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The ability to adapt and utilize emergency facilities is a critical element in responding to surges resulting from man-made and natural events resulting in mass casualties. Emergency services must be adequately prepared to effectively absorb a sudden increase in patients and to allow the medical staff to operate effectively Objectives : To qualitatively describe patient, hospital care, and clinical pathway characteristics that may be associated with pathway effectiveness in an emergency department . Methods :The current study is retrospective, cross-sectional and descriptive study theflow of clinical pathways in an emergency hospital is described in case of an acute mass trauma accident involving victims. Drawbacks and pathway laggings and redundancies were presented and discussed. A list of characteristics that might impact clinical pathway effectiveness was developed .A hypothesis-driven qualitative analysis was used to describe key characteristics that might differentiate effective from ineffective critical pathways. Results: The care pathway adopted during the discrete event under study was perceived to be redundant by the management and by the working staff. Laggings of sequential steps and interventions were inevitable . The patient total times in the department wasaffected and had effects on medical services performance Conclusions: Recommendations for improving the effectiveness of the emergency services of the hospital under study were given. The adoption of clinical pathways may be a very promising method to improve the emergency department service at a hospital and so to react to the challenges of massive surges in patient care. Principles of care maps when integrated into the early stage of planning and design of a building and a service are expected to facilitate modifications to be implemented at modest capitalcost increases for the benefit of both high-risk patients and over-stressed Health Care Workers.

EVALUATION OF CLINICAL PATHWAYS OF AN EMERGENCY HOSPITAL IN CASE OF AN ACUTE MASS TRAUMA ACCIDENT