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Purpose A sentinel event is an unexpected occurrence resulting in death or serious physical or psychological injury or the risk thereof. The purpose of this paper is to investigate the influencing factors of sentinel events in the emergency department of a military hospital in Tehran to find out some of the effective solutions. Design/methodology/approach In this qualitative study with content analysis approach, 20 hospital healthcare personnel participated as participants from the fields of medicine and nursing. Purposive random sampling and semi-structured interviews were used for data collection. Atlas.ti software version 5.2 was used for data analysis. Findings Four themes and 32 subthemes were identified by numerous revisions and combining the codes. The four main themes of sentinel events were: causes, incidence barriers, cause prevention solutions, and barriers’ improvement solutions. Moreover, these main factors were related to these issues: staff and patients’ education, communication, assessment, patients and their companions, employee rights, leadership, care continuum, human factors, physical environment, information management and medication use. Some solutions were also suggested according to these factors and a policy was recommended. Practical implications Hospital managers and authorities should try to find the main causes of sentinel events by periodical analysis to find ways to prevent them in the future, using logical and reasonable solutions. Originality/value This study confirms that strategies to reduce the sentinel events in emergency departments should focus on empowerment of all staff.

Introduction : Service quality is a judgment that the customer compares his/her expectations by this judgment, with the perception of the received services. The purpose of this study was to compare service quality in teaching hospitals with non-teaching hospitals in Kerman city. Methods : This cross-sectional study has been done on 166 hospitalized patients and the standard SERVQUAL questionnaire with an approved validity and reliability was used. Data analysis was performed using SPSS software version 19. Results : The results show that the service quality from the patients’ perception in non-teaching hospitals is more than the teaching hospitals (p=0.002). Most of the service quality gap is in the tangibility dimensions and also in providing amenities for patients and their companions. Conclusion : Teaching setting of the hospital typically can cause poor subjectivity in patients about the quality of services provided and it is recommended that authorities identify factors causing these kind of thinking and solve them. Also the negative scores indicate a need for improvement in all aspects, especially the tangibility dimensions having the maximum gap. Keywords : Patient Expectations, Service Quality, Teaching Hospital, SERVQUAL