The evaluation of academic emergency department design

BACKGROUND
In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated.
METHODS
In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed.Two Emergency Medicine Departments that were not operating at that time were not included in the study.
RESULTS
The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academical efforts in this field is emerging in challenging physical conditions.
CONCLUSION
The results of our study revelaed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.

Ülkemizde Acil Týp Anabilim Dallarý’nda acil servislerin fonksiyonel mimari açýsýndan deðerlendirilmesi

AMAÇ
Ülkemizdeki Acil Týp Anabilim Dallarý’na (ATAD) baðlý acil servislerinin iç ve dýþ mimari yapýlarý araþtýrýldý.
GEREÇ VE YÖNTEM
Tanýmlayýcý tipteki bu araþtýrmada, çalýþmanýn yapýldýðý tarihte mevcut olan 26 ATAD’ye anket formlarý gönderildi. Bu anketle acil servislerin iç ve dýþ mimari yapýlarý ve fonksiyonel hizmet durumlarý sorgulandý. Anketi yanýtlayan 22 ATAD’nin verileri deðerlendirmeye alýndý. Henüz kurulma aþamasýnda olan ve hizmet vermeyen iki Anabilim Dalý çalýþmaya dahil edilmedi.
BULGULAR
Geri bildirimlerin deðerlendirilmesinde ATAD’den ancak %59’unun (n=13) hizmet verdikleri alanýn acil servis alaný olarak planlandýðý izlendi. Acil servislerin ambulans giriþlerinin %77 oranýnda uygun olmadýðý, %54,5 ATAD’de (n=12) acil servis giriþinde ambulanslarýn hasta býraktýðý alanýn hava koþullarýndan korumalý olmadýðý görüldü. Gelen yanýtlara bakýldýðýnda ancak %59 ATAD’de (n=13) acil serviste triyaj ünitesinin bulunduðu, yine sadece bir ATAD’de (%4,5) acil serviste temizlenme (dekontaminasyon) odasý bulunduðu bildirildi. Halen hizmet vermekte olan ATAD’lerine baðlý acil servislerin ancak %32’sinde (n=8) mevcut lokal risk faktörleri doðrultusunda geniþleyebilme düzeyinin yeterli olabileceði belirlendi. ATAD’lerin sadece %18’inde (n=4) özürlü tuvaletinin var olmasý ülke genelinde özürlülere yönelik mimari deðiþikliklerin eksikliðinin acil servislerde de olduðunun göstergesidir. Acil týbbýn ülkemizde 12 yýllýk geçmiþi olduðu düþünüldüðünde ATAD’lerin ancak %68’inde (n=15) seminer odalarýnýn var olmasý, akademik yapýlanmaya fiziksel alt yapý yetersizliði olan yerlerde baþlandýðýnýn göstergesidir.
SONUÇ
Ülkemizdeki acil týp yapýlanmasý içerisinde acil servis mimarisine gereken önemin verilmediðini, verilen hizmetteki bilimselliðin mimari yetersizliklerle gölgelendiðini göstermiþtir. Acil servis mimari tasarýmý, bilimsel veri ve kurallar çerçevesinde saðlanmalýdýr. Bunun için hastane ve özellikle acil servis mimarisi hakkýnda bilgi ve tecrübesi olan mimar veya mimarlar yetkili kiþiler ile hedefler üzerinde bir anlaþmaya varmalýdýrlar.