Background: Emergency departments represent high-pressure healthcare environments where organizational responsiveness and the quality of clinical and diagnostic processes are critical determinants of care outcomes. While previous studies have examined emergency clinical quality and patient satisfaction, limited research has explored the integrated effects of organizational responsiveness and emergency clinical–laboratory practices on patient experience and institutional trust.

Aim: This study aimed to examine the impact of organizational responsiveness and the quality of emergency clinical and laboratory practices on patient experience and institutional trust.

Methods: A cross-sectional analytical study was conducted among 312 patients attending emergency departments. Data were collected using a structured questionnaire measuring organizational responsiveness, emergency clinical practice quality, laboratory practice quality, patient experience, and institutional trust. Reliability and construct validity were confirmed using Cronbach’s alpha and exploratory factor analysis. Data were analyzed using descriptive statistics, Pearson correlation, multiple regression, and mediation analysis.

Results: All measurement scales demonstrated strong reliability (Cronbach’s α = 0.85–0.93). Significant positive correlations were found among organizational responsiveness, emergency clinical–laboratory practice quality, patient experience, and institutional trust (p < 0.001). Multiple regression analysis revealed that the model was statistically significant (F = 68.42, p < 0.001) and explained 57% of the variance in institutional trust (R² = 0.57). Patient experience emerged as the strongest predictor of institutional trust (β = 0.46, p < 0.001), followed by organizational responsiveness (β = 0.29, p < 0.001). Emergency clinical practice quality (β = 0.17, p = 0.003) and laboratory practice quality (β = 0.12, p = 0.021) also showed significant effects. Mediation analysis confirmed that patient experience partially mediated the relationships between organizational responsiveness, emergency clinical–laboratory quality, and institutional trust.

Conclusion: The findings demonstrate that institutional trust in emergency healthcare settings is shaped by an integrated system of organizational responsiveness, clinical excellence, diagnostic efficiency, and patient-centered care. Patient experience plays a central mediating role, highlighting its importance as a strategic pathway for translating quality improvement efforts into trust-building outcomes. Healthcare organizations and policymakers should prioritize responsiveness, coordinated clinical–laboratory workflows, and patient experience–driven quality frameworks to enhance trust in emergency care services.