Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study is to present strategies that have proven to reduce delay and overcrowding in EDs. In this review article, initial electronic database search resulted in a total of 1006 articles. Thirty articles were included after reviewing full texts. Inclusion criteria were assessments of real patient flows and implementing strategies inside the hospitals. In this study, we discussed strategies of team triage, point-of-care testing, ideal ED patient journey models, streaming, and fast track. Patients might be directed to different streaming channels depending on clinical status and required practitioners. The most comprehensive strategy is ideal ED patient journey models, in which ten interrelated substrategies are provided. ED leaders should apply strategies that provide a continuous care process without deeply depending on external services.

The implementation of e-health in Iran, particularly Isfahan, is subject to similar challenges as in other countries throughout the world. Hence, e-health implementers need to adhere to the proposed solutions in order to overcome the mentioned challenges in such complex projects.

Context:The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously.Aims:The main goal of this study was to assess the MRD performance with BSC approach in a hospital.Materials and Methods:This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran.Statistical Analysis Used:To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed.Results:The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively.Conclusions:The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital.

IntroductionToday, health information technologies are base of health services and Electronic Medical Record is one of them. The purpose of this paper is to investigate the Technology Acceptance Model (TAM) on EMR at Central Polyclinic Oil Industry that is a pioneer in implementation of EMR in Isfahan.MethodsThis study was an applied and analytical survey that it was done at the Central Polyclinic Oil Industry. Because statistical population were limited, sampling bas been done by conducting the census and the sample was according to the population. The data was collected by a researcher-made questionnaire that it was validated by experts and its reliability was confirmed by test retest. The questionnaire was developed in 5 scopes including external factors (data quality and user interface), perceived usefulness, perceived ease of usefulness, attitude toward using, and behavioral intention to use. The Results analyzed by SPSS.ResultsThere was a significant relationship between data quality with PU(r=/295, p/005).DiscussionThe survey of the scopes in the polyclinic showed that there is relationship among user interface, perceived usefulness, perceived ease of usefulness, attitude toward using, and behavioral intention to use, but data quality has no relationship with attitude. It seems the system designers didn’t consider to data quality characteristics. It is proposed that they consult with health information management professionals for improvement the existing system.

Introduction: Today, eHealth is base of health services around the world, and electronic health records as an essential core element and its basic architecture for telehealth is considered. EHR offers many potential opportunities for healthcare systems we must focus on its challenges and related guidelines but for EHR deployment. The purpose of this paper is exploration challenges of EHR implementation and related guidelines in Isfahan. Methods: This is a qualitative study and we used the method of phenomenology, a in-depth semi-structured interviews were conducted with 15 of Physicians, Managers and Clear Sighted persons who had experiences regarding with electronic health record. Conclusion: The researcher divided challenges into two areas of infrastructure and structural. Challenges of electronic health records infrastructure are due to information technology, lack of uniform definitions and concepts, cultural problems, and lack of needs assessment before implementation and the challenges of structural are due to instability enforced, violations of privacy and legal cases, compromise getting information management, and lack of integration and sharing of enterprise-level.

No abstract

BACKGROUND:After a disaster, all victims have to be rapidly and accurately identified for locating, tracking and regulating them. The purpose of this study was to summarize people's experiences that how the patients were tracked in past earthquake disasters in Iran. METHODS:A qualitative study was carried out in 2015. This was an interview-based qualitative study using content analysis. The interviewed people included physicians, nurses, emergency medical technicians, disaster managers, Red Crescent Society' first responders and managers. Participants were identified using a snow ball sampling method. Interviews were audiotaped, transcribed, coded, and entered into MAXQDA (version 10) for coding and content analysis. RESULTS:Three main themes and seven categories including content (recoding data), function (identification of victims, identification of the deceased, informing the patients' relatives, patients' evacuation and transfer, and statistical reporting), technology (the state of using technology) were identifi ed that showed the patient tracking status in past earthquakes in Iran.CONCLUSION: Participants believed that to identify and register the data related to patients or the dead, no consistent action plan was available. So developing a consistent patient tracking system could overcome this issue and improve patient safety.

No abstract