Penelitian ini bertujuan untuk menganalisis pengaruh Information of Delays, Doctor’s Performance, Waiting Time, dan Accessibility terhadap Trust in the emergency department (ED) melalui Patient Satisfaction dan Perceived Quality of Healthcare pada pasien dewasa di UGD RS Siloam Manado. Penelitian menggunakan pendekatan kuantitatif dengan metode survei terhadap 127 responden pasien yang mendapatkan pelayanan di UGD selama Januari–Mei 2025. Teknik analisis data menggunakan Structural Equation Modeling (SEM) berbasis SmartPLS. Hasil penelitian menunjukkan bahwa Doctor’s Performance dan Information of Delays memiliki pengaruh langsung signifikan terhadap Patient Satisfaction, sedangkan Waiting Time memiliki pengaruh terhadap Perceived Quality of Healthcare. Namun, Accessibility tidak menunjukkan pengaruh signifikan. Selain itu, baik Patient Satisfaction maupun Perceived Quality of Healthcare terbukti secara signifikan memediasi pengaruh variabel-variabel tersebut terhadap Trust. Temuan ini menegaskan pentingnya peran kepuasan pasien dan persepsi kualitas layanan sebagai mediator dalam membentuk kepercayaan terhadap pelayanan gawat darurat. Penelitian ini diharapkan menjadi dasar pengembangan strategi peningkatan kualitas layanan dan kepercayaan pasien di UGD. / This study aims to examine the effects of information about delays, doctor performance, Waiting Time, and Accessibility on Trust in the emergency department (ED), with Patient Satisfaction and Perceived Quality of Healthcare acting as mediators, among adult patients at the Siloam Manado Hospital ED. Employing a quantitative survey design, data were collected from 127 patients who received ED services between January and May 2025. Structural Equation Modeling (SEM) using SmartPLS was applied for data analysis. The results reveal that doctor performance and information about delays have significant direct effects on Patient Satisfaction, while Waiting Time significantly influences Perceived Quality of Healthcare. Accessibility shows no significant effect. Moreover, both Patient Satisfaction and Perceived Quality of Healthcare significantly mediate the relationships between the independent variables and Trust. These findings highlight the critical mediating roles of Patient Satisfaction and perceived service quality in fostering Trust in emergency care and offer a foundation for developing strategies to enhance service quality and patient Trust in the ED