The process of reorganization of the emergency medicine system in the Republic of Croatia began in 2009, and included both out-of-hospital and hospital EMS. The reorganization was conducted by the Ministry of Health and the Croatian Institute of Emergency Medicine (CIEM) as an umbrella professional healthcare institution tasked with designing the emergency medicine doctrine in Croatia. For that purpose, in 2008, under the Development of the Emergency Medical Services and Investment Planning Project, the International Bank for Reconstruction and Development granted a loan to the Republic of Croatia.

The goal of the improvement of hospital emergency medical services was to organize the departments of emergency medicine with adequate standardised work processes in the care of emergency patients. Another goal was to standardise equipment and specialised staff in order to meet all professional criteria for efficient and quality emergency patient care, as well as to minimise the possibility of unwanted events, mortality and invalidity. The system (previously based on patients waiting in lines) was replaced with a standardized triage procedure in acute hospitals, resulting in quality management and better clinical results. Through the project, 21 departments of emergency medicine (EDs) in the Republic of Croatia were fully equipped. By putting the patient to the centre of specialists’ interests and diagnosing enables hospitals to secure high standard and quality of care for emergency patients.

Today’s departments of emergency medicine are a unique entry point for all emergency patients, ensuring 24/7 availability of emergency medical care. They provide services of reception, examination, diagnoses and treatment. They also contain triages, modern diagnostics, emergency laboratories, resuscitation rooms, emergency operating rooms and areas for accommodating and monitoring acute patients with modern equipment, thus ensuring higher safety and more precise diagnostics.

The CIEM has standardised the emergency medicine procedures for emergency patients in EDs, and have published standards for the education of workers conducting triage. In accordance with legal provisions, the CIEM monitors emergency medicine quality indicators, which are essential for securing, improving and promoting the quality of emergency medical care.

Maja Grba-Bujević,
Croatian Institute of Emergency Medicine, Zagreb, Croatia

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