasters in emergency ward at Razi teaching hospital, Ahvaz after increased capacity ability to accept injured in emergency ward increased to 38 persons. This study showed that it is necessary to take measures in order to hold periodic exercises and training courses, planning and providing facilities and equipment for crisis management.

Quality of services in hospitals should be continuously evaluated in terms of structure, process, and outcome. The purpose of this study was to compare�patient satisfaction, physical space and medical equipment between governmental and privative hospitals in Qom, Iran. In this descriptive-analytcal study, 500 patients from selected Qom hospitals were recruited based on stratified random sampling. Data were collected by patient satisfaction form and assessment check lists of physical atmosphere and medical equipments. Data were analyzed by SPSS, version 11.5. The authors declare that they have no conflict of interests. Patient satisfaction in inpatient and emergency wards of governmental hospitals were, respectively %69 and %71/14. Patient satisfaction in inpatient and emergency wards of privative hospitals were %80 and %78, respectively. General and emergency wards of governmental hospitals were somewhat equipped with medical equipments. Physical atmosphere, in terms of facilities and the building, was acceptable in general and relatively acceptable in emergency wards of governmental hospitals. This atmosphere were relatively acceptable for both general and emergency wards of privative hospitals. Satisfaction among patients were relatively good. It is possible to improve satisfaction through increasing the visiting time, improving quality of lavatories, and modifying personnel interactions with the patients.Also, promoting medical equipments and physical space can improve the situation according to organizational goals.

Nowadays, researchers pay special attention to patient's satisfaction with emergency care services, as the first line of hospital health care services. However, few researches have been done about its related factors in our country. The aim of this study was assessment of patient's satisfaction with emergency care services in six military hospitals in our country and its related factors. In this cross-sectional study, Satisfaction level of 360 patients of emergency care services in six military hospitals of Iran in 2007 was assessed. After discharge from emergency ward, a checklist containing basic information and a 12-item questionnaire about their satisfaction level with emergency care services was completed for each patient. A 5-level Likert scale was used for the response of each item. 20 to 100 scores were allocated to each response (completely dissatisfied to completely satisfied), respectively. 3559/4220 responses (82.4%) were completely satisfied or satisfied. In respect to priority; "Observation of moral points", "giving information" and "behavior of reception personnel" had the highest and on the other hand, "variety of medical specialists", "emergency ward facilities" and "speed in calling doctor" had the lowest satisfaction scores. The total satisfaction score which was reported by patients older than 35 yr(p=0.022), insurance coverage(p=0.002) and with history of previous referring to that emergency ward(p=0.017) were significantly higher than others. Sex, marital status and educational level had no statistical correlation with the total satisfaction score(p>0.05). The findings of this study revealed favorable satisfaction level of patients with emergency care services in military hospitals. However, it seems that using a variety of expert physicians and more facilities and also improvement in the process of calling doctor in emergency ward are the aspects which need the most amount of concern of health care managers in emergency centers.