Abstract of Dissertation

Agency : Gap Analysis, Emergency Department, Accident Department, Quality Standards

Methodology : A Cross sectional study was done in the emergency and accident department. Total 120 samples were selected for record review and patient relatives were interviewed. All staff of emergency department was interviewed. Random sampling has been done for patient interview.

Findings : The score has been obtained at the each checkpoint mentioned in the checklist and after analysis the result has been presented in the bar diagram. The overall quality score for the emergency and accident department is 57 per cent. The result show that the hospital is providing almost all the facility or the service provision, inputs and the clinical services (score is more than 60 per cent) but the other areas like supportive services, infection control and the patient right score is less than 60 percent. The quality management and Outcomes score was very less.

Recommendations : Huge gap has been identified in each area. Quality standards were not fully compliance in the emergency department. The Hospital is providing all secondary care services except few. There are ample resources but the utilization of those resources with proper procedures and standards is not there. Staff were not oriented for their role and responsibility, and not trained for specific procedures. The approach towards quality in the emergency department was not defined properly.

Death is the most tractable outcome of care. It is easily measured, of undisputed importance to everyone, and is common in hospital settings. Mortality rates, especially overall Hospital Mortality Rates, have therefore become the natural focus for measurement of clinical quality. District hospital has all the secondary level of healthcare facility institute, sanctioned by the government of Gujarat. District hospital has 220 bedded, with 5 beds in the emergency and accident department and linked with the operation theater (OT).In 2013-2014 the death rate of the emergency department at district hospital was 16.36 percent which comparable high with the other hospital in Gujarat. There can be so many causes behind these deaths but this study focus on the gaps in the emergency and accident department according to the Indian Public Health Standards (IPHS) Guidelines.