Background There is increasing evidence that patients avoid emergency departments due to fear of contracting COVID-19, which increases morbidity and mortality. To ensure the effectiveness of emergency services, department's performance must be measured. Today, various tools and methods are used to measure the performance indicators of the emergency department. Methods The current study is a descriptive-analytical cross-sectional study, which was conducted in the year 1400 in the emergency department of Kowsar hospital in Sanandaj. The research population included all patients admitted through triage from 1397 to 1400. Data were collected using SPSS statistical software version 23 and descriptive statistics (percentage, frequency, mean and standard deviation) and inferential (ANOVA, independent t-test, and post hoc test) were subjected to statistical analysis. A P value of 0.05 was considered. Results In the data related to emergency admissions after Corona during the outbreak of the disease, the first, second, third, fourth and fifth periods of the epidemic compared to the same period in the previous year were 48.7, 34.1, 31.7, 25.2, and 16.2, respectively. Percentage decreased. The average age of clients increased from 33.50 to 36.93 during the epidemic. In the study of the gender variable, before covid-19, 56.5% of clients were men, and 43.5% were women. After the pandemic, these percentages reached 62.5% and 37.5%, respectively. The index of assignment within 6 hours averaged 84.69% in 4 years, which has increased after the Covid-19 pandemic. The percentage of patients discharged under 12 hours was also calculated with an average of 94.54% in 4 years, which has decreased after the covid-19 pandemic. The percentage of self-responsible discharges in the emergency department was 40.8% before and 59.2% after the Covid-19 pandemic, which has been increasing. The index of unsuccessful cardiopulmonary resuscitation decreased from 112 cases before the pandemic to 64 cases after. The average duration of triage during four years was calculated as 8.11 minutes, which increased significantly compared to before. Conclusion The Covid-19 pandemic has had greatly impacted patient referrals to the emergency department. This research showed that the beginning of the covid-19 pandemic affected emergency management indicators and patients' visits to the emergency room.
Background: Safety culture is the basis and dominant part of patient's safety, and is considered as the main axis of safety promotion programs and service quality. The purpose of this study was to explain the challenges of safety culture in Iranian educational centers with a qualitative approach. Methods: This study was a contractual qualitative content analysis which conducted in 1400. The study population consisted of people who had 5 years of experience in taking care patient or working in the patient's safety and quality control unit in teaching and medical centers affiliated to Tehran University of Medical Sciences. Study data were saturated by purposeful snowball sampling and in-depth and semi-structured interviews with 25 participants. “Granheim and Landman approaches” and “Goba and Lincoln criteria” were used to analyze the data and solidify the research. The process of coding and analyzing research data was performed simultaneously; Finally, the extracted categories and subcategories were confirmed by the interviewees. MaxQDA 10 was used to analyze data. Results: By analyzing the interviews, 331 codes, 7 categories and 20 subcategories were extracted. Lack of reporting errors, poor culture regarding no-blame, staffing issues, low understanding of patient safety, poor management support for patient safety, poor teamwork between units, and lack of open organizational communication were the main categories found and the most important challenges of safety culture in teaching and medical hospitals. Conclusion: According to the findings of the research, developing codified and continuous educational programs, strengthening teamwork and communication, adopting a comprehensive approach to increase the presence of all members of the treatment team in the process of reporting, and analyzing and implementing error prevention programs are among the requirements for improving and promoting the safety culture and quality of service to patients.
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